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RF-10-909Inspection Number: INSP - 144049 Permit Number: RF -5 -10 -909 Scheduled Inspection Date: June 17, 2010 Inspector: Bruhn, Norman Owner: PATNICK, JOHN Job Address: 181 NW 100 Terrace Project: <NONE> Miami Shores, FL 33150- Contractor: ENVIROTECH ROOFING & EQUIPMENT Building Department Comments June 16, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Type: Roof Inspection Type: Final Roof Work Classification: Tile Phone Number Parcel Number 1131010230240 Phone: (305)207 -4993 Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 10 of 20 Inspection Number: INSP - 144050 Permit Number: RF -5 -10 -909 Scheduled Inspection Date: June 17, 2010 Inspector: Bruhn, Norman Owner: PATNICK, JOHN Job Address: 181 NW 100 Terrace Project: <NONE> Miami Shores, FL 33150- Contractor: ENVIROTECH ROOFING & EQUIPMENT Building Department Comments June 16, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Type: Roof Inspection Type: Up Lift Report Work Classification: Tile Phone Number Parcel Number 1131010230240 Phone: (305)207 -4993 Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 11 of 20 Job Address Owner's Name Type of Tile FLAT TILE Contact Name 305Y LOCATION Corner Perimeter Field Ridge Total A -1 Engineering Inspection Services, Inc 7066 SW 44th Street Miami, FI 33155 Tel: 786- 326 -9877 Fax: 305 -485 -9011 a1roofinspection@gmail.com Roofing Contractor ENVAROTECH ROOFING LAB CERTIFICATION # 10- 0111 -01 SITE SPECIFIC INFORMATION UPLIFT TEST - TAS #106 181 NW 100T TERRA MIAMI 33150 JOHN PATNICCK Permit # RF- 510909 Approximate Roof Height 12 feet Roof Pitch 3/12 Type of access to Roof OK Approximate Square Footage of Roof 19 ft 2 Date Tested 6/16/2010 Number of Tests 32 Testing Equipment: F.G.E. 100 # OF TEST 5 Tests 8 Tests 17 Tests 2 Tests 32 Tests PASS MB TO CONTREEAS P.E P.E # 21522 A -1 ENGINEERING INSPECTION SERVICES INC CERTIFICATION NO 10- 0111 -01 Phone # (786) 246 -8896 ✓ Pass J Pass V Pass ✓ Pass Pass Date Installed Required Testing Force 35 /bs # OF TEST O Tests O Tests O Tests O Tests O Tests IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL PA 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST. THIS TAS 106 TEST HAS BEEN PERFORMED IN FULL ACCORDANCE TO THE REQUIREMENTS OF DADE COUNTY, WITH NO DEVIATIONS. THIS REPORT IS NOT GUARANTEED IN CASE OF NATURAL DISASTERS. 7066 SW 44th Street Miami, FI 33155 — Telephone (786)326 -9877 — Fax (305)485 -9011 FAIL LI Fail Fail L-il Fail ❑ Fail ❑ Fail r Rooting Contractor ENVAROTECH ROOFING Job Address 181 NW 100T TERRA MIAMI 33150 Owner's Name JOHN PATNICCK Type of Tile FLAT TILE A -1 Engineering Inspection Services, Inc 7066 SW 44th Street Miami, FI 33155 Tel: 786- 326 -9877 Fax: 305 -485 -9011 a1roofinspection@gmail.com LAB CERTIFICATION # 10- 0111 -01 SITE SPECIFIC INFORMATION UPLIFT TEST - TAS #106 Date Installed Approximate Roof Height 12 feet Roof Pitch 3/12 Type of access to Roof OK Required Testing Force 35 /bs Approximate Square Footage of Roof 19 ft 2 Date Tested 6/16/2010 Number of Tests 32 Testing Equipment: F.G.E. 100 Contact Name JOSY SKETCH OF ROOF t t t t t t t Phone # (786) 246 -8896 t t t t t t t t 7066 SW 44th Street Miami, FI 33155 N Telephone (786) 326 -9877 - Fax (305) 485 -9011 Permit # RF-510909 t t t Revised by je Cepa/ Q INSPECTION AFFIDAVIT I l� t- P. ti DG a licensed as a (n) Contractor / Engineer / Architect, (Print name and drde License Type) FS 468 Building Inspector License #: CCC 1.32 8 9 a - i On or about J u oe. )S 20 it' , I did personally inspect the roof deck nailing and (Date & time /I / Secondary water barrier work at /d'/ *fry (Complete Job Site Address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S) Signature State of Florida County of Dade: The undersigned, being the first duly swom, deposes and says that he /she is the contractor for the above property mentioned. Swam to and subscribed before me this 4 -6.- day of c.! -.2-61/0 NATALY FERNANDEZ MY COMMISSION #DD798288 EXPIRES: JUN 16, 2012 8onde through 1st State Insurance Notary Public, Sate of Florida at Large 'General, Bufd'ag, Residential, or Roofing Contractors or any individual certified under 468 F.S. to make such an inspection. Include photographs of each plane of the roof with permit # and address # dearly shown marked on the deck for each inspection Revised on 5/21/2009 RE: Permit # 1 / 99 M iami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 DATE: //- S.//4 Project Address 181 NW 100 Terrace Miami Shores, FL 33150- 1131010230240 Block: Lot: JOHN PATNICK Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number PP O .. Expiration: 11/23/2010 Applicant JOHN PATNICK 190 NW 99 Street MIAMI SHORES FL 33150 -1756 Contractor(s) Phone Cell Phone ENVIROTECH ROOFING & EQUIPMEN (305)207 -4993 Type of Work: Re Roof Additional Info: TILE ROOF Classification: Residential Fees Due CCF Education Surcharge Permit Fee - New Roof Scanning Fee Technology Fee Total: Amount $8.00 $2.00 $275.00 $9.00 $8.00 $300.00 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy May 28, 2010 Pay Date Pay Type Invoice # RF -5 -10 -37960 05/28/2010 Cash 05/20/2010 Cash Amt Paid Amt Due $ 250.00 $ 50.00 $ 50.00 $ 0.00 Valuation: Total Sq Feet: $ 9,500.00 1700 Available Inspections: Inspection Type: Up Lift Report Tin Cap Final Roof Tile In Progress Roof Review Renailing Affidavit Cap Sheet In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL PLUMBING, MECHANICAL WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. May 28, 2010 Date 1 111111111111111111111111111111111111111111111 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street/ad re \�` .S 2. Description of improvement 1 2:W N Ce$V 3. Owner(s) name and address ��t1 mow C 5� N\ S YL,3�So Interest in property: Name and address of fee simple titleholder: 4. Contractor's name and address: '■ . 5. Surety: (Payment bond required by owner from contrabr,: 3 , � 43 c �� C��, 9�a ,c,. Name and address: .F�fy��� ��.�' °Aa �ti _ :7;i _ + : t.. vns WAPS Amount of bond $ - 71 6. Lender's name and address: 7. Persons within the state of Florida designated by Owner u whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a diffe 1 - n , • ate is s • - cified) Notary Public Print Notary's Name My commission expires: 123.01 -52 PAGE4 8/02 .� .. ature of owner lL 74 Owner's Name. JO �[ Atit-1 Sworn to and subscribed before me this „. ( ?.."-) ... dayy of , 2U ‘if. t 1 1 17 111rrh/1! .;' i1d d uo S S9UJW0 ( 3 11811d ANy10N Z /90 /EO CFH 2010R'X361318 OR Isk 27301 Ps 2479; t1psf RECORDED 05/28/2010 14:31:12 HARVEY RUVIN: CLERK OF COURT 11IAMI -DAZE COUNTY? FLORIDA LAST PAGE Prepared by ,rby Address: �T' Sv ' c / \sx )14 L3� \Th BUILDING PERMIT APPLICATION FBC 20 Miami Shores Village Building Department Permit Type: BUILDING ROOFING Owner's Name (Fee Simple Titleholder) +- \—\"\\ Phone # Owner's Address \ N.-4\1.N C, \ - City N State Zip -> A Tenant/Lessee Name Phone # Email 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No. r " mo t 0 `"CtO C( Master Permit No. Job Address (where the work is being done) \$\ \■ \ :NZ City ` Miami Shores Village County Miami -Dade FOLIO / PARCEL # ®`Z— Is Building Historically Designated YES NO, Contractor's Company Name E�- ■1/4 l IC, Gel P Contractor's Address �?j'V) a City \1 State Qualifier Name` %k� C?,Io/L +6, -M. Submittal Fee $ �(� - Permit Fee $ PAA7 Notary $ Scanning $ 0 �OO Radon $ Double Fee $ Structural Review. $ Training/Education Fee $ DPBR $ Violation date: CCF $ P�IAY 2 2810 Zip Flood Zone hoe# C6Z�0'N Zip 2?jN Phone #`30 57 ° I3 State Certificate or Registration No. c_�,- .j Certificate of Competency No. Contact Phone E -mail Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $�t • �� Square / Linear Foota e Of Work: ��� Type of Work: ❑Addition ❑Alterario :New Ri ❑ Demolition �.� r/R lace Describe Work: epa *** ***** * * * * * * * * * * * * * * * * * * * * * * * ** * * * * ** Fees* � �****** ** * * * * * * * * * * * * ** * * * * * * * * * * * ** * * ** CO /CC $ Technology Fee $ Bond $ Total Fee Now Due $CD- See Reverse side - • ciLTh Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. N/ Signature Owner or Agent The foregoing instrument was acknowledged before me this day of 1 - " � , 20 �1� by )4- ltd '�4T1'LIC.k� who is personally known to me or who has produ ced, t 0 ,0 As identification aY�i�Qa. path. NOTARY PUBLIC: uoissiwwoo eland A MON l tiO11901F0 • vo �'% • S ad Sign: Print: My Commission Expires: (Revised 07 /10 /07XRevised 06/10/2009) Engineer Sign: Print: Signature / �✓� Contractor The foregoing instrument was acknowledged before me this \c; day of who is personally known or who has produced as identification and who did take an oath. NOTARY PUBLIC: ARY PUBS: TATE OF FLORIDA _ �om ussion #DD$03602 , „;,o°° pires: OCT. 04, 2012 My Commission Expi sn au ATLANTIC BONDING CO,, nvc, APPROVED BY J or' Plans Examiner Zoning Clerk checked CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. 4IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: CELL PHONE L_____) MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 M iami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: k VI r) �.g.8 t E al .e Z, BUSINESS ADDRESS: /(370 c,.5. // GAI /.QirCITY STATE P7 ZIP CODE 3ji 7f BUSINESS PHONE: () FAX NUMBER ( ) �,,// QUALIFIER'S NAME: / arjbi tr ?A'JC/eZ QUALIFIER'S LIC NUMBER: cr /,vero E -MAIL ADDRESS (IF APPLICABLE): Created on 3119109 BY MLDV 1 RV 3126109 MLDV DBPR - FERNANDEZ, DARWIN; Doing Business As: ENVIROTECH ROOFING & E... Page 1 of 1 Licensee Details Licensee Information Name: Main Address: County: License Mailing: LicenseLocation: License Information License Type: Rank: License Number: Status: Licensure Date: Expires: Special Qualifications Construction Business Fingerprint (Construction Industry Licensing 06/05/2008 Board) View Related License Information View License Complaint FERNANDEZ, DARWIN (Primary Name) ENVIROTECH ROOFING & EQUIPMENT LLC (DBA Name) 13721 SW 21ST TERRACE MIAMI Florida 33175 DADE Certified Roofing Contractor Cert Roofing CCC1328704 Current,Active 07/18/2008 08/31/2010 Qualification Effective 07/18/2008 l Terms of Use i 1 Privacy Statement l 1:07:41 PM 5/19/2010 https:// www. myfloridalicense .com/LicenseDetail.asp ?SID= &id =F96DB 8B 8BE30CF9113... 5/19/2010 AC# 0 I M.iL air r L.vuivp DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION R ION INDUSTRY STREET BOARD (850) 487 -1395 TALLAHASSEE FL 32399 -0783 FERNANDEZ, DARWIN ENVIROTECH ROOFING & EQUIPMENT LLC 13721 511 21ST TERRACE MIAMI FL 33175 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers, from boxers to barbeque . restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our warvices, please kg onto www.myffoddalicense.com. There you can find mom trdwitation about i � ands that impact [)epnt' suixicribe to in s d rhn�t newsletters Our mission at the Department kr License Effidently, Regulate Fairly. We constantly to serve you better so that you can serve your customers. - Thank you for doing business in Florida, and congratulations on your new license! e ROOF C1 Under o` `t= Expiration date: 31, DETACH HERE. AC# 28:=34 town EftifitatTAIENT OF BUSINESS AND SIONAL REGULATION t- 07/18/08 880036089 TIF. • ROOFING .CONTRACTOR r , " DARITIN ROOFING ;& EQUIPMENT L IS t.' under the provisions of Ch. 489E esuaoa3;` ° 2oto 1.480718003.0 4;''s. DATE :BATCH NUMBER MIAMI-DADE COUNTY TAX COLLECTOR 140 W. FLAMER ST. 1st FLOOR MIAMI, FL 33130 OWNER ENVIROTECH ROOFING & EQUIPMENT PAYMENTROCEIVEO . . COUNTY TAX COLLECTOW 09/29/2009 02210022001 000075.00 SEE OTHER OMR 2009 LOCAL BUSINESS TAX RECEIPT 20 MIAMI-DADE COUNTY - STATE OF FLORIDA EXPIRES SEPT. 30, 2010 MUST BE DISPLAYED AT PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER 3A - ART. 9 & 10 631039 -5 RENEWAL BUSINESS NAME /LOCATION RECENT NO. 657668 -1 ENVIROTECH ROOFING & EQUIPMENT STATE& CCC1328704 LLC 13721 SW 21 TERR 33175 UNIN DADE COUNTY !T -CLASS U.S. POSTAGE PAID FL PERNT NO. 231 Sim ire a of Basina WORKER'S S 196 SPECIALTY BUILDING CONTRACTOR 1 THUS IS ONLY A LOCAL. BUSINESS TAX RECEIPT. IT DOES LD TO VIOLATE A EXISTING REGULATORY OR ZONING LAWS OP THE COUNTY OR cmES: NOR HaH.o� IR S T*RD ANY REQUIRED B LAW, NOT A CERTINCATWON OP THE Homan QUAWBICA- DO NOT FORWARD ENV ROOFING & EQUIPMENT LL DARWIN FERNANDEZ MGM 13721 SW 21 TERR MIAMI FL 33175 92 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE 15S'JED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ENCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSA ALIOL TYPE OF INSURANCE POLICY NUMBER F°I�Y n+t w1cma m rmwma�una° a1PIMWD Y I LIMAS GENERAL LIABILITY COMMERCIAL GENERALLIARRM• APP127336101 08/12/2010 01IT2120Tt1 EACH $300.000 DAMAGE TOtEaREIWED 1 $50.000 FM O (Any caw N>amon) $5,000 I 1 CLAIMS MADE tri OCCUR ] PERSONAL 8 AO': LVJURY $300,000 GENERAL ABGRE3ATE $300,000 ] GENE. AGGREGATE LIMITAPPUESPER: ] POLICY ❑ : ■ LOC FRODtrcrs ''�" $300,004 AUTOMOBILE LIABILITY ] GAD ANY AUTO ] ALLOWED AUTOS ] SCHEDULED ANTOS ] HIRED AUTOS NON OWNED t ' SOME LMT pa anideng $ ROOMY INJURY (Per person) $ BODILY INJURY (Perenelaant) $ PROPER YOAM CE (Per A) $ ® GARAGE LIABILITY ] ANY AIITO ] AUTO OMY -EA PGci ENT $ EAACC OTHER THAN $ AUTO ONLY: ASO $ EXCES9NAIBRELIALIABWIY ] OCCUR !—I unues LJ — DEDUCTIBLE —. RETENTION $ °- S AGGREGATE $ $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOMPARTNERIEXECUTME OFFIC REJCLUDED? IIye%t blow SPECIAL j WC STATU- U OTH- TOW tOATS ER F1. EACH $ EL DISEASE - EA EMPLOYEE $ ELL DISEASE -POLICY i.ADr $ OTHER DESCRIPTION OF OPERATIONS /LOCATIONS /VEHIC ES F EXCLUSIONS ADDED BY ENDORSEMENMPECIAL PROVISIONS ACORD ,A CERTIFICATE OF LIABILITY INSURANCE 1 CATZ 05/20/I010 ` Y1 PRODUCER (305)441 First Class Insurance Market 392 Minorca Ave. Coral Gables, FL 33134 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES B aow. INSURERS AFFORDING COVERAGE NAIL 0 INSURED ENVIROTECH ROOFING & EQUIPMENT 13721 SW 21 TERRACE MIAMI, FL 33175 INSURERA ATLANTIC CASUALTY INSURANCE INSURER Et INSURER C: INSURER 0: INSURER E MIAMI SHORES VILLAGE HALL BUILDING DEPARTMENT 10050 NE 2ND AVENUE MIAMI, FL 33138 SHOULD ANYCI THE ABM DESCRIBED POUOIESBE CANCELLED BEFCRE THE E IRKATIOr DATE . _ , =• `. THE M " , ,',_• TEU. mEAYGRTor t 30 M1rStiAPTEN ,•• . ` «' TO THE CERTIFICATE '.. ,.'- NAMEDTO THE LEFT. BUT FAILURE TO DO SO S'ALL ,:,.— NOOBLREA� OR LIABILITY ANY K DUONTHEINSUERITSAGEVTEOR REPRESENTATIVES � 05/20/2010 THU 12:52 FAX 305 441 6443 FIRST CLASS INSURANCE MA COVERAGES CERTIFICATE HOLDER ACORD 25 (2001108) CANCELLATION IJ001 /001 ACORD CORPORATION 1988 EFFECTIVE DATE PERSON: FEIN: BUSINESS NAME AND ADDRESS: ENVIROTEtH ROOFING & EQUIPMENT LLC 13721 SW 21ST TERRACE MIAMI FL 33175 SCOPES OF BUSINESS OR TRADE 1- CERTIFIED ROOFING CONTRACTOR PERSON DARWIN FERNANDEZ FEIN 262682151 BUSINESS NAME AND ADDRESS: ENVIROTECH ROOFntG & EQUIPMENT LLC 13721 SW 21ST TERRACE MIAMI, FL 33175 SCOPE OF BUSINESS OR TRADE CERTIFIED ROOFING CONTRACTOR 11/12/2008 EXPIRATION DATE 11/12/2010 FERNANDEZ DARWIN 262692151 STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELEC ION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE 11/12/2008 EXPIRATION DATE: 11/12/2010 3WC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 CUT HERE 11-12-2008 ALEX SINK STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. * IMPORTANT: Pursuant to Chapter 440 . 051141 F.S., an officer of a corporation who elects exemption from this chapter by tiling a certfficate of election nnder this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be exempt.— apply only within the scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 4411.051131 F.S., Notices of election to he exempt and certificates .01 or election to be exempt shall be subject to revocation if, at any time attar the filing of the notice or the issuance of the certificate. *the person nar amed on isilnre the notice person certifleate no logger meets the requirements of this section for Issuance of a certificate. The department shall revoke a certificate at any t named on the certificate to meet the requirements of this section. QUESTIONS? 18501 413 - 1609 OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09-06 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE IMPORTANT F Pursuant to Chapter 440.051141, F.S., an officer of a corporation who O elects exemption from this chapter by filing a certificate of election I- under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05112), F.S., Certificates of election to be H exempt_ apply only within the scope of the business or trade listed on E the notice of election to be exempt. E Pursuant to Chapter 440.051131, F.S., Notices of election to be exempt and certificates of election to be exempt stall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named an the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? 1850) 413-1609 • Carry bottom portion on the job, keep upper portion for your records. To: Miami Shores Village Building Department Date: Si lb 1201, 10050 NE 2nd Ave Miami Shores, Fl 33138 Re: Owner's Name: �.�� e i Property Address: \R:::\ � z \ • \ ' N. c , Roofing Permit Number: De; Building Official: 5 1 1 certify that I am not required to retrofit the roof to wall connections of my b %ing because: ❑ The just valuation for the structure for purpose of ad valorem taxation is less than $300,000.00. Please attach proof of ad valorem taxation. ❑ The building was constructed in compliance with the provisions of the Florida Building Code (FBC) or with the provisions of 1994 edition of the South -rida Building Code (1994 SFBC) 4 - 4 ) ja—r4( A Print Name Signature OWNERS'S AFFIDAVIT OF EXEMPTION ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE- BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PERSUANT TO SECTION 553.844 F.S. State of Florida County of Dade The undersigned, being the first duly sworn, deposes and says that he /she is the owner for the above property mentioned. Sworn to and subscribed before me this 2 co ti ': ®= • When the just valuation of the structure for purpose of ad valorem taxation i4g�ual tq or e as Cr:00` , and the building was not constructed with FBC nor a 1994 SFBC. Then you must provide a building application from a General Contract649r the Itootto&laa rti D i Hunic ane Mitigation. ,,,, S T P� ��\��`\ /►►n►► %I " Notary Public, Sate of Florida at Large Revised on 5/21/2009 M iami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Primary Zone: 0800 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds/Baths: 2/2 Floors: 1 Living Units: 1 Adj Sq Footage: 1,356 Lot Size: 8,100 SQ FT Year Built 1940 $0/$246,217 BONMAR PK ADD A RE- City: SUB PB 24-71 LOT 16 & Legal E25FT OF LOTS 5 6 7 & Description: 8 BLK 3 LOT SIZE 75.000 X 108 OR 17252- 3133 0596 4 Year. 2009 2008 181 NW 100 TER Applied Applied Taxing Authorfty: ETaxabl n/ Exemptin/ / Isquali ied as a result of Value: Value: Regional: $0246,217$0335,530 County: $0/$246,217 $0/$335,530 City: $0/$246,217 $0/$335,530 School Board: $0/$246,217 $04335,530 :- 1996 e Amount 181 NW 100 TER e O/R: OHN PATNICK JR Ies Sales which are Qualification Isquali ied as a result of Descri • on: = xamination of the deed Folio No.: li>X i/1 410.Zil .......... ............................... 17.1== 181 NW 100 TER Mailing ddress: OHN PATNICK JR arket Value: 190 NW 99 ST MIAMI HORES FL R 150 -1756 anllin 2009 2008 =EMI= MEL/ a METIMME= EEMICI 4 b arket Value: EMEMI .x Miami -Dade My Home My Home rtr iianiidade. gov Show Me: ............................... ............................... Property Information Search By: Select Item rM Text only Property Appraiser Tax Estimator Property Appraiser Tax Comparison Summary Details: Properly Information: Assessment Information: Taxable Value Information: Sale Information: Additional Information: Community Development District Community Redevelonment Area A AA ACTIVE TOOL: SELECT' Aerial Photography - 2009 http: / /gisims2. miamidade .gov /myhome /propmap.asp jNv Home 1 Property Information 1 Property Taxes 1 My Neighborhood 1 Property Appraiser Home 1 Using Our Site' Phone Directory I Privacy 1 Disclaimer If you experience technical difficulties with the Property Information application, or wish to send us your comments, questions or suggestions please email us at Webmaster. Web Site m 2002 Miami -Dade County. All rights reserved. 0 111 ft Page 1 of 2 Legend Property Boundary Selected Property Street Highway Miami -Dade County Water N S 5/19/2010 Miami Shores Village 10050 NE 2nd Avenue Phone: 305 - 795 -2204 Printed: 8/31/2005 Applicant: MARIA Owner: MARTIN JOB ADDRESS: 9717 N MIAMI Contractor PRECISION TECH, INC. Local Phone: 954- 704 -8006 Parcel # 1132060130960 Work: REPLACE HOOD ON MATCH CAN Electrical Permit Permit Number: EL2005 -303 MARTI N MARIA AVE Contractor's Address: 8500 N. W. 23 ST. Page 1 of 1 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 N1/2 LOT 13 & LOT 12 BLK 7 LOT SIZE Fees: FEE2005 -11930 FEE2005 -11931 FEE2005 -11932 FEE2005 -11933 FEE2005 -11934 Description Building Fee CCF Training and Education Fee Technology Fee Scanning Fee Total Fees: Amount $100.00 $0.60 $0.20 $2.50 $3.00 $106.30 Total Fees: $106.30 Total Receipts: $0.00 Permit Status: APPROVED Permit Expiration: 2/26 /2006 Construction Value: $500.00 &11 S EP 0 C 6D /fN/1b Signed: (INSPECTOR) In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responisibility for all work done by either myself, my agent, servants or employes. Signed: (Contractor or Builder) BY: 1. SECTION R440 HIGH VELOCITY HURRICANE ZONES — REQUIRED CONSIDERATI R4402.13.1 Scope. As it pertains to the section, it is the responsibility of roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of the section. The provisions of Section R4402 govem the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner ant the contractor. T e owner's initial in the designated space indicates that the item has been explained. Aesthetics - Workmanship: the workmanship provisions of Section R4402 are for the purpose of viding that the roof system meets the wind resistance and water instruction performance standards. sthetics (appearance) are not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the a. reement between the owner and the contractor. .�i Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be nailed in accordance with the current provisions of Section R4403. (The roof deck is usually concealed prior to re ; ving the existing roof system). . � Common roofs: Common roofs are those which have no visible delineation between neighboring nits (i.e., townhouses, condominiums, etc.) In buildings with common roofs, the roofing contractor and /or owner should notify the occupants of adjacent units of roofing to be performed. . w' Exposed Ceiling: Exposed, open beam ceilings are where the underside of the roof de &king can viewed from below. The owner may wish to maintain the architectural appearance; therefore, 1Qpt{r?g nail .... • • p enetration of the underside of the decking may not be acceptable. This provides o jgp ti of maintaining the .. appearance. • ,. h: • • • . .. • . I Ponding water: The current roof system and /or deck of t building __••• W and may..... use water to pond (accumulate) in low -lying areas of the roof. Pounding can be f11itdtcat on of %tNtural ..:.... istress and may require the review of a professional structural engineer. Poundin 1$a i h errt .life .... • • expectancy and performance of the new roofing system. Pounding conditions mayppt tie i0 nt until the • . origi roofing system is removed. Pounding conditions should be corrected. ' fi: '' • ov ' ...... Overflow scuppers (wall outlets): It is required that rainwater f lows o thaat- a ricrolii riot verloaded from a buildup of water. Perimeter /edge wall or other roof extension may block this discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance with the requirements of Sections R4402, R4403 and R4413. r Ventilation: Most roof structures should have some ability to vent natural airflow through the tenor of the structure assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting which can result in extending the service life of the ■ roof. caner /Agent's Signature Date Contractor 'nature Date Revised on 7/9/2009 LD MAY 2 o 2O1 rErnlir et0Q( Miami Shores Village APPROVED ZONING DEPT BLDG DEPT JECT i O COMPLIANCE 11TH ALL FEDERAL RSLQU 4I g ROOF ASSEI®UES AND ROOFTOP STRUCTURES Florida Building Code Edition 2004 High- Velocity Hurricane Zone Uniform Permit Application. Form. Section A (General Information) Master Permit No. Process No. Contractor's Name Nr.l. Job Address ROOF CATEGORY C] Mechanically Fastened Tile El Metal Panel/Shingles o Low Slope 0 Asphaltic Shingles 0 Prescriptive BUR - RAS 150 ROOF TYPE `Mortar /Adhesive Set no 0 Wood Shingles/Shakes 0 New Roof i erooting 0 Recovering e0 Repair 0 Maintenance ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) Steep Sloped oo lopedd RRo r of .pea (SF) Total (SF) It Section 9 (Roof Nan) •••• Sketch Roof Plant Illustrate all levels and sections, roof drains, scuppers, overflow scuppers end overflow & OF, ' include dimensions of sections and levels, cleariy.identify dimensions of elevated pressure zorwatinti Iocatlq l gl. parapet, • •.•. •. • VD • • -I ... • • • • •• ...... • •••• • • .....• • • • •••••• • • •.•.•. •.•.• .• •.••• •.•• • • . . . • . . . . • • . • • ...••• • Roof System Manufacturer. Notice of Acceptance Number: ©A .., oz,p52.$ M-\ Minimum Design lid Pressures, if Applicable (From RAS 127 or Calculations): S ' \ . P2 - P3: \�'o ..tr i Maximum Design Pressure (From the Producfi ise oual Specific System). • Roof - h14 10 pry AN /60 Steep Sloped Roof System Description Roof Slope: • 3 :12 :• Ridge Ventilai Deck Type: f) woad 6/pi \ Type Underiayment: 3 0 /-4 ' 4 07777 .)- 124I Insulation: 1 \ Fire Barrier: [ Fastener Type & Spacing: Mean Roof Height: , NZ Florida Building Code.Edition 2004 High - Velocity Hurricane Zone Uniform Permit Application Form. Section D (Stomp Sloped Roof System • • Roof Covering: • • 1� .... • I. • • 1 ••. •• • • • • . . • `• i fltfY. Adhesive Type: A 4'A A/7 p' :2 /� '� i • • • . • •• ••• i• • N:de • 4 s d ° . Type Cap sneer IOW �... • • •••• Type & Size Drip 0 9 _ Edge: kA Florida Building Code Edition 2004 High- VslocHy Hurricane Tone Uniform Permit Application Form. Section E (Tile Calculations) For Moment based the systems, choose either Method I or 2. Compare the value for Mr with the values from Mr. lithe Ml values are wester than or equal to the M values, for each area of the roof, then the die attachment method is acceptable. Method I "Moment Based The Calculations Per RAS 127" (P1`\S•NxX 2 ��y . Mg:' y M ,1 6. Product Approval M (P • Mg-" Mr�S\ Product Approval MI ® +• 4 � (1112K � , . �� Mg:�1 •• M,] ' Product Approval Mr Method 2 "Simplified Tile Calculations Per Table Below" • • Required Moment of Resistance (Mr) From'Thblc Below3ZZ Product Approval Mrs *•Vt M required Moment Resistance* Meat Roof H•gM ^► Root slops 4 212 3:12 4:12 5:12 8:12 7:12 15' 34.4 32.2 30.4 28.4 28.4 24.4 20' 28.0 25.9 25' 38.2 38.0 33.8 30' 39.7 37.4 35.1 32.8 38.6 34.4 32.2 30.1 28.4 27.1 30.5 28.2 40' 42.2 39.8 37.3 34A 32.4 30.0 •Must be used in eonJuncdon with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals. Par UpUfl baud tile systems use Method 3. Compared the values for F with the values for Fr. If the F values are greater than or equal to the Fr values. for each area of the roof, then the tile attachment method is accept:Mk. Method 3 "Moment Based Tile Calculations Per RAS 127" (P xL a w : • •W: x • Fri (P x L a x w: • _-� • W: , x cos B o Fr2 x w: • ) W: x cos B • Fr] (P]: xL • In Information unit application. ROOF ASSEMBLIES AND ROQFTOP STRUCTURE 1111 • ••• • • • • Product Apptots8 Y • • ; • • • • • • • • • • 1111•• Product Appsmv& AAA_.- • • • • • • • . • • • 1111• Product ApptvO>0 f .�_ • • • • • • • • •• Where to find • • 1. • • • • • •••.•• • • • • • •• • •••• • • by an engineering analysis prepared by PE W �CE 7 • • • • • • 000000 of •••• • •••••• •111 • • •.••. 1.331• • • • • • .. • •1111 Where to Obt Description Symbol RAS 127 Table 1 of Design Pressure ' P1 or P2 or P3 Man R00[11681'1. H Job Site Roof Slope 0 lob She Aemdyulmlc MuldpUer A Product Approval Restoring Moment due to Gravity M 6 Approval Attachment Resistance Mr Product Approval Calculated Required Marten Resistance M Minimum Attachment r Product Approval Resistance Required Uplift Resistance Fr Calculated Approval Average Tile Weight W Product Tile Dimensions L." length Product Approval pp W • width building official at the time of r MI calculations must be submitted to the Florida Building Code Edition 2004 High- VslocHy Hurricane Tone Uniform Permit Application Form. Section E (Tile Calculations) For Moment based the systems, choose either Method I or 2. Compare the value for Mr with the values from Mr. lithe Ml values are wester than or equal to the M values, for each area of the roof, then the die attachment method is acceptable. Method I "Moment Based The Calculations Per RAS 127" (P1`\S•NxX 2 ��y . Mg:' y M ,1 6. Product Approval M (P • Mg-" Mr�S\ Product Approval MI ® +• 4 � (1112K � , . �� Mg:�1 •• M,] ' Product Approval Mr Method 2 "Simplified Tile Calculations Per Table Below" • • Required Moment of Resistance (Mr) From'Thblc Below3ZZ Product Approval Mrs *•Vt M required Moment Resistance* Meat Roof H•gM ^► Root slops 4 212 3:12 4:12 5:12 8:12 7:12 15' 34.4 32.2 30.4 28.4 28.4 24.4 20' 28.0 25.9 25' 38.2 38.0 33.8 30' 39.7 37.4 35.1 32.8 38.6 34.4 32.2 30.1 28.4 27.1 30.5 28.2 40' 42.2 39.8 37.3 34A 32.4 30.0 •Must be used in eonJuncdon with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals. Par UpUfl baud tile systems use Method 3. Compared the values for F with the values for Fr. If the F values are greater than or equal to the Fr values. for each area of the roof, then the tile attachment method is accept:Mk. Method 3 "Moment Based Tile Calculations Per RAS 127" (P xL a w : • •W: x • Fri (P x L a x w: • _-� • W: , x cos B o Fr2 x w: • ) W: x cos B • Fr] (P]: xL • In Information unit application. ROOF ASSEMBLIES AND ROQFTOP STRUCTURE 1111 • ••• • • • • Product Apptots8 Y • • ; • • • • • • • • • • 1111•• Product Appsmv& AAA_.- • • • • • • • . • • • 1111• Product ApptvO>0 f .�_ • • • • • • • • •• Where to find • • 1. • • • • • •••.•• • • • • • •• • •••• • • by an engineering analysis prepared by PE W �CE 7 • • • • • • 000000 of •••• • •••••• •111 • • •.••. 1.331• • • • • • .. • •1111 BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 NOTICE OF ACCEPTANCE (NOA) Hanson Roof Tile 1340 SW 34 Ave Deerfield Beach, FL. 33442 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by Miami Dade County Product Control Division and accepted by the Board of Rules and Appeals (BORA) to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Hanson Flat Tile •••• • LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, . ity, gtate and .. following statement: "Miami -Dade County Product Control Approved ", unless otherwise ni Wein. ' • • • • RENEWAL of this NOA shall be considered after a renewal application has been filed andthhas been no change in the applicable building code negatively affecting the performance of this product, ' . • TERMINATION of this NOA will occur after the expiration date or if there has been a reyigawu or change arthe materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any • • product, for sales, advertising or any other purposes shall automatically terminate this NOA :F4 to to comply, with any section of this NOA shall be cause for termination and removal of NOA. : • • • • ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Flog+ aid follou�o� py the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then'it %fall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This revises NOA #08- 0804.12 and consists of pages 1 through 4. The submitted documentation was reviewed by Alex Tigera. NOA No.: 09- 0928.04 Expiration Date: 04/10/13 Approval Date: 12/02/09 Page 1 of 4 000000 • • • .1111• • • •1.1. • • 11.1• • • •.•.• •.•.1• •' • •1••11 • • •••••. • • 1 ROOFING ASSEMBLY APPROVAL Category: Sub- Category: Material: Roofing Flat Profile Roofing Tiles Concrete 1. SCOPE This is a new system using Hanson Flat Tile, as manufactured by Hanson Roof Tile Inc. in Deerfield Beach, Florida and described in Section 2 of this Notice of Acceptance. For locations where the pressure requirements, as determined by applicable Building Code does not exceed the design pressure values obtained by calculations in compliance with RAS 127 using the values listed in section 4 herein. The attachment calculations shall be done as a moment based system. 2. PRODUCT DESCRIPTION Manufactured by Test Applicant Dimensions Specifications Hanson Flat Tile 1= 17.25" TAS 112 w= 13" Trim Pieces Test Agency IBA Consultants, Inc. American Test Lab of South Florida American Test Lab of South Florida PRI Construction Materials 3. LIMITATIONS 1= varies w = varies varying thickness 2.1 SUBMITTED EVIDENCE: TAS 112 Test Identifier 2381 -265 RT0922.01 -09 RT1008.01 -09 HRT -053 -02 -02 Product Description Flat, interlocking, concrete tile equipped with two nail holes. For direct deck or battened nail -on, mortar or adhesive set applications. Accessory trim, concrete roof pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tile profile. Test Name/Report TAS 112 TAS 102 TAS 101 TAS 101 • • • • • • ...... 09/22/OA • • • ...... ..•• 10/109 '. • • • •• •••• •• •• • • • • • • • • •..•.• • • • • • • •••• static field uplift test shall be performed.in. • • 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile applications, a accordance with RAS 106. 3.3 Applicant shall retain the services of a Miami -Dade County Certified Laboratory to perform quarterly test in accordance with TAS 112, appendix `A'. Such testing shall be submitted to the Building Code Compliance Office for review. 3.4 Minimum underlayment shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.5 30/90 hot mopped underlayment applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayment material manufacturers published literature. 3.6 This acceptance is for wood deck applications. Minimum deck requirements shall be in compliance with applicable building code. NOA No.: 09 -0928.04 Expiration Date: 04 /10/13 Approval Date: 12/02/09 Page 2 of 4 000000 • • • .•••.. • • •..••• • • ....• • • •..•. 000000 000000 • • • •..... • • Table 4: Attachment Resistance Expressed For Nail -On Systems as a Moment - Mt (ft -Ibf) Tile Application Minimum Attachment . Resistance • Direct Deck Direct Deck ••• __ Tile Fastener Type (min 15/32" (min. 't9 /3t'.• BattgnS. Profile Direct Deck plywood) piywg951) • '..' • Hanson Flat Tile Two (2). # 8 x 3" Screws 31.51 31.51... ° ' _ •1 Table 5: Attachment Resistance Expressed as a Moment - Mf (ftlbil: •,,, For Two Patty Adhesive Set Systems • • •• .... Tile Profile Tile Application Minimum Attachment . Resistance • Hanson Flat Tile Tile Bond . 30.7 1 ° •;;, Dow Chemical Tile Bondie' Two •a 's of 6• were installed as •er Tile Bond NOA. Table 6: Attachment Resistance Expressed as a Moment - Mf (ft-ibf) - For Single Patty Adhesive Set S ystems Tile Profile Tile Application Minimum Attachment Resistance Hanson Flat Tile Polyfoam PolyPro 38.67 2 Medium • add • Iacement of 47 • rams of Pol ProT'' AH -160. Table 3: Restoring Moments due to Gravity - M ft-Ibf) Tile Profile 2 ":12" 3 ":12" 4 ":12" 5 ":12" 6 ":12" 7 ":12" or greater Hanson Flat Tile Direct Deck Direct Deck Direct Deck Direct Deck Direct Deck Direct Deck 8.58 8.42 8.37 8.20 8.0 7.78 Table 1: Average Weight (W) and Dimensions (1 x w ) Tile Profile Weight -W (lbf) Length -1 (ft) Width -w (ft) Hanson Flat Tile 11.6 1.4375 1.08 Table 2: Aerodynamic Multipliers - ❑ (ft) Tile Profile 0 (ft Batten Application ❑ (ft3) Direct Deck Application Hanson Flat Tile N/A 0.330 4. INSTALLATION 4.1 Hanson Flat Tile and its components shall be installed in strict compliance with Roofing Application Standard RAS 118, RAS 119, and RAS 120. 4.2 Data For Attachment Calculations •••• roaMNnaoe COUNTY APPROVED NOA No.: 09- 0928.04 Expiration Date: 04/10/13 Approval Date: 12/02/09 Page 3 of 4 • • • • 00000 • • • .••••• • • ••••.S • ••••• • • 0000 • 000000 • • • • • • • • 00000 • • •••••• • • 5. LABELING All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo (See Detail Below), or following statement: "Miami -Dade County Product Control Approved ". HANSON FLAT TILE LABEL (LOCATED ON UNDERSIDE OF TILE) 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Any other documents required by the Building Official or applicable building code in order to properly evaluate the installation of this system. PROFILE DRAWINGS HANSON FLAT TILE END OF THIS ACCEPTANCE • ••• • • •••• • .•• • • • •• • • •• • • • • •• ••• • • • •••• • • • ••0.0• • •••• • • ••• NOA No.: 09- 0928.04 Expiration Date: 04 /10/13 Approval Date: 12 /02/09 Page 4 of 4 . • • •0 • • 00 • • ••• • • •• • • • •• • • •.•..• • • MIAMID BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) Polyfoam Products, Inc. 11715 Boudreaux Road Tomball, TX 77375 MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by the BCCO and accepted by the Building Code and Product Review Committee to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The BCCO (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BCCO reserves the right to revoke this acceptance, if it is determined by BCCO that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the High Velocity Hurricane Zone of the Florida- Building Code. DESCRIPTION: Polypro® A11160 • • • • •••• RENEWAL of this NOA shall be considered after a renewal application has been filed andtterrhas been ire • change in the applicable building code negatively affecting the performance of this product. • • • •••••• • TERMINATION of this NOA will occur after the expiration date or if there has been a revisions gr chaz e.iri the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsel nt of AL • • product, for sales, advertising or any other purposes shall automatically terminate this NOA? FUME to cap/. • with any section of this NOA shall be cause for termination and removal of NOA. • •••••• • • • • • ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida,.and follower by the expiration date may be displayed in advertising literature. If any portion of the NOA is di pia3Ted, the? it still be done in its entirety. • INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA renews NOA No.01- 0521.02 and consists of pages 1 through 7 The submitted documentation was reviewed by JRrge L. Acebo. NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 1 of 7 •••••• • • • •••••• • • ••.••• • •••.• • • •.•.• 000000 • • • ••.... • • .•••.. ROOFING ASSEMBLY APPROVAL: Category: Sub Category: Materials: SCOPE: This approves Polypro® A11160 as manufactured by Polyfoam Products, Inc. as described in Section 2 of this Notice of Acceptance. For the locations where the design pressure requirements, as determined by applicable building code, does not exceed the design pressure values obtained by calculations in compliance with Roofing Application Standard RAS 127, for use with approved flat, low, and high profile roof tiles system using Polypro® AH 160. Where the attachment calculations are done as a moment based system for single patty placement, and as an uplift based system for double patty systems PRODUCTS MANUFACTURED BY APPLICANT: Product Dimensions Test Specifications Polypro® AH160 N/A TAS 101 Foampro® RTF1000 ProPack® 30 & 100 PRODUCTS MANUFACTURED BY OTHERS: PHYSICAL PROPERTIES: Property Density Compressive Strength Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability Closed Cell Content Roofing Roof tile adhesive Polyurethane N/A N/A Test ASTM D 1622 ASTM D 1621 ASTM D 1623 ASTM D 2127 ASTM E 96 ASTM D 2126 ASTM D 2856 Product Description Two component polyurethane foam adhesive Dispensing Equipment Dispensing Equipment •••• Any Miami -Dade County Product Control Accepted Roof Tile Assembly having a current NOA whit;p. • • • list moment resistance values with the use of Polypro A11160 roof tile adhesive. • • • • • • • •• • • • • • • • 0.00•• •• • • •••••• Results •••. • • •.•• •••••• • • •• •• 1.6 lbs. /ft. 18 PSI Parallel to rise 12 PSI Perpendicular to rise 28 PSI Parallel to rise 0.08 Lbs./Ft 3.1 Perm / Inch +0.07% Volume Change @ -40 F., 2 weeks +6.0% Volume Change @158 100% Humidity, 2 weeks 86% 0.00•• • • • • • • • • • • . • • Note: The physical properties listed above are presented as typical average values as determined by accepted ASTM test methods and are subject to normal manufacturing variation. . • • • • • • .• •••• • • .•.• • • ..•••0 •••• • • •••• NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04/13/06 Page 2 of 7 ••...• • • • ••..•. ••0005 • •00•• • • •000• •.•.•0 • • • •0000• • • 0.00•• • • Total Fee Now Due $ BUILDING PERMIT APPLICATION FBC 2001 Permit Type (circle): Building Owner's Name (Fee Simple Titleholder) Owner's Address C C - 1 t 7 City Mt t} tin t State - Tenant/Lessee Name Code Enforcement $ (Continued on opposite side) 1% .30 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305- 7 9:_ ''t `7 •.8972 Plumbing Mechanicat Roofing r i1 rV i e M A5t" l Gv Phone #� 3 S S G C 5 7 K Pioe Job Address (where the work is being done) - P-1 / V Architect/Engineer's Name (if applicable) Phone # $ Value of Work For this Permit 5 • dO Structural Plan Review. $ SEP 6 PAID Permit No. — — L 3 : ) 3 Zip 3 31St Phone # City Miami Shores Village County Miami -Dade Zip Is Building Historically Designated YES NO Contractor's Company Name ' re CI' Sf®f /c..12e ( Sr/C, Phone # Contractor's Address L CW 7/ City /G7VY1 / State Zip 3 3 /S 5 Qualifier JO &..( R SR fd'? e, Z 3 0 S Z65 /5i" State Certificate or Registration No. E R 13013035 Certificate of Competency No. G 5 Square Footage Of Work: Type of Work: DAddition DAlteration :New �Re air/Re lace p p 0 Demolition Describe Work: / .. /7 i2 t-C e- »'ems oI cps-7 e %C - C•dr Iv ****************************F Submittal Fee $ Permit Fee $ /00. &P!' CCF $ CO /CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ Zoning Bond $ EVIDENCE SUBMITTED: Test Agency Test Identifier Test Name/Report Date Center for Applied Engineering #94 -060 TAS 101 04/08/94 257818 -1PA TAS 101 12/16/96 25- 7438 -3 SSTD 11 -93 10/25/95 25- 7438 -4 25- 7438 -7 SSTD 11 -93 11/02/95 25 -7492 SSTD 11 -93 12/12/95 Miles Laboratories NB -589 -631 ASTM D 1623 02/01/94 Polymers Division Ramtech Laboratories, Inc. 9637 -92 ASTM E 108 04/30/93 Southwest Research Institute 01 -6743 -011 ASTM E 108 11/16/94 01- 6739- 062b[1] ASTM E 84 01/16/95 Trinity Engineering 7050.02.96 -1 TAS 114 03/14/96 Celotex Corp. Testing Services 528454 -2 -1 TAS 101 10/23/98 528454 -9 -1 528454 -10 -1 520109 -1 TAS 101 12/28/98 520109 -2 520109 -3 520109 -6 •••• 520109 -7 •••••• 520191 -1 TAS 101 :••.t/02/99,•.. • . •, 520109 -2 -1 •••••• •••••• • . •.••• %•• •• •1011 LIMITATIONS: • • • •. • •S.. ..••• .• 1111.. • 1 . Fire classification is not part of this acceptance. Refer to the Prepared Roof Tile A� �emilly fo fire• • • • rating. 1111.. 1111.. 4. Roof Tile manufactures acquiring acceptance for the use of Polypro their tile assemblies shall test in accordance with TAS 101. 5. Roof Tile manufactures acquiring acceptance for the use of HANDI -STICK roof tile adhesive with their tile assemblies shall test in accordance with TAS 101 with section 10.4 as modified herein. / F F'= MS • • • . • ...... . • 2. Polypro® AH160 shall solely be used with flat, low, & high tile profiles. • • • • • • • ••.•• •. • • 3. Minimum underlayment shall be in compliance with the Roofing Application Standard RAS 120. • • ' AH160 roof tile adhesive with NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04/13/06 Page 3 of 7 Table 1: Adhesive Placement For Each Generic Tile Prang ..... . ' • Tile Profile Placement Detail Single Paddy Weight Min. (grams) Two Paittli Weight. per p &idd•Min. : (grate), • Flat, Low, High Profiles #1 35 N?A "_ High Profile (2 Piece Barrel) #1 17 /side on cap and 34 /pan 1i ; • • • • Flat, Low, High Profiles #2 24 14/4 • • Flat, Low, High Profiles #3 8 INSTALLATION: 1. Polypro® AH160 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of Polypro® AH160. 2. Polypro® AH160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof tile assembly's adhesive attachment with the use of Polypro'? AH160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed the uplift resistance determined in compliance with Miami -Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA 3. Polypro® AH160 roof tile adhesive and its components shall be installed in accordance with Roofing Application Standard RAS 120, and Polyfoam Products, Inc. Polypro® AH160 Operating Instruction and Maintenance Booklet. 4. Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by Polyfoam Products, Inc. Polyfoam Products Inc. shall supply a list of approved applicators to the authority having jurisdiction. 5. Calibration of the Foampro® dispensing equipment is required before application of any adhesive. The mix ratio between the "A" component and the "B" component shall be maintained between 1.0- 1.15 (A): 1.0 (B). The dispense timer shall be set to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No other settings shall be approved. 6. Polypro AH160 shall be applied with Foampro RTF1000 or ProPack® 30 & 100 dispensing equipment only. 7. Polyproo AH160 shall not be exposed permanently to sunlight. 8. Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after Polypro® AH160 has been dispensed. 9. Polypro® AH160 placement and minimum patty weight shall be in accordance with the Placement Details' herein. Each generic tile profile requires the specific placement noted herein. . • • • • • •••• LABELING: All Polypro® AH 160 containers shall comply with the Standard Conditions listed herein. BUILDING PERMIT REQUIREMENTS: As required by the Building Official or applicable building code in order to properly evaluate the installation of this system. ••• • • • • • •• ••• • •• • • • •••• • NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 4 of 7 •.•••• • • . ..•.•. • • • 1111• • • .•••• • • •.... ••••.• • • • ••...• • • 1 .•.•. • • ADHESIVE PLACEMENT DETAIL 1 SINGLE PATTY 1) Place enough adhesive to achieve If to 23 QpBonal2z4's square Inches in contact with the pan tile steeP Pttch a PP n 2 Tom covers upside down. Plate adhesive 112 In. To 1 In. From outside edge of covertite. Ten instep the file. top podia of the eave NUM cover Ufa. Abut to second course of end of pan pan and coverE eaaro flush ateavefine. Eave elosure (morlarshown) Nall enough plastic cement •••• • • • • • • p�, M or t ar • • • • •••• • • NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04/13/06 Page 5 of 7 •••••• • • • 00000 • • •••••l • •111 • • ••• •••••• •• • 0 000 0 0 • • • • • • 1 • • • ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY • • • • • •• • 00000 • 000000 •••• • • •••••• • • •• •• 00000 • • • • • • • • • • •• • • • • ••• • • • •• • • •• • • • • • •• • • •••• • NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 6of7 .••••• • s • •••••• • • ••••• • ••••• • • 00 000 •••••• • • • • • • •.••• •••••• • • • •••••• •••• • • • • •••• Nall through plastic cement fain. x3in. Single paddy on under- layment Single paddy on top of the Single Paddy under tile Paddy (between Paddy (under tile) Eave course 2 in. X 7 in. medium size paddy eave Fascia course only Nail through plastic cement 1 3 in. x3in. Single paddy on undoriayment Single paddy on top of tile ADHESIVE PLACEMENT DETAIL 3 DOUBLE PATTY Eave Course Nall through plastic cement Underlayment 1 r in.x 3 in. Single 4In. ■ paddy on under - layment Single paddy on top of the Eave Course Single paddy under the Single paddy between the 2 111.x 7 in. medium size paddy eave course only Fascia Weephole Eave closure Drip edge Single paddy between tile Eave Closure 2 In. x 71n. medium s paddy eave course only END OF THIS ACCEPTANCE • • • • • • • • •••••• • •••••• •••• •• • • • • • •••• • •• •••• • • • • • • 0 • • • • • .• • • • • • •• • •••• • •••• • ••• • • • •• • • •••• � •••• • • .... • •••• NOA No.: 06- 0201.02 Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 7 of 7 •.•••• • • • •••••• • • •.•••• • • 00000 • • 00 000 0 00000 • • • ..••.• 0 00000 • • Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S Al( 14'DAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose properly is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notice, the inspection will not b approved and a reinspection fee will be charged Signature Owner or Agent The foregoing instrument was acknowledged before me this day ofe - , 200j who is personally known to me or who has produced NOTARY PUB C: Sign: Print: As identification and who did take an oath. My Commission DD2a2384 on Wires FebruaryZ0�2008 My Commission Expires: My Commission Expires: ******************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPLICATION APPROVED BY: Chc 45/13/03 Signa Nealitza C-AcD Contractor The The foregoing instrument was acknowledged before me this day of 9 u S T , 20 05 , by JOSQ e ��r1G� P� J ' who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: fro d t— C f1/)o1' ***************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 'Plans Examiner Engineer Zoning