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RF-09-1554 F gy ! i s g Miami Shores Village ` f& 3Y - T 10050 N.E. 2nd Avenue Y k f� r ( Miami Shores, FL 33138 -0000r 4 Phone: (305)795 -2204 r Expiration: 03/23/2010 Project Address Parcel Number Applicant 138 105 Street 1121360131310 Miami Shores, FL 33150 -1244 Block: Lot HILDA MARTINEZ Owner Information Address Phone Cell HILDA MARTINEZ 138 105 Street MIAMI SHORES FL 33150 -1244 Contractor(s) Phone Cell Phone Valuation: $ 13,800.00 _... Total Sq Feet: 2300 Type of Work: For Inspections please call: Additional Info: (305)762 -4949 Classification: Residential Available Inspections: Inspection Type: Up Lift Report Tin Cap Final Roof Tile In Progress Roof Review Renailing Affidavit Cap Sheet Fees Due Amount Invoice # Total Amt Paid ]Due CCF $8.40 RF 9-09 -35946 $ 50.00 $ 50.00 Education Surcharge $2.80 Permit Fee - New Roof $300.00 Check #: 25842 Scanning Fee $ RF -9-09 -35973 $ 277.70 $ 277.70 Submittal Fee $50.00 Submittal Reversal Fee ($50.00) Check #: 25908 Technology Fee $7.50 Total: $327.70 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. October 08, 2009 Authorized Signature: Owner / Applicant / Contractor / Agent Date Building Department Copy October 08, 2009 1 1 11!1111111! !III! !111! 1!11! 11!11 !!11! Ill! 1!!1 OR 8k 27714 Ps 0777; (Ips } NOTICE OF COMMENCEMENT RECORDED 0 91/6/2170 11 :14:24 A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION HARVEY RUWINF CLERK OF COURT MIAMI -GAGE COUNT`r FLORIDA PERMIT NO. TAX FOLIO NO 11-2136-013-1310 LAST PAGE STATE OF FLORIDA: COUNTY OF MIAMI -DADS: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real � p c � 3 Y 9 Pm d w ,,i 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/address: 138 N.W. 105 Street s, LU Miami Shores F1 33150 ®t ®' 2. Description of Improvement: Reroof to a new Tile roof . ° t I` 3. Owners) name and address: Hilda A. Martinez 0- 138 N.W. 105 Street Miami Shores, F1 33150 ®G a� re U_ Interest in property: Owner ®r- y _ Name and address of fee simple titleholder: N /A I ®L CIO z ��,, ' 4. Contractor's name and address: Quality Roofing Contractor, Inc. ,� Y> 9E s m 13800 N.W. 1st Avenue Miami, F1 33168 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: N /A Amount of bond $ 0 0 6. Lender's name and address: N/A 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: N/A 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: N/A 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is sp i d) 1 �) Signature of Owner Print Owner's Name Prepared by Carlos Arocho Sworn to and subscribed before me thi ) day of , 20 Quality Roofing ^ont . YLOU Address: 13 8 0 0 N.W. 1st Ave Notary Public •° �,OMMISS /''• °% Miami, F1 33168 Print Notary's Name = °` r °' ( 305) 953 -3333 My commission expires: °. 123.01 -52 PAGE 4 8{02 .m• • � dB � QQO� �G. d t Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING RECEOVED Permit No. _Q -0q-15-5 PERMIT APPLICATION SP 1 2009 aster Permit PVo. FBC 20 Permit Type: BUILDING OOFING Owner's Name (Fee Simple Titleholder) Hi A _ Mart Phone . # 13 4 5) 300-0561 Owner's Address 138 N.W. 10 5 Street City Miami Shores State F1 Zip 33150 Tenant/Ussee Name Phone # Email Job Addres's (where the work is being done) 13 N.W. 1 0 5 Street City Miami Shores Villaee County Miami -Dade Zip 33150 FOLIO / PARCEL # 11 Is Building Historically Designated YES NO X Flood Zone Contractor's Company Name Quality Roofing Contractor Phone# (305) 953 -3333 Contractor's Address 13800 N. W. 1- s t Avenue City . Miami State 'Florida Zip 33168 Qualifier Name Carlos Arocho Phone# ( 736) 367 -2029 State Certificate or Registration No. RC 0 0 5 8 6 2 7 Certificate of competency No. 0 0 0 017 8.8 9 Contact Phone (305) 953 -3333 E -mail gualityroofing38 @yahoo.com Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ 13 , 8 0 0.0 0 Square/ Linear Footage Of Work: 2 3 0 0 s q f t . Type of Work: ❑Addition DAlteration ONew Repair/Replace 5R*n litiou Describe Work: Reroof to a new colorthru tile roof . • ...... .... ...... • • '''*0 • l.t' L�,t, � ����, ��r�, �, ��r��* �* ��, �x�: �x. r��* ��, r, r��r, ����Fees+ �x����r�rx* ��` �, ���` �axx*` x*, r, ���x�•r�, :��`���a�t�t�l�! ...... Submittal Fee OU ® Permit Fee $ ac J CCF $ °, • • • • •; O Training/Education Fee $ "—' Telnoio�y Fee • �' • � .. ..... Scanning $ ✓ Radon $ DPBR $ Bond; • • • • Double Fee $ Violation date: 0 -gin Structural Review. $ Total Fee Now Due $ e�?2/ See Reverse side .�q j`. r 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 COlVIl MNCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged.. Signatur �� Signature �l Owner or Agent Contractor The foregoing instrument was acknowledged before me this � s The foregoing instrument was acknowledged before me thi day of , 20 05 , by �� A ka t 711— day of 20 1�L by �Zrlo.> & , who is p oLwz 1lyl own to me or who has produced who is oerso�� me or who has produced As identification and who did take an oath. as identification and who did take an oath. • • • • NOTARY *1RVBLIC. mo�gttts�ttis ®` NOTARY PUBLIC: 0 • • • yo ff c.. • • •e..•Jign: •� ® •fir ©N1Ml$,�� ®••�i9 Si .dam—.— ®® ° '• 0 •U�' ® ® � ®® • • • sees • B e�' • ® o .. .. Print: °.:• e °bg > ° �:� e • o sees• • se e • • My Commission Expn2l:• • =� ° �4L — ® ® ° • r sees . sees .. m S- 3g m e My Commission Expires: o , ®�,� te a—, ; rn sees•• ••••�• • e s6•o�6thru 2 • • e e • • ®�® l/C .; Undehy(�t8t° •• \O s/ C� G : w . / • e..e•• \ ®. • e d • o 'e • • sees. s ®� S TATE OF F� - • % ��� ®e• P ®° tea® . • • • . * arts �r ,��a�a ,rr �c�r�r , * a� �cvr �r 8t/4 b$ �c vie *�r * *�e,� *,r x *,� *,� ,�,u� *�e �rs�,t � ,� �r *sa :a t �lp� WWW • 1 08011111@ 8 • . sees e • • APPRQ'7FP.:1Y • • • • Plans Examiner Zoning . sees Engineer Clerk checked (Revised 07 /10 /07)(Revised 06/10/2009) t r x Wed r 10050 NE 2^d Ave' Miami Shores, Fl 33138 �•�• p.. " Phone 305 - 795 -2204; Fax 305 - 756 -8972 it 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. To: Miami Shores Village Building Department Date: 9/15/2009 10050 NE 2 Ave Miami Shores, Fl 33138 Re: Owner's Name: Hilda A. Martinez Property Address: 138 N.W. 105 Street Miami Shores, Fl 33150 Roofing Permit Number: Dear Building Official: I Hilda A. Martinez certify that I am not required to retrofit the roof to wall connections of my building 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 Florida Building Code (1994 SFBC) Signature Print Name . " ". . . 0000 000000 .. • 00000. 0000 000000 State of Florida 660:09 0 • 0000.. County of Dade 0 00000 • • 0 ' .. 0000. 0000 .. 0000.. . . 00000 The undersigned, being the first duly sworn, deposes and says that he /she is the ashilactor for the abow :' ® , o ,����aaofaa � ® '. property mentioned. • �� ®r ® ® ® ••• Sworn to and subscribed before me this /5 ay of S�>��. 0 7��•�i��� o `. co w �''V ® '•� v 0 p�•„ RIE Notary Public, Sate of Florida at Large %'l/ -�' °% a B�? �� "1a. When the just valuation of the structure for purpose of ad valorem taxation is equal to or more than $19, 000.00, and the building ® 4cros� FBC nor a 1994 SFBC. Then you must provide a building application from a General Contractor for the Roof to Wall connection Hurricane ®� Property Information Map Page 1 of 1 My Home Miami -Dade County, Florida MIAMI•DADE Property Information Map S mmary Details: ' 106 7" 8T Folio No.: 11- 2136 -01 -1310 �{ i __ ""'* Pro 138 NW 105 ST Mailing GILBERTO MARTINEZ &W g dress: HILDAA V,, � m _ _ 138 NW 105 ST MIAMI `r= ISHORES FL 3150 -1244 t ° Prope Information: 800 SINGLE FAMILY �! Primary Zone: { NW 109TH ST � � r±s� RESIDENCE r* a 0001 RESIDENTIAL- - CLUC: t INGLE FAMILY BedslBaths: 1 Units: 1 a Foota e: 1 482 h M of Size: 150 SQ FT Buiit: 1940 : NW 104TH ST , �' MIAMI SHORES SEC 5 PB 10-47 LOT 5 & E1/2 fj . I _ Legal LOT 6 BLK 126 LOT Description: SIZE 75.000 X 122 OR 14836-2400 1190 1 OR – ;- 14836- 24001190 00 Assessment Information: _ ear: 2009 2008 Land Value: $105,448 215 690 Building Value: $123490 1316 M arket Value: $228,938 347, Digital Orthophotography - 2007 0 112 ft Assessed Value: $85,241 $85 156 This map was created on 9/15/2009 1:06:48 PM for reference purposes only. Exemptlon Information: Web Site O 2002 Miami -Dade County. All rights reserved. ear: 2009 2008 Homestead: 1 $25,000 1 $25,000 12 nd Homestead: I YES I YES Taxable Value Information: Y ear: 2009 2008 Applied Ogplied axing Authority: Exemption/ Ex=15n/ . • • • • • • =Uble axable • • Value: • V f — • • • •$50}000/ $% / • • • • • • Regional: 41 1 $35.156 • • -1 a County: : 5 ,000/ �$�0,000/ • • • • • • $�36 41 • 150 : CCity: 0001 50, 0/ • • • • • • .936 41 :W hool Board: • 5, 00/ 425,000/ • • • • • A $60 56 • Salct InfOrroation: • • • • • • • • • • Sale Date: 11/1 90 • • le Amount • $6T000 • • • • • • le O/R: 836 -240 • • • [as Qualification Sales which are qualified ascript vew Ad ' i n I le http:// gisims2 .rniamidade.gov /myhome /printmap. asp? mapurl = http: / /gisims2.miamidade.go... 9/15/2009 i I SECTION 1524 HIGH - VELOCITY HURRICANE ZONES — REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 Scope. As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of this section. The provisions of Chapter 15 of the Florida Building Code, Building govern 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 and the contractor. The owner's initial in the designated space indicates that the item has been explained. 1. Aesthetics - workmanship: The workmanship provisions of Chapter 15 (High - Velocity Hurricane Zone) are for the purpose of providing that the roofing system meets the wind resistance and water intrusion performance standards. Aesthetics (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 agreement between the owner and the contractor. `�✓' ` — 2. Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Chapter 16 (High - Velocity Hurricane Zones) of the. (The roof deck is usually concealed prior to removing the existing roof system.) 3. Common roofs: Common roofs are those which have no visible delineation between neighboring units (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 work to be performed. 4. Exposed ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be viewed from below. The owner may wish to maintain the architectural appearance; therefore, roofing nail penetrations of the underside of the decking may not be acceptable. The owner provides the option of maintaining this appearance. �5. Ponding water: The current roof system and /or deck of the building may not drain well and may cause water to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural distress and may require the review of a professional structural engineer. Ponding may shorten the life expectancy and performance of the new roofing system. Ponding conditions may not be evident until the original roofing system is removed. Pond ko conditions should be corrected. 0 0.00 0. •• • . a •• • 6. Overflow scuppers (wall outlets): It is required that rainwater flowvftso that thV roof is hbt overloaded from a buildup of water. Perimeter /edge walls or other rabfvAensions bl&40-: this discharge if overflow scuppers (wall outlets) are not provided. It nWbNneceUaryto insJgll overflow scuppers in accordance with the requirements of: Chapter 15 grid 16 herein and tNg Florida Building Code, Plumbing. 0 0 000000 .• 7. Ventilation: Most roof structures should have some ability to vent rtatufaLairflow .1giough *em• :- interior of the structural assembly (the building itself). The existing arrnount of a$icaA ntilatipN shall not be reduced. It may be beneficial to consider additional vehV g ivhich;cprrresult0in • extending the service life of the roof. 0 Owner's /Agent's Signatu a Da a Contractor's Signature Date ROOF ASSEMBLIES 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 Quality Roofing Contractor, Inc. Job Address 138 N.W. 105 Street Miami ShDres, Fl 33150 ROOF CATEGORY ❑ Low Slope ❑ Mechanically Fastened Tile )® Mortar /Adhesive Set Tile ❑ Asphaltic ❑ Metal Panel/Shingles ❑ Wood Shingles/Shakes Shingles ❑ Prescriptive BUR -RAS 150 ROOF TYPE ❑ New Roof XW Reroofing ❑ Recovering ❑ Repair ❑ Maintenance ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) NSA Steep Sloped Roof Area (SF) 2300.%#1. Total (SF) 2300sgft. Section B (Roof Plan) Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. Include dimensions of sections and levels, clearly identify dimensions of elevated pressure zones and location of parapets. Q •• • 0000 ••...• •0000• •• . •. . • • so 's . 00 •00.0 •. . . 0.000 ` •• •• • •• • .••• 0000.. o • • 00.0 00.00. 00•• 15.32 FLORIDA BUILDING CODE — BUILDING ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2004 High - Velocity Hurricane Zone Uniform Permit Application Form. Section D (Steep Sloped Roof System) Roof System Manufacturer: Hanson Roof Tile Notice of Acceptance Number: 07-0914.06 Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations): 1: -45.1 P2: -78.6 P3: -116.2 Maximum Design Pressure (From the Product Approval Specific System): 86.61 Steep Sloped Roof System Description Deck Type: wood 1 x 6 Roof Slope: Type Underlayment: (1) 301b. AST14 D -2 - - - - -- - 12 - Insulation: N/A Fire Barrier: N/A Ridge Ventilation? Fastener Type & Spacing: 1 /4" R/ n ails -" /c at laps N/A - — - - -- 2 - r-ows 12" o/c Adhesive Type: Type 111 mapping as phalt 0 "A • 0 Type Cap Sheet: (1) 9 0lb .' ASTi4 .. , • -- ...iii • • Mean Roof Height: 13' Roof Covering: Hacienda ile ••• 0000 • •. 69.06 ..iiii • . • iiii Type & Size Drip 3 .x'63' 26 :'$ "' 0060•• Edge: • ga3.iusnized 6 • • . .... ...... • . . 0000 . • 60666. •. . i 0• 0 . 6 6066 15.34 FLORIDA BUILDING CODE — BUILDING ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2004 High - Velocity Hurricane Zone Uniform Permit Application Form. Section E (Tile Calculations For Moment based the systems, choose either Method 1 or 2. Compare the values fur M with the values from M If the M values are greater than or equal to the M values. for each area of the roof, then the tile attachment method is acceptable. Method I "Moment Baud Tile Calculations Per RAS 127" ( 44&9 - .28-9 - Mg: 8 = Mrt 6-n Product Approvai m 86. 61 (R,:78-6_ x X.2 - a - Mg: 6_-80- = Mr2 1:.7-_7.6 Product Approval Mf .86. 6 1 (?; 1 16 . Z k. 289 3 _ M g : 6. 80 = M r , 26. 7 8 Product Approval M 86.6 Method 2 "Simplified Tile Calculations Per Table Below" Required Moment of Resistance (Mr) From l'uble Below Product Approval Mf M required Moment Resistance* Mean Roof Height Roof Slope 1 15' 20' 25' 30' 40' 2:12 34.4 36.5 38.2 39.7 42.2 3:12 32.2 34.4 36.0 37A 39.8 4:12 30.4 32.2 33.8 35.1 37.3 5:12 28.4 1 30.1 31.6 32.8 1 34.9 6:12 26.4 28.0 29.4 30.5 32.4 7:12 24.4 25.9 27.1 282 30.0 *Must be used in conjunction with a list of moment based file systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based tile systcros 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, ibr each area of the r ol'. then the tilt attachment method is acceptable. Method 3 "Moment Based Tile Calculations Per RAS 127" (P x t. = x w: = ) - W: x cos A = Frl Product Approval F' (P,: x 1. x w: - ) W: x cos t/ = Fr2 Product Approval F (P1: x L = x w: = ) - W: x cos A = Fr3 Product Approval F Where to Obtain Information Description Symbol Where to find Design Pressure PI or P2 or P3 RAS 127 Table I or by an engineering analysis prepared by PE based on ASCE 7 Mean Roof Height H Job Site Roof Slope 61 Job Site 004 • • Aerodynamic Multiplier i. Product Approval • • 00, • 9064, • Restoring Moment due to M, Product Approval • • • • • + • • i • 0001, • Gravity • • • ••• • Attachment Resistance Mf Product Approval • • • • • • • • • • Required Moment Resistance M Calculated 0000 • • 000 • Minimum Attachment • • • • • • • F' Product Approval • • • • • 000 • Resistance Required Uplift Resistance Fr Calculated i • • • • • • " 00 • Average Tile Weight W Product Approval • + • • • • • ••• • 09 a • • • ••+ Tile Dimensions 1.- length Product Approval •• W = width All calculations must be submitted to the building official at the time of permit application. FLORIDA BUILDING CODE - BUILDING 15.35 M IA M DARE MIABU -DADS COUNTY, FLORIDA METRO -DARE FLAOLER BUILD= WELDING CODE COMPLIANCE OFFICE (BCCO) 144 WEST FLAGLER STREET, sUITE 16a PRODUCT CONTROL DIVISION MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -29M NOTICE OF ACCEPTANCE (NOA) Hanson Roof Tile 1340 SW 34 Ave Deerfield Beach, FL 33442 S COPE: 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 AW (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. N this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHT 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 Hacienda Double Rol Roof The LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami Dade County Product Control Approved ", unless otherwise noted herein RENEWAL of this NOA shall be considered after a renewal application has been filed and there has 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 revision or change in the 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. Failure to comply with any section of this NOA shall be cause for termination and re 0 gj Of 0696 NOA. • • .. .. • ADVERTISI ff: The NOA number preceded by the words Miami-Dade �, Florit>�; end • *00 ' • followed by the expiration date may be displayed in advertising literature. If any pbltdbVof the NOA is .000: displayed, then it shall be done in its entirety. 0 00000 9 ' 0 • 0 INSPECTION: A copy of this entire NOA shall be provided to the user by the many uer orits 000 9 distributors and shall be available for inspection at the job site at the request of the Buddit g Official 0.0. • .00900 This NOA consists of pages 1 through 7. . . 9099 0000.0 The submitted documentation was reviewed by Jorge L. blo 0 0000 • 9 9 . 0000.. 6 • AA No.: 07 -pli a Expiration Date: 1=6112 Approval Date: - 12AW07 Page i of 7 a ROOFING ASSEMBLY APPROVAL Category: Roofing Sub Category: Roofing Tile Material: Concrete 1. SCOPE This renews a roofing system using Hanson Hacienda Roof Tile, as manufactured by Hanson Roof Tile in Hobe Soa4 Fien'd's and as described in Section 2 of this Notice of Acceptance. For the locations where the pressure requirements, do not exceed the values listed in section 4 herein. The attachment calculations shall be done as a moment based system. 2. PRODUCT DESCRIPTION Manufactured by Test Product Specifications Description Length: 1IPA' Low profile, interlocking, extruded concrete Hanson "Hacienda" Width: 13" Tk4S 112 roof file equipped with two nail hole a thick double roll ribs. For direct deck or battened nail -on, mortar or adhesive set applications: Length: varies Accessory trim, concrete roof pieces for use Trim Pieces Width: varies TAS 112 at hips, rakes, ridges and valley terminations. Varying thickness Manufactured for each tile profile. 2.1 COMPONENTS OR PRODUCTS MANUPACTURSD BY OTHERS Test Product Product Dimensions S dons Deseziption Manufacturer Wood Battens Min. 1 7 x 4" Wood Preservers Salt pressure treated Generic Horizontal Institute LP -- 2 or decay resistant nth current NOA) Min. 1"x 4" for use lumber battens with vertical battens or •••••• •••• ••• * Min.1 "x2 "for use • • alone • Corrosion resistant • •••••• TAS114 • • • • • • Tils Nails ... • Min. 10dx 3" screw or smooth Generic • Appendix E • ••••• •• • •••• shank nails (With current NOA) ••••• • • •••••• • •••••• • • • •••••• •••• • • • • •••• • • • NOA No.: 07. 0914.06 l q*udon Date: 12/16/12 Approval Date: 12/06/07 Page 2 of 7 Test Product Product phnensions ftedfieations ' Deadation lVlanufacbrrer #8x 2 Vi' long Corrosion resistant, Tile Screws 0.335" head dia. TAS 114 coated, square drive, Generic 0.131" shank dia Appendix E galvanized, coarse nth current NOA) 0.175' screw thread thread wood screws dia. Clips Corrosion resistant Hurricane Clip & Min. W' width TAS 114 clips with corrosion Generic Fasteners Min. 0.060" thick Appendix E resistant nails. (Wiih current NOA) Clip Fasteners Min. 8d x 1 1 /4" 2.2 EVEDENCE SMN r= Test Aeencv Test Identifier Test Name/Reoort Date Redland Technologies 7161 -03 PA 102 Dec. 1991 7161 -03 PA 102(A) Dec. 1991 7161 -03 PA 108 Dec. 1991 PO402 Withdrawal Resistance Testing of Sept. 1993 screw vs. smooth shank nails P0631 -01 PA 108 July 1994 Letter Dated Aug. 1, 1994 PA 108 Aug. 1994 Professional Service 224 -47099 PA 112 Sept. 1994 Industries, Inc. The Center for Applied 94 -060B PA 101 March, 1994 Engineering, Inc. 94 -084 PA 101 May 1994 25 -70941 PA 102 Oct. 1994 25- 7094 -7 PA 102 Oct. 1994 25- 7094 -4 PA 102 Oct. 1994 Project No. 307025 PA 100 Oct. 1994 Test #UW -76 25- 7183 -1 PA 102 Feb. 1995 25-7183-2 PA 102 Feb. 1995 25-7214-2 PA 102 March, 1991 25-7214-6 PA 102 ; • March, 1995• 0000.. .. . • •• • Celotex Corporation 528454 -2 -1 PA 101 • •': "Sep. 1998• • • 0 0 ....0. Testing Services 520109 -2 • • • • Dec. 1998 00 ; 0 0 • • ; • 0 000.' Walker Engineering, Inc. Calculations Aerodynamic Multiplier • •; 0 0 Marcia I* . 090000 .00000 • 0000.. IBA Consultants, Ine. 2381 -249 TAS 112 :* 09120/07 • • • • 0000 • • • 0000.. 0 40A*Ti.: 07- 091 00 6 • • • •: em.-. Expiration Date: ftJGU2 0 • Approval Date: 12/0610'1 Page 3 of 7 3. LEMTATIONS 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set file applications, a static field uplift test in accordance with RAS 106 may be required, refer to applicable building code. 3.3 Applicant shall retain the services of a Miami Dade County C erdfied Laboratory to perform quarterly test in accordance with TAS 112, appendix W. Such testing shall be submitted to the Building Code Compliance Office for review. 3.4 hfimhnum 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 'Phis acceptance is for wood deck applications. Minimum deck requirements shall be in compliance with applicable building code. 4. INSTALLATION 4.1 Hanson 'Hacienda' Roof Tile and its components shall be installed in strict compliance with Roofing Application Standard RAS 118,119, & 120. 4.2 Data For Attachment Calculations Table 1: Aerod m Mul liers -X (M Tile % ( f e) ( e Profile Batten Application Dlreat Deck Applicatlon Hacienda The 1 0.267 0.289 Table 2: Restoring Moments due to Gr ft -Ib Tile* S ":12" 4 ":12" 5 ":12" 6 ":12" 7 12" or Profile ofenter Hanson Battens Direct Battens Direct Battens Direct Battens Direct Baths Direct Hacienda Deck Deck Deck Deck Deck file 5.92 6.80 5.1 6.69 5.70 6.55 57W7 6.39 5.41 6.22 ...... . .• .... •. • ' ' NOA No.: 074914.06 . Esphation Date: 12/16/12 Approval Date n "A6107 Page 4 of 7 y Table 3: Attachment Resistance Expressed as a Moment - Mf (ft -lbf) For Nall -On m� Tile Fastener Type Direct Deck Direct Deck Battens Profile (Min 15/32" (Min.1 W32" plywood) plywood) Hanson 2 -10d Ring Shank 27.8 37A 28.8 Hacienda Nails Tile 1 -10d Smooth or 8.8 11.8 4.1 Screw Shank Nail 2 -10d Smooth or 16.4 21.9 7.1 Screw Shank Nails 1 #8 Screw 25.8 25.8 22.9 2 #8 Screw 47.1 47.1 49.1 1 -10d Smooth or 24.3 24.3 24.2 Screw Shank Nail Field Cli 1 -10d Smooth or 19.0 19.0 22.1 Screw Shank Nail Eave Clip) 2 -10d Smooth or 35.5 35.5 34.8 Screw Shank Nails Field Cli 2 -10d Smooth or 31.9 31.9 32.2 Screw Shank Nails Eave Cli 2 -10d Ring Shank 43.0. 67.5 50.9 Nails 1 Installation with a e file hmWlw and fasteners are toasted a min. of M from head of Hie. Table 4: Attachment Resistance Expressed as a Moment Mt (ft -ibf) For Two Patty Adhesive Set Systems Tile TII® Applicatlon Minimum Attachment Profile - Resistance Hanson Hacienda Tile Adhesive 26.1 Sees 2 See manufaeures oonyment app roval for installation .... iremerns. • • • �• • 3 Fiwdble Products Company THeBond Average weight per patty 11.4 grams. e r • e 0 • • • Po oam Product Inc. Average wel ht r 8 • • • • • • . e • • ..... • • .... • a Eapiratlon Date:1WA2 • Approval Dab:1ZVM Page 5 of 7 Table 4A: Attachment Resistance Expressed as a Moment - K (ft Ibf) For Single !ft Adhesive Set Systems Tile Tile Application Minimum Attachment Profile Resistance Hanson Hacienda Tile Polyf Pol ProTM . 88,61 Polyf Pol ProTm 45.5 4 Laras Daft Ofacement of Oarams of Po Prolm. b Medium Paddy olacement of 24 rams of po Prow, Table 40: Attachment Resistance_Expressed as a Moment - M, (ft -lbf) For Mortar Set Systems Tile Tile Attachment Profile Application Resistance Hanson Hacienda The Mom Set 20.60 S. 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". H nson HANSON HACIENDA ROOF TILE TILE IDENTIFICATION MARK (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. 0000 • 0 . 0.0.00 0000 0 0 : . . . •• 0 0 0000.. 0000.. • 0000.. . • 0000.. . .. 0000 0 . 0 0 0 . . .. . .00. 0000. . : ..0.0. 0000. 0000.. • 00.00. 0 0000.. • .....r 0 so • 0 NOA No.: &7-014.06 0000.. � .. Expiradon Date: 1=6112 Approval Dabe:12AW07 Page 6 of 7 PROFILE DRAWINGS HANSON HACIENDA CONCRETE. ROOF TILE FASTENER HOLES OVERLOCK dj UNDERLOCK 13" END OF THIS ACCEPTANCE •••0 ,. , , 0000 000 W 00 . ; „ , 000.08 0000 • 0000.. 000000 , 0000 „ , 0 .0000. 0 0000 0 • • • • • • 0000. • 00 0. :00000 0 0000. 0000.. 0000 , 0 s 0 • • 0 0 0000 • , , 000000 NOANa ,: 07- 09a.36 : 0000 : d Expiration Date: ] tMM2 • Approval Date:1?UM Page 7 of 7 II I I i MIM MIAMI -DADE COUNTY, FLORIDA METRO -DARE FLAGLER BUILDING BUILDING CODE COMPLIANCE OFFICE (BCCO) 140 WEST FLAGLER STREET, SUITE 1603 PRODUCT CONTROL DIVISION MIAMI, FLORIDA 33130 -1563 (305) 375 -290I FAX (305) 375 -2908 NOTICE OF ACCEPTANCE (NOA) Polyfoam Products, Inc. 11715 Boudreaux Road Tomball, TX 77375 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 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. N 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: Polyprog AR160 RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMIN ATION of this NOA will occur after the expiration date or if there has been a revision or change in the 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. Failure 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, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its dipitors and shall be available for inspection at the job site at the request of the Building Official.: . •. • • • • ` 0004 This NOA renews NOA No.01- 0521.02 and consists of pages 1 through 7 ": " • • • • 0 04 0 :0 ...... • The submitted documentation was reviewed by J rge L .A cebo. .... • • ...... �. ' i••0 ' • • • • ' • •• 0000• 0 000•• • •• •• 0000•6 • so • 0 000•• •00.0• 0 • 0 • • • • • •0•• • • •00.0• • NOA•No.: 06'VM.02 • • ExpWialk Date„" 0$fl13`J ; •' • • Approval Date.VW13/06 Page 1 of 7 ROOFING ASSEMBLY APPROVAL: Category: Roofing Sub Category: Roof toe adhesive Materials: Polyurethane SCOPE: This approves Polypro® AH160 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, b 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® AR 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 Product Description S� cations Polypro® AH160 N/A . TAS 101 Two component polymvfl ne foam adhesive Foampr@ RTF1000 N/A Dispensing Equipment ProPack® 30 & 100 N/A Dispensing Equipment PRODUCTS MANUFACTURED BY OTHERS: Any Miami Dade County Product Control Accepted Roof Tile Assembly having a current NOA which list moment resistance values with the use of Polypro AH160 roof tile adhesive. PHYSICAL PROPERTIES: Property Test Refits Density ASTM D 1622 1.6 lbsJfL Compressive Strength ASTM D 1621 18 PSI Parallel to rise 12 PSI Perpendicular to rise Tensile Strength AS17Jg 171623 28 PSI Parallel to rise Water Absorption ASTMD 2127 0.08 Lbs./Ft Moisture Vapor Transmission ASTM E 96 3.1 Perm / Inch Dimensional Stability ASTM D 2126 +0.07% Volume Change @ -40° F., 2 weeks 0000 0 + Volume Change @I 58 100% • • ..tiold Cejl ASTM D 2856 Hu 2 weeks • .... ....: f0te; The�juical properties listed above are presented as typical average values as determined • • by hisip ed ASTM test methods and are subject to normal manufacturing variation. • • • • NOA No.: 06. 0201.02 • • • • • • • • • Expiration Date: OW10 /11 ' Approval Date: 04/13/06 Page 2 of 7 EVIDENCE SUBNIITrED: Test Agency Test Identifier Test Name/Renort Date Center for Applied Engineering #94-060 TAS 101 04/08/94 257818 -IPA TAS 101 12/16/96 25- 7438 -3 SSTD 11 -93 10/25/95 25-74394 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 Wxwatories, Inc. 9637 -92 ASTM E 108 04/30/93 Southwest Research Institute 01- 6743 -011 ASTM E 108 11/16/94 01- 6739 -062b[l] ASTM E 84 01116195 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 03/02/99 520109-2-1 LIWfATIQNS: 1. Fire classification is not part of this acceptance. Refer-to the Prepared Roof Tile Assembly for fire rafting. 2. Polypra AH160 shall solely be used with flat, low, & high tile profiles. 3. Minimum underlayment shall be m compliance with the Roofing Application Standard RAS 120. 4. Roof Tile manufactures acquiring acceptance for the use of Polypro® AM 60 roof the adher488 Vh their the assemblies shall test m accordance with TAS 101. '..' •; • • • • • •.: ti 0000.. .. • 5. Roof Tile manufactures acquiring acceptance for the use of HANDI -STICK ro4Uhgdhesive . with • • • • • • their the assemblies shall test in accordance with TAS 101 with section 10.4 as reodyfied hewn. :0000: '0000 F: w 0000.. 0000. 6 • • 00 0000 000 �..... 1 .0096. ��.. 9 99669 6 MS 0 0000 • 6 0000.. • NOA4 No.: O "M1.02 ESplrat9n Data: OIWIJ • • Approval Date.-'U'13106 Page 3 of 7 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 PoIypro® AH160. 2. Polypro® AH160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof file assembly's adhesive attachment with the use of Polypro® AH160 shall provide sufficient attachment resistance, expo as an u ps based system, to meet or exceed the uplift resistance determined in c with Miami Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA 3. PolyprodD AH160 roof the adhesive and its components shall be installed m 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 require, before application of any adhesive. The mix ratio between the "A" component and the "B" component shall be maintainW between 1.0- 1.15 (A): 1.0 (B). The dispense timer shall beset to deliver 0.0175 to 0.15 pounds per file 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. Polypro® AH160 shall not be exposed permanently to sunlight. 8. Tiles must be adhered m freshly applied adhesive. Tile must be set within 2 to 3 minutes after PolyproO AH160 has been dispensed.. 9. PolyproV AH160 placement and minimum patty weight shall be in accordance with the 'Placement Details' herein. Each generic file profile requires the specific placement noted herein. Table I; Adhesive Placement For Each Generic Tile Profile Tile Profile Placement Single Paddy Two Paddy Weight Detail Weight Min, per paddy Min. (gr ains ) Flat, Low, High Profiles #1 35 N/A High Profile (2 Piece #1 17 /side on cap and N/A Basel) 34 Flat, Low, Ifigh Profiles #2 24 N/A Flat, Low, High Profiles #3 g • ' ELING• • 0000 • 0 ••000• • All PolyprobI H160 containers shall comply with the Standard Conditions listed herein. . • ...... BUMI)M 'PERMIT REQUIREMENTS: ..... • �r�*quired by;i Official or applicable building code in order to properly evaluate the • Uwa stion .0.00 .••... 000.0• 0000•• • • NOA No.: 06- 0201.02 • 0 * ::1 - Fjq*adon Date: 05/10111 •' Approval Date: 04/13/06 Page 4 of 7 ADHESIVE PLACEMENT DETAIL 1 SINGLE PATTY Net;fttt�gi►Pt Been t P fBe Tde) Rd ft-gbph t amm p� P8*t7Qe1 10�. 1eu� 2 e ENCoome o 0 . Faseie E�eCmme Psi eeatt��c Eaeeeamow.. F�BCtee 41&up fmmwnphft cpfi= Doedp O P" 2 M fOr 91ieerougltao9roaBrotoer�eve171o2i tl � & re' to the�tBe *9PM V fteemed Tel hLftmc 1Lea hretaAibelBe. . 10 b 1 EMCMM • • rmte Em Go= ,�* e4uu+w FMC13 ri g no: eft PIMO Ahr6to� Whatem�a' Tort Ear do n . im�atstewm) Fassb •.. • " • 0000 0000• 0000.. •.•• 000000 0000.. 0000 .• • . `. 00.60. . 0 00000 .0.000 .. .. . 0000.0 0000.. . 0000 0000.. 0000 . • . . 0000.. NDA No.: 060201.02 ©" Expiration Date: 05/10/11 Approval Date: 04/13/06 Page 5 of 7 AD1RESIVE PLACEMENT D ETAIL 2 SINGLE PATTY mdeffflopwftomot Fa rtBeaso► �? NaB agh P�ticeamreM PaaNhr►'� l ° 7 - i�in, EnaCaase •� • wDock % EMOOM Emdmn • . EamCbm MM M* Pwft mat ' ur"71www �@� • .. . : •.. • EmCbm • • • • EmCcrose • Pia • • • i. • • .. NOA No.: 06-0201.02 Expiration Date: 05 110/11 Approval Date: W13/06 Page 6 of 7 ADHESIVE PLACEMENT DETAIL, 3 DOUBLE PA TTY Nag thr * pl c cem nt Fly Nag through pWft cament S�gle paddy under file {between tte) undarlaYmem Single paddy befeen tte 2 hr. x 7 hL medium {und r tge} e sb paddy swe cause only r x' �fi.x3bw 3 L h4 under tge t paddy on e 2 hw 4In. 4 hr. 2 in. paddy on hymmidt o Odor- Single on top of the Fascia weepm paddy 2 bi.X 7la. mom Em Save cleosure simwqww % C alm on top of the Fascia emmonly Drip Wp Nail tuough plastc cement Sho paddy under the P between b'bt a /$�Iin.x3bL 4in o Single paddy a►underlayment 2 n. e 0000 Single paddy Em Clow s • • • • •. • •.. • • • • On top Of tie ••. •. 2ILXI In. Medlum 0000•• 0000 0000•• Eau Cc= Fascia ! Course Only • 0000.• • • • 0000.• 0000 •• • • • • • • • 0000 • •• 0000• b 0000.• • • 0000• • • •000. •• •• 0 0.00•. • 0000.• . • • •... •....• es END OF THIS ACCEPTANCE '..'�: ••o••• 0 00 0000 NOA No.: 06-0201.02 Expiration Date: 05/10/11 Approval Date: 04 /13/06 Page 7 of 7 54 p, 7 P O D � BY DATE ZONING DEPT BLDG DEPT SUBJECT TO COMPLIANCE WITH ALL FEDERAL • "• STATE AND COUNTY RULES AND REGULATIONS • f •fff•• •ff• • • • •fff•• • • • • • •fff•• ••f••• • • �;; • • •• •• • f Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 - Inspection Number: INSP - 125015 Permit Number: RF -9 -09 -1554 Scheduled Inspection Date: March 02, 2010 Permit Type: Roof Inspector: Bruhn, Norman Inspection Type: Final Roof Owner: MARTINEZ, HILDA Work Classification: Tile Job Address: 138 NW 105 Street Miami Shores, FL 33150 -1244 Phone Number Parcel Number 112136013131 Project: <NONE> Contractor: Building Department Comments Reroof to a new colorthru tile roof. Inspector Comments Passed 44 r Failed Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 01, 2010 For Inspections please call: (305)762 -4949 Page 6 of 27 FLORIDA INTERNATIONAL ENGINEERING AND TESTING LAB LLC - 16701 SW 117 Avenue, Miami, Florida 33177 Telephone: (305) 378 -1991- Fax: (305) 378 -1997 y - FLORIDA INTERNATIONAL ENGINEEMG & 1TSTING tae Miami Dade Lab Cey fication # 07 -0612.11- State of Florida CA # 27273 SITE SPECIFIC INFORMATION N2 1675 Job Address: 1 wner's ame : Contractor: ?l�Permit _ -� Install Date: Type of Tile: r 1� GL Approx. Height e Z- Floor: Type o Access: Scaffolds: Ladder: Slope: Test date: App. Sq.Ft. `Zi ®® Req. Force: 351bs. Testing Equipment. F.G.E. 1QOX,Shimno Instrument ------------------------------------------------------------------------------------------------------- TEST RESULTS P = PASS, F = FAIL Tic Upllfti' ttlt. Ust u t Po11 Tat Upl l lull . 17pllff rR Teat ; Try .! 11 ocatlon Tact {P iE►r Loeat[gn Test {P or p} Lomow Test (P or ? 7 ! 's T (�' ar r}' qi tGai Tit 1 /7�rj� 21 41 61 81 2 22 42, 62 82 3 23 43 63 83 4 24 44 64 84 5 25 45 65 85 6 26 46 66 86 7 27 47 67 87 8 28 48 68 88 9 29 49 69 89 10 30 50 70 90 11 31 51 71 91 12 32 52 72 92 13 33 53 73 93 14 34 54 74 94 15 35 1 55 75 95 16 36 1 56 76 96 17 3 1 57 77 97 18 38 58 78 98 19 39 59 79 99 20 40 60 80 100 a ------------------------------------------------------------------------------------------------------- IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL TAS 106, THIS ROOF ASSEMBLEY HAS PASSED THE STATIC UPLIFT QUAIITY CONTROL TEST. R SubmOtted By: Vinayagar M. Balalaishnan v, P.E. State of Florida Lic # 63107 b %, ,?,A/&) 105 10050 NE 2"d Ave Rmp' Miami Shores, FI 33138 Phone 305 - 795 -2204; Fax 305 - 756 -8972 www.miamishoresvillage.com RE: Permit # R f - 9 -qcj- 155 DATE: -� INSPECTION AFFIDAVIT I Coa l S 4 , licensed as a (n Contracto / Engineer/ Architect, (Print name and circle License Type) FS 468 Building Inspector License #: 0 C) On or about cl� - C ) ` 'Zo D C l , I did personally inspect the roof deck nailing and /or (Date & time) l� secondary water barrier work at e�� (��t,�� X05 ��`T �s�: �,�, (tc (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 sworn, deposes and says that he /she is the contractor for the above property mentioned. ® ®oev ai�eeeeeP�is >si Sworn to and subscribed before me this day of�C \� °o err %�q2 . 4 '' �O ` ;�® Notary Public, Sate of Florida at Large ;� °a ye /�, •. Underwntes �Q. ° ®!j ��ATE OF FV�Ve *General, Building, Residential, or Roofing Contractors or any individual certifi under 468 F.S. to make such an i90 n. Include photographs of each plane of the roof with permit # and address # clearly shown marked on the deck for each inspection