The URL can be used to link to this page

RF-11-1315Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 162293 Scheduled Inspection Date: August 22, 2011 Inspector: Bruhn, Norman Owner: SEDMAKOV, KRASSIMIR Permit Number: RF -7 -11 -1315 Job Address: 17 NW 107 Street Project: Miami Shores, FL 33168 -4306 <NONE> Contractor: FLORIDA BUILDERS & ASSOCIATES Permit Type: Roof Inspection Type: Final Roof Work Classification: Tile Phone Number Parcel Number 1121360070470 Phone: (786)554 -7926 Building Department Comments RE ROOF FROM EXISTING ROOF TILE COLOR THRU CONCRETE TILE Passed fie Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments August 19, 2011 For Inspections please call: (305)762 -4949 Page 8 of 32 Miami Shores Viiiage Building Department RE: Permit # /3 /6 INSPECTION AFFIDAVIT v •'s v '7 licensed as a (n (Print name and crce License Type) License #: CC - 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 DATE: FS 468 Building Inspector /'{ /1) e/ / Engineer / Architect, On or about $ 4/12-0 11 1 12: ,© PA.( , I did personally inspect the roof deck nailing and (Date & time) Secondary water barrier work at 17 M ua 10 7 Arect lei, SGT FL jll 1' (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. Sworn to and subscribed before me this Notary Public, Sate of Florida at Large 3 day of 411"1"—*V 4%e'''a DIANEYSIS HARO ' , a; My Comm. Expires May 23, 2015 � nYo's: Commission 0 EE 80887 *General, Building, 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 # clearly shown marked on the deck for each inspection t A -1 Engineering Inspection Services, Inc 7066 SW 44th Street Miami, FI 33155 Tel: 786- 326 -9877 Fax: 305 - 485 -9011 a 1 roofinspection @gmail.com LAB CERTIFICATION # 10- 0512 -01 SITE SPECIFIC INFORMATION UPLIFT TEST - TAS #106 Roofing Contractor FLORIDA BUILDING ASS Job Address Owner's Name Type of Tile EAGLE DOUBLE ROLL 17 NW 107 ST Permit # RF -7 -11 -1315 KRASSIMIR SEDMAKOV Date Installed Approximate Roof Height 12 feet Roof Pitch 3/12 Type of access to Roof OK Approximate Square Footage of Roof 14 ft 2 Required Testing Force 351bs Date Tested 8/20/2011 Number of Tests 46 Testing Equipment: F.G.E. 100 Contact Name CHELE Phone # (786) 499 -0422 LOCATION # OF TEST PASS # OF TEST FAIL Corner 8 Tests Pass 0 Tests Fail " Perimeter 10 Tests Pass 0 Tests Fail d Field 20 Tests ' Pass 0 Tests Fail Ridge 8 Tests v Pass 0 Tests Fail Total 46 Tests k Pass 0 Tests Fail 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. C . rdially 40.1/ RODRIGUEZ A 6691 A -1 ENGINEERING INSPECTION SERVICES INC CERTIFICATION NO 10- 0512.01 7066 SW 44th Street Miami, FI 33155 — Telephone (786)326 -9877 — Fax (305)485 -9011 Roofing Contractor Job Address Owner's Name KRASSIMIR SEDMAKOV Type of Tile EAGLE DOUBLE ROLL A -1 Engineering Inspection Services, Inc 7066 SW 44th Street Miami, Fl 33155 Tel: 786- 326 -9877 Fax: 305 -485 -9011 a1roofinspection@gmail.com LAB CERTIFICATION # 10- 0512 -01 SITE SPECIFIC INFORMATION UPLIFT TEST - TAS #106 FLORIDA BUILDINGASS 17 NW107ST Permit # RF -7 -11 -1315 Date Installed Approximate Roof Height 12 feet Roof Pitch 3/12 Type of access to Roof OK Approximate Square Footage of Roof 14 ft 2 Date Tested 8/20/2011 Contact Name CHELE Required Testing Force 351bs Number of Tests 46 Testing Equipment: F.G.E. 100 Phone # (786) 499 -0422 SKETCH OF ROOF Revised by r 7066 SW 44th Street Miami, R 33155 « Telephone (786) 326 -9877 Fax (305) 485 -9011 17 NW 107 Street MIAMI SHORES FL 33168 -4306 tnce with all ordinances and regulations ar authorities of Miami Shores Village. In I understand that separate permits are )fiance with all applicable laws regulating Ju! / 28, 2011 Project Address 17 NW 107 Street Miami Shores, FL 33168 -4306 Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 turszomulmomarosaav Owne. inc; oration Parcel Number 1121360070470 Block: Lot: Address KRASSIMIR SEDMAKOV 17 NW 10i Street MIAMI SHORES FL 33168 -4306 Contractor(s) Phone CeII Phone FLORIDA BUILDERS & ASSOCIATES (786)554-7926 Type of Work: Re Roof Additional Info: TILE COLOR THRU Classification: Residential Scanning: 5 Applicant KRASSIMIR SEDMAKOV Phone Sg33333330. 'AM Valuation: Total Sq Feet: Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - New Roof Scanning Fee Technology Fee Total: Amount $5.40 $4.13 $4.13 $1.80 $275.00 $15.00 $7.20 $312.66 Pay Date Pay Type Invoice # RF -7 -11 -41516 07/20/2011 Credit Card 07/28/2011 Credit Card Amt Paid Amt Due $ 50.00 $ 262.66 $ 262.66 $ 0.00 Cell $ 9,000.00 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 compl, pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the prof accepting this permit I assume responsibility for all work done by either rr.yse;', r ; ;.; ;:;art, servant:, cr employes requirea for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL wor OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in com construction and zoning. Futhermore, I authorize the above -named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Building Dep4 rtment Copy July 28, 2011 )ate 1 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 PERMIT APPLICATION FBC 20 57 '77 77 At L 0 2011 :. ....................... Permit Nol! °i5 lS Master Permit No. Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder):, RASSl Ll!12, 3.5EPH&V.0V Phone #: Address: 7 N (4) 107v 57ia City: P ! Arm, .5i-tflQ,es State: FZ-- Zip: 4 (o Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 11 71 ik) t®7 1 STREET City: Miami Shores County: Miami Dade Folio/Parcel #: 11 -21 0 D©7- o41 Is the Building Historically Designated: Yes NO) Flood Zone: Zip: �� t CONTRACTOR: Company Name: FLO 2( !74 1301 WE RS Address: ' 8316- MO 1 7/ 5T 'l S72e City: /�I /}# State: P(i Qualifier Name: L0 LS Aveit pj a 4-AC4O lke - ' Phone #: 554 —.71 WO, State Certification or Registration #: ('??2 Contact Phone #: ? f' -MI.- 7,24, Email Address: DESIGNER: Architect/Engineer: i4/® Zip: ,t9/5' Phone #: 2,4&-5;94--7724 Certificate of Competency #: G c jTh/c Je i e6,970 e. e Phone #: Value of Work for this Permit: $ /0 40 0 Square/Linear Footage of Work: Type of Work: Addition ❑Alteration Description of Work: RC R oar i FDf ( ff (t $T)V(0, OF 7-1 1—e "TO ONew '' `' epair/Replace /7 Demolition * * * * * * ** 7+ ionwwwwwwwwwipt Submittal Fee $ Permit Fee $ c771 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ 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,' otice. of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachmen E Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs , $ en (7) days after the building permit is issued. In the absence of such posted tice, the inspection will ;.t 'eapproved - spection fee will be charged. Lied ,/A Signature .L Owner or A_ent Conn tor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of 0 ar>! �J , 20 1 , by 4SS/tZci� U ij , day of ��1� , 20 -I(, by h1(4 �i •- , who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: My Commission r - State -4110W flora a ires May 23, 2015 ,soon # EE 96657 6 NOTARY PUBLI_: Sign: e Am- Dit;rits. ,f, {IIIIIIII Itte? .671 s Notary Public - tate of flarfda . My Comm. Expires May 23, 2015 '1,14, Commission # EE 98657 �� 1/ N iN,,, APPROVED BY , 1 ,)J'/ Plans Examiner Structural Review (Revised 07 /10 /07XRevised 06 /10 /2009XRevised 3/15/09) Zoning Clerk 1111111 11111 11111 1111111111111111111111111111 NOTICE OF COMMENCEMENT CF-14 2011R0480170 - P A RECORDED COPY MUST BE POSTED ON THE JOB SITgAT AM FIRST INSPECTION 0F Bk 27763 g 0632; (11)9) PERMIT NO. STATE OF FLORIDA: COUNTY OF MIAMI-DADE: RECORDED 07/20/2011 13:43:17 HARVEY MINI CLERK OF COURT TAX FOLIO NO.1% -at -007 -04 4.0 HIAHI-DADE COUNTY! FLORIDA , LAST PAGE THE UN D. ' qNR.;*.tiOrflbY:DIYes. AP.VON#140N1PrOvetnerftel.Will be made to certain re,a1,-' ProPertw.and in, accordanoewith- Dhapter713, Florida Statutes, the inforntatfort-: Is provided irt,this Notice of ComrnenCement.. • , • n . . . • • . • Space above resorracrAir NO0„67' Mei offica 1. Legal description of property and street/address: VOW tit/ 6 44 I 44.4. $145/2a.c ex-LA/0.5 f3/.1-( 2,11 loT ft• r2PC16:0003112.9in 11,267,-4463 Ot Mpg:. t7 N1 lO1T M 2. Description of improvement 128— Re) 5 14-04206 ,p #4 P' 3. Owner(s)narne andnadqrsek 1ZII 044.112_ AKON1 11 IOW ,1977,47,: 3 , 2 Interest in prOperty:. L14 PL,E. : • Name and address of fee simple titleholder: KRAMI e-p14 1■1 UJ ter?*.7'st'iq:Sti4isivis' W•-0" -516 4. Contractor's narne, address and phone number: L.()) E- . A.11 e 1J 1)14-015 5.41c-` �J t 11 4t.igirt • 4k4J. :FL_ ee:.01.- -7t4, 5477-11--.7er2A,. 5. Surety owner froth contractor, if any) ••'' • . • Name, address and phone nun*r: • • Amount of . • ' ' • • - • . ... • , ... • ••... 6. Lenderii hart* ads: rtoladrei'•-• • . 7. Persons within the State of Flbrida designated by Owner upon whom notices or other documents maybe servo:J.:as:provided, by Section 713.13(.1)(a)7; RordaStattitee,• . • ' -• - Name; addrai.s'indOntine ribitiben • ' ' • . • , 8. In addition to lilinseit'Oiaiera designates the following person(s) to receive a. copy Pf the ,Lienor's Not. Ids esprovidsd in Section 713:13(1(b) , FloridaiStatutek Name, addres.S•andPhone number .• • 9. Expiration date-of this-Notice of Commencement: • , (the exphatIon date is 1 jeer from the date of recordhig unless.* different date Is spec WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENTARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYIN'OTWICE FOR IMPROVEMENTS TO YOU PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTEDDN THE JOB .SITE-BEFORETHE FIRST INSPECTION. IF YOVINIEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY_SEFOREOOMMFMINGWORK OR RECORDING YOUR NOTICE OF COMM • Signature(s)1 Prepared By Print Name 'ntieioffice •40-e-rtroce- 7 e- Aer(s onriZenct Officer/Director/Partner/Manager • - . Prepared By. • Print Name. Tit's/Office. STATE OF FLORIDA * • n, COUNTY , • The foregoinOristrUitietit was doknoWledged before me thls t2 day of ,Z• By kg0.0,4ofie .S Se...b1:14-/‹.ts it• • • 1 Indivir:14119.,*- or Las for PerSonallY1n1OVVri,'Or'rWiiroOdoiditileinttoWitigIYoateloentitification: .. , Signature of Notary Publlb: Print Nanie: (SFAL). . • . VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES Under penalties orperjury, I declare that I have read thelOregoing and that the facts stet,- n it are true, to the best of my knowledge and belief. Signature(s) By L1 s) or Qwner(s)'s Authorized Officer/Director/Partner/Man KAQA ss'clai-tt '1"1- $ .00,14A le-00 By STA 01ANEYSIS NARO • Notary Public - State of Rork*, MyContar. Expires. May 23, 20)5 ..twasy- contagion MIE`913851 • GrIpTe. . — orig!nol Ned in this OW on........day of At2 4 2mi . , A.D. 20........ WITNESS my nano soromost Seat hiA , CLERK, dOrcuit Courts EY Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 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. IF 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: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: iO Ri Z» OIL D E'S A 3S° CIct, ±ems BUSINESS ADDRESS: 8v tU l7 /JrCITY STATE ` V ZIP CODE 5 BUSINESS PHONE: (7L�T) 6-6Y-1120 FAX NUMBER (IA Tom' 3 — 66° CELL PHONE (71a ) QUALIFIER'S NAME: ,� 1.1)5 AYelli Ei c) QUALIFIER'S LIC NUMBER: C.CC C &c / 5177149 E -MAIL ADDRESS (IF APPLICABLE): g7 c/idz, G97,4f" &oo Created on 3159109 BY MLDV 1 RV 3126109 MLDV MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. 1st FLOOR MIAMI, FL 33130 2010 LOCAL BUSINESS TAX RECEIPT 2011 MIAMI -DADE COUNTY - STATE OF FLORIDA SEPT. MUST BE DISPPLAYED AT PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER 8A - ART. 9 & 10 680402-6 THIS IS NOT A BILL - DO NOT PAY NEW BUSINESS IDAEBUILDERS & ASSOCIATES CO STATE& RECEIPT 707766 -2 8345 NW 171 ST 33015 UNIN DADE COUNTY FIRST -CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 OWNER FLORIDA BUILDERS & ASSOCIATES CO Sec. T of Business CIAL 196 SPETY BUILDING CONTRACTOR THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY ZONING REGULATORY R OF THE R COUNTY OR CmES. NOR DOES IT EXEMPT THE PERMIT FOR ANY CENSE REQUIRED BY LAW. THIS IS NOT A RTIRCATION OF THE HOLDER'S QUALIFICA- TIONS. PAYMENT RECEIVED MIAMI -DARE COUNTY TAX COLLECTOR: 02250002001 000075.00 SEE OTHER SIDE WORKER /S 1 DO NOT FORWARD FLORIDA BUILDERS & ASSOCIATES CO LUIS E AVENDANO PRES 8345 NW 171 ST MIAMI FL 33015 h,I 1ff 1JJfJJfff flfIiflfjfifliflfff /fllif lflff1I11h hJFJf,�1f1T 04 -14 -2010 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 LAWi * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: PERSON: FEIN: 04/14/2010 EXPIRATION DATE: 04/13/2012 AVENDANO LUIS 270683813 BUSINESS NAME AND ADDRESS: FLORIDA BUILDERS & ASSOCIATES CORP 8345 NW 171 STREET HIALEAH FL 33015 SCOPES OF BUSINESS OR TRADE: 1— CERTIFIED ROOFING CONTRACTOR 2— CERTIFIED GENERAL CONTRACTOR * IMPORTANT: Pursuant to Chapter 440 . 05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certificate of election under 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 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on 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. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 • QUESTIONS? (850) 413 -160 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE 04 /14/2010 EXPIRATION DATE: 04/13/2012 PERSON: LUIS AVENDANO FEIN: 270683813 BUSINESS NAME AND ADDRESS: FLORIDA BUILDERS & ASSOCIATES CORP 8345 NW 171 STREET HIALEAH, FL 33015 SCOPE OF BUSINESS OR TRADE 1- CERTIFIED ROOFING CONTRACTOR 2- CERTIFIED GENERAL CONTRACTOR IMPORTANT Pursuant to Chapter 440.05(14), F.S., an officer of a corporation who 0 elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.05(12), F.S., Certificates of election to be H exempt.. apply only within the scope of the business or trade listed on Rthe notice of election to be exempt E Pursuant to Chapter 440.05(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on 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? (850) 413-1609 CUT HERE * Carry bottom portion on the Job, keep upper portion for your records. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 09 -06 ,Jul .t0. 2011 10:00AM o.1204 P. 1/1 ACIOROr CERTIFICATE OF LIABILITY INSURANCE (MMIDDYY) DATE IYI' 071M0111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Florida Bankers Insurance 7278 SW 8 Street Miami, FL 33144 Phone (305)266 -6493 Fax (305)262 -0679 CONTACT MARTA ALONSO NAME: PHONE No, Ext): (305)266 -6493 7 (.w C, No): (305)262 -0679 ADDRESS: MARTA @FLORIDABANKERSINSURANCE.COM INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : AMERICAN VEHICLE INSURANCE CO. INSURED FLORIDA BUILDERS & ASSOCIATES CORP. 8345 NW 171 St HIALEAH, FL 33015- INSURER B INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICY EFF (MMIDDIYWY) POLICY EXP (MMIDDIYYYY) LIMITS A GENERAL V ❑ ❑ LIABILITY COMMERvI.AL GENERAL LIABILITY ❑ CLAIMS -MADE �/ OCCUR GL- 0504007379 -00 0510312011 05103/2012 EACH OCCURRENCE $ 300,000.00 PREMI ES Ea oc ED PREMISES (Ea occurrence) $ 100,000.00 MED EXP Any one person) $ 5,000.00 PERSONAL& ADV INJURY $ 300,000.00 ❑ GENERAL AGGREGATE $ 300,000.00 GEN'L AGGREGATE LIMIT APPLIES PER RO- 1/ POLICY ❑ JECT ❑ LOC PRODUCTS - COMP1OP AGG $ 300,000.00 $ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALLLOWNED . AWNED TOS AUTS HIRED AUTOS NON - OWNED ❑ MI AUTOS ❑ ■ COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS LL#B ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DEC, ❑ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIP.ARTNEPJEXECUDVE OFFICEPJMEMBER EXCLUDED? (Mandatory in NH) If yes, describe untie DESCRIPTION OF OPERATIONS below y I N N I A WC STATU- OTH- ❑ TORY LIMITS ❑ ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS J VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2nd AVE MIAMI SHORES, FL 33138 fax 786 - 463 -6500 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) QF O 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Miami Shores Vtiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 AFFIDAVIT OF COMPLIANCE WITH ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE -BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PURSUANT TO SECTION 553.844 F.S. To: Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores, Fl 33138 Re: Owner's Name: /c if,/'(» , -5 1) 1W'fKO V Property Address: / 7 N 1'( /0 7 677e Y ..Z./ /4/a 0xee,, AEI Roofing Permit Number: Dear Building Official: I /fCG & .'h'/,e. a 4 % 4AVb'certify that I have improved the roof to wall connections of the referenced property as required by the Manual of Hurricane Mitigation Retrofits for Existing Site -Built Single Family Residential Structures as adopted by the Florida Building Commission by Rule 9B -3.047 F.A.C. Signature State of Florida County of Dade Print Name 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 day of <lJ` j 20 y Notary Public, Sate of Florida at La • e 1 . ��, * I t,, oo e��., DIANEYSIS HARD = : ° - Notary Public - State of Florida (SEAL) _ - ►� �,,, � �` w My Comm. Expires May 28, 2015 ;sofft.010 Commission • EE 19857 • - Revised on 5121/2009 - - - -- 44/44__• FINAL COMPLIANCE ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 20 High - Velocity Hurricane Zone Uniform Permit Applicati Master Fle mlt $46: ontractor's Name 1-4) . V C/U b-A- ill 0 Miami Shores Village SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS Process No. Job Address (, ❑ Low Slope ❑ Asphaltic Shingles ❑ Mechanically Fastened Tile X Mortar /Adhesive Set Tile ❑ Metal Panel /Shingles ❑ Wood Shingles /Shakes ❑ Prescriptive BUR -RAS 160 ROOF TYPE ❑ New Roof eroofing ❑ Recovering ❑ Repair ❑ Maintenance 6 me ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) 1g 1/1 {� Total (SF) /83 6 ►* Section R (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. M 49; 1 *:••. • • • •• • • • • FLORIDA BUILDING CODE — BUILDING ••• • • • • • :••• • • • • • •• • • • : •• •• : • • • • • •• •• • • ••• • ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 High - Velocity Hurricane Zone Uniform Permit Application Form. Section C (Low Slope Application), Fill in specific roof assembly components and identify manufacturer (If a component is not used, identify System Manufacturer: Product Approval No.: Design Wind Pressures, From RAS 128 or Calculations: Pmax1: Pmax2: Pmax3: Max. Design Pressure, from the specific Product Approval system: Deck: Type: Gauge/Thickness: Slope: Anchor/Base Sheet & No. of Ply(s): Anchor/Base Sheet Fastener/Bonding Materia Insulation Base Layer Base Insulation Size and Thickness: Base Insulation Fastener /Bonding Material: Top Insulation Layer Top Insulation Size and Thickness: Top insulation Fastener/Bonding Material: Base Sheet(s) & No. of Ply(s): Base Sheet Fastener/Bonding Material: Pty Sheet(s) & No. of Ply(s): Ply Sheet Fastener /Bonding Material: Surfacing: Fastener Spacing for Anchor/Base Sheet Attachment: Field: " oc @ Lap, # Rows © " oc Perimeter " oc @ Lap, # Rows @ " oc Corner: " oc @ Lap, # Rows @ " oc Number of Fasteners Per Insulation Board: Field Perimeter Corner Illustrate Components Noted and Details as Applicable: Woodblocking, Gutter, Edge Termination, Stripping, Flashing, Continuous Cleat, Cant Strip, Base Flashing, Counter - Flashing, Coping, Etc. Indicate: Mean Roof Height, Parapet Height, Height of Base Flashing, Component Material, Material Thickness, Fastener Type, Fastener Spacing or Submit • • •• • • • • • • • • • i ROOF ASSEMBUES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 High - Velocity Hurricane Zone Uniform Permit Application Form. ,Spr_tion II (Steep Shaped Roof System) Roof System Manufacturer: e Ah7C,e: L/*U 4 tone' e T L Notice of Ace �cee Number: - Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations): P1: -6.y ,, P2: -1,3 , (0 P3: 'lI (' ?/ Maximum Design Pressure (From the Product Ap r valSpecific System): Roof Slope: • • 12 Stepp slnped Roof System Desc ription \ Deck Type: 6g. P! oo 4 • Type Underlaymen Insulation: Fire Barrier: Nyik ')/4 Fastener Type & Spacing: Adhesive Type: fa.f tea r 4/44-1 Type Cap Sheet: Mean Roof Height: VI -11) Ptd5 Roof Covering: Type & Size Drip Or lip 14 141 ••••Edge:,.•.• ', e'ih0'D s 9ile ,Q f .rnl v et-foci/oak ite� a ri ••• ••• ••• ••• • • • • • • .•.• • .• • • • . •• • FLORIDA BUILDING CODE — BUILDING • • ••• • • • • • • • • • • • • • : • • • • ; :•'•; • •• •: • . ••• • ••0 • ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 High - Velocity Hurricane Zone Uniform Permit Application Form. Sgntinn E ITileSiIr uIatinnc) For Moment based tile systems, choose either Method I or 2. Compare the values for Mr with the values from Mf. If the Mf values are greater than or equal to the Mr values, for each area of the roof, then the tile attachment method is acceptable. /� j qq QQ Method 1 "Moment Based a Calcu none er RAS 127" (Pl:'7 it x l!/V7 = 0,01_,,,,, ! =Mrt t l lx Product Approval Mr (P2' x 'Pk = !/� I� - Mg ' 4 = Ma 1`1 -�V Product Approval Mf li '- x . =�j�1O - M Al , iV F Product Approval M �3 % g' = = Mfi a _. 1 PPro f Liao Method 2 "Simplified Tile Calculations Per Table Below" Required Moment of Resistance (Mr) From Table Below Product Approval Mf Mr required Moment Resistance* b(G Mean Roof Height + Roof Slope ,, 2:12 3:12 4:12 5:12 6:12 7:12 1 20' 34.4 36.5 25' 30' 40' 38.2 39.7 42.2 32.2 34.4 36.0 37.4 39.8 30.4 32.2 28.4 30.1 26.4 28.0 33.8 35.1 37.3 31.6 32.8 34.9 29.4 30.5 32.4 27.1 28.2 30.0 *Must be used in conjunction with a list of moment based ti e systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based tile systems use Method 3. Compared the valu forF 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 . ceptable. • Method 3 "Moment Based Tile Calculations Per RAS 127" (PI: x L = x w: = ) - W: x cos 0 = Frl Product Approval F' (P2: x L = x w: = ) - W: x cos 0 = Fa Product Approval F (P� = x w: = _) - W: cos 0 = F Product Approval F xL Where to • btain Information Description Symbol Where to find Design Pressure P1 or P2 or P3 RAS 127 Tabl= 1 or by an engineering analysis prepared by PE based on ASCE 7 Mean Roof Height H Job Site Roof Slope 0 Job Site Aerodynamic Multiplier x Product Approval Restoring Moment due to Gravity Mg Product Approval Attachment Resistance Mf Product Approval Required Moment Resistance MB Calculated Minimum Attachment F Product • Approval • • • • • • • • • • • Required Uplift Resistance Fr • • • • • • • • Calculated • • ; • • • • ••• • • • • • • Average Tile Weight W • • •• Product Apd t•Val • • • • Tile Dimensions L= length W =width Product Approval • • • • ••• ••• • • • • • • • • • • • • . • All calculations must be submitted to the building official at the time of itipp ,cart n. • • • • • • • • • FLORIDA BUILDING CODE — BUILDING •• • • • • • • • • ••• • • ••• • • • • • • • • • • • ••• • • • • • • • • • • s •• •• • :• •• ••• ••• • • • ••• • • MIAMI•DiADE COUNTY BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT (BNC) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) MIAMI -DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 33175 -2474 T (786) 315 -2590 F (786) 315 -2599 www.mtamidade,gov /buildine/ Eagle Roofing Products LLC 1575 East C.R. 470 Sumterville, FL 33585 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed and accepted by Miami -Dade County BNC - Product Control Section 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 Section (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. BNC reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Section 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: Malibu Concrete Tile 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 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 distributors and shall be available for inspection at the job site at the r.eistie.si of the Bt{i1Qin� 61% iaial. • This renews NOA #06- 0526.09 and consists of pages 1 tbrougb.. 7• •. ;• : • • • The submitted documentation was reviewed by Alex Tigers. • • • • • MlAMFDADE COUNTY APPROVED • • • • • • • ••• • • • • • • •• • • • • •• • •�• • • • • • • ; NOA No.:11- 0321.01 • • Emilration Date: 10/05/16 Approval Date: 05/12/11 Page 1 of 7 • • • • • • • • • • • • • • • • • . • . • •. •. • •• .• •,• • • • • ROOFING ASSEMBLY APPROVAL Category: Sub Category: Material: Roofing Roofing Tiles Concrete 1. SCOPE: This approves a system using Eagle Roofing Products Malibu Concrete Roof Tile, as manufactured by Eagle Roofing Products LLC in Sumterville, FL. 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 Applicant Dimensions Malibu Concrete Tile 1 =17" w = 12'/z" '' /" thick Trim Pieces 1= varies w = varies varying thickness Test Product Specifications Description TAS 112 Low profile, interlocking, high pressure extruded concrete roof tile equipped with three nail hole and double roll ribs. For direct deck or battened nail -on, mortar or adhesive set applications. TAS 112 Accessory trim, concrete roof pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tile profile. • .••:• :; . • :• • • •• : . ••• •• • • •: ::•• :••• •• • •• •. • • •.• • :• • : •.• •• :NOA No.:11-0321.01 • • • • • • . • : • .1xPlratlon Date: 10105 /16 • • • • • Approval Date: 05/12/11 Page 2 of 7 • • • .•• • • • • • ••• • • • • •• •• •.• ••• • • ••• • 2.1 EVIDENCE SUBMITTED: Test Agency PRI Construction Materials Technologies Redland Technologies Redland Technologies Redland Technologies The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. Redland Technologies Redland Technologies Professional Service Industries, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. Test Identifier PR106I78 Test Name/Report TAS 112 7161 -03 Static Uplift Testing Appendix III TAS 102 & TAS 102(A) 7161 -03 Wind Tunnel Testing Appendix II TAS 108 (Nail -On) P0402 Withdrawal Resistance Testing of screw vs. smooth shank nails 94 -060B 94 -084 P0631 -01 Letter Dated Aug. 1, 1994 224 -47099 25 -70941 25- 7094 -7 25- 7094 -4 Project No. 307025 Test #MDC -76 25- 7183 -1 25- 7183 -2 Static Uplift Testing TAS 101 (Adhesive Set) Static Uplift Testing TAS 101 (Mortar Set) Wind Tunnel Testing TAS 108 (Mortar Set) Wind Tunnel Testing TAS 108 (Nail -On) Physical Properties TAS 112 Static Uplift Testing TAS 102 (4" Headlap, Nails, Direct Deck, New Construction)EI Static Uplift Testing TAS 102 (4" Headlap, Nails, Battens) Static Uplift Testing TAS 102 (4" Headlap, Nails, Direct Deck, Recover/Reroof) Wind Driven Rain TAS 100 Static Uplift Testing TAS 102 (2 Quik Drive Screws, Direct Deck) Static Uplift Testing TAS 102 ..(2.Quik -Drbie $ccews�Battens) • ; ' • • . 4, ; • •• • • ••• ••• ••• . • • • • • • ; • • • • • •. •• •• • • Date 08/23/06 Dec. 1991 Dec. 1991 Sept. 1993 March, 1994 May 1994 July 1994 Aug. 1994 Sept. 1994 Oct. 1994 Oct. 1994 Oct. 1994 Oct. 1994 Feb. 1995 Feb. 1995 • • • ;• • NOA No.:11- 0321.01 • • • • EStpiration Date: 10/05/16 Approval Date: 05/12/11 Page 3 of 7 • • • ••• • • • • • : • •' ': • • •• •' •• • The Center for Applied Engineering, Inc. Celotex Corporation Testing Services Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. 25- 7214 -2 25- 7214 -6 528454 -2 -1 520109 -2 Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Calculations Calculations Static Uplift Testing TAS 102 (1 Quik -Drive Screw, Direct Deck) (1 Quik -Drive Screw, Battens) Static Uplift Testing TAS 101 Two Patty Adhesive Set System 25 -7183 25 -7094 25 -7496 25 -7584 25- 7804b -8 25- 7804 -4 & 5 25- 7848 -6 Aerodynamic Multiplier Restoring Moment Due to Gravity March, 1995 Sep. 1998 Dec. 1998 April 1999 March 1995 February 1996 April 1996 December 1996 Sep. 2006 Sep. 2006 3. LINIITATIONS: 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile applications, a static field uplift test in accordance with TAS 106 may required, refer to applicable building code. 3.3 Applicant shall retain the services ofa 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. MIAMbDADE COUNTY APPROVED •• • • .. ;• .. • • ••. •. • • • • ... • • • • :• • • • • • • ' • • • ; : NOA No.:11- 0321.01 . • • • • .• E:q iration Date: 10/05/16 • • • • • • • Approval Date: 05/12/11 • Page 4 of 7 ••• • • • • • • • • • • • • • ••• • • • • • • • • • . •. •• •• •: ••. ••• • 4. INSTALLATION 4.1 Eagle Roofing Products LLC Malibu Concrete 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 Table 1: Average Weight (W) and Dimensions (ix w ) Tile Profile Weight W (lbf) Length -I (ft) Width -w (ft) Malibu Tile 9.5 1.417 '1.04 Table 3: Restoring Moments due to Gravity - Ma (ft-Ibf) Tile Profile Table 2: Aerodynamic Multipliers - X ft 3) 5 ":12" Tile 7 ":12" greater Battens A. (ft3) X. (ft3) Battens Profile Battens Batten Application Direct Deck Application Malibu Tile Battens Direct Deck 0.305 0.282 Table 3: Restoring Moments due to Gravity - Ma (ft-Ibf) Tile Profile 3 ":12" 4 ":12" 5 ":12" 6 ":12" 7 ":12" greater Battens or Direct Deck Malibu Tile Battens Direct Deck Battens Direct Deck Battens Direct Deck. Battens Direct Deck 6.30 6.65 6.21 6.54 6.08 6.41 5.93 6.25 5.77 6.08 Table 4: Attachment Resistance Expressed as a Moment - Mt (ft-Ibf) for Nail -On Systems Tile Profile Fastener Type Direct Deck (min 15/32" plywood) Direct Deck (min. 19132" plywood) Battens Malibu Tile 2 -10d Ring Shank Nails 27.8 37.4 28.8 1 -10d Smooth or Screw Shank Nail 8.8 11.8 4.1 2 -10d Smooth or Screw Shank Nails 16.4 21.9 7.1 1 #8 Screw 25.8 25.8 22.9 2 #8 Screw 47.1 47.1 49.1 1 -10d Smooth or Screw Shank Nail (Field Clip) 24.3 24.3 24.2 1 -10d Smooth or Screw Shank Nail (Eave Clip) 19.0 19.0 22.1 2 -10d Smooth or Screw Shank Nails (Field Clip) 35.5 35.5 34.8 2 -10d Smooth or Screw Shank Nails (Eave Clip) 31.9 •. ••• : $1.S • ; .' • t : 32.2 • : •• :: ••• -• • • 2 -10d Ring Shank Nails' 43.0. ,• •4: • • •� • t'7.8• 50.9 •1 Installation with a 4" tile headlap and fasterners are lofted a min. of 2'/z" from head of tile. MNAMODADE COUNTY APPROVED • ••• . ••• ..• • • • • • • • • :. . sr • • • ;110A 14o.:11-0321.01 :.. exptration Date: 10/05/16 Approval Date: 05/12/11 Page 5 (0 '7 • • • ... ... • • • .: • • • •. • • • • • • • • • : 41,6 •: : :s*: •. ••• • Table 6: Attachment Resistance Expressed as a Moment Mf (ft-Ibf) for Two Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Malibu Tile Adhesive'` 26.13 2 See manufactures component approval for installation requirements. 3 Flexible Products Company TileBond Average weight per patty 11.4 grams. Polyfoain Product, Inc. Average weight per patty 8 grams. Table 6: Attachment Resistance Expressed as a Moment - Mf (ft-ibf) for Single Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Malibu Tile Polyfoam PolyPre" 86.61" Polyfoam PolyProTM 45.53 4 Large paddy placement of 54grams of PolyPrcP. 4 Medium paddy placement of 24grams of PoIYProTM. 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 ". EAGLE.-oer" FLORIDA MALIBU CONCRETE ROOF TILE LABEL, SUtITTyRVN.ISE.,PLANT (LOCATED OV INI E:R81p OF:Ilten ' • •• •: : : : ' :: ••• • ••• •• • •• • ••• • ••• ••• ••• • • •NOANo.:11- 0321.01 MAMMAL* COUNTY • ▪ • • • • ;• • • •• Eltu ration Date: 10/05/16 • • • • • • ' •' • • • • Approval Date: 05/12/11 • Page 6 of 7 APPROVED • • • • ••• • • ••• • • • • • • • • • . • • •• • •• •• ••• ••• • Table 7: Attachment Resistance Expressed as a Moment - Mf(ft-Ibf) for Mortar Set Systems Tile Profile Tile Application Attachment Resistance Malibu Tile Mortar Set' 20.60 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 ". EAGLE.-oer" FLORIDA MALIBU CONCRETE ROOF TILE LABEL, SUtITTyRVN.ISE.,PLANT (LOCATED OV INI E:R81p OF:Ilten ' • •• •: : : : ' :: ••• • ••• •• • •• • ••• • ••• ••• ••• • • •NOANo.:11- 0321.01 MAMMAL* COUNTY • ▪ • • • • ;• • • •• Eltu ration Date: 10/05/16 • • • • • • ' •' • • • • Approval Date: 05/12/11 • Page 6 of 7 APPROVED • • • • ••• • • ••• • • • • • • • • • . • • •• • •• •• ••• ••• • 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 Building Official or Applicable building code in order to properly evaluate the installation of this system. PROFILE DRAWING MALIBU CONCRETE ROOF TILE END OF THIS ACCEPTANCE • • • .. • •• • ... •• •. • • ... • • • • • • • . •• • . • • • • • : NOA No.:11- 0321.01 • • Expiration Date: 10/05/16 Approval Date: 05/12/11 Page 7 of 7 • • • ••' : • 4100 • • . • : • • • • • •• .. : • ' ; SECTION R4402.13 HIGH VELOCITY HURRICANE ZONES — REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 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. The owner's initial in the designated space indicates that the item has been explained. 1. Aesthetics - Workmanship: the workmanship provisions of Section R4402 are for the purpose of providi g that the roof system meets the wind resistance and water instruction 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. S Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Section R4403. (The roof deck is usually concealed prior to removing the existing roof system). 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 to be performed. 4. Exposed Ceiling: 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 penetration of the underside of the decking may not be acceptable. This provides the option of maintaining the rrappearaance. 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. Pounding can be an indication of structural distress and may require the review of a professional structural engineer. Pounding may shorten the life expectancy and performance of the new roofing system. Pounding conditions may not be evident until the original roofing system is removed. Pounding conditions should be corrected. 6. Overflow scuppers (wall outlets): It is required that rainwater flows off so that the roof is not overlo ed 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. Ventilation: Most roof structures should have some abilk to %nt natural airflow through the interior of the s ture assembly (the building iVOlf) ahe exgst4Ig.arlogntof attic ventilation shall not be reduced. It may �:� beneficial to consider additlbnal ve•r inifthreh cap'rQsuf in extending ervice life of the • • ro ture Date Revised on 7/9/200: " D • •.• •• • • dintractc r iigp8tura • • •• %• • ••' ••• ••• • • • • • • • •••• • T. ••• • • • • • • • • • • • • • ••• • • • • • • • •• •• • t ••••: •.- ••• • Dat c®f/ Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 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: 10050 NE 2nd Ave Miami Shores, Fl 33138 Re: Owners Name: X RA / ,1/& 11 4-1 < t/ Property Address: /7 /V W /0 737 Roofing Permit Number: Dear Building Official: I gg building because: The just valuation for the structure for purpose of ad valorem taxation is Tess than $300,000.00. Please attach proof of ad valorem taxation. o The building was constructed in compliance with the provisions of the Florida Building Code (FBC) or with the provisions of 1994 edition of the S th Flo a Building Code (1994 SFBC) A1/ o4-d./ , /tr)e.e g keYdrtify that I am not required to retrofit the roof to wall connections of my State of Florida County of Dade XR4v5iII /2 .56-Z Al 17 Print Name DtANEYSIS HARO Notary Public - State of Florida • My Comm. Expires May 23, 2015` _ • • • • • �r o 'sworrP,° gesicifs tthe/ste;lslhQ•ownerfor the above property mentioned. The undersigned, being th Sworn to and subscribed before me this f,9 • .dayof� 2a� • • • . je Notary Public, Sate of Florida at Large • • Aio/ ois ••• • • • When the just valuation of the structure for purpose of ad valorem r : tlon Is equal to or more than $300,0QO�Q, aed the blinding was not constructed with FBC nor a 1994 • SFBC. Then you must provide a building application from a General Contractor Witt R of to VMaII qpiectioit HuiIcage I+Fiitlgatfon. ••• • Revised on 5/21/2009 Property Information Report My Home Page 1 of 1 ade Property Information Report Summary Details: Folio No.: 11- 2136- 007 -0470 Property: 17 NW 107 ST Mailing Address: KRASSIMIR S SEDMAKOV 17 NW 107 ST MIAMI SHORES FL 33168- Property Information: Primary Zone: 0800 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds/Baths: 2/1 Floors: 1 Living Units: 1 Adj Sq Footage: 1,333 Lot Size: 9,225 SQ FT Year Built: 1940 Legal Description: DUNNINGS MIAMI SHORES EXT NO 3 PB 42 -33 LOT 15 BLK 211 LOT SIZE 75.000 X 123 OR 19256 -4403 08 2000 4 COC 23037 -2823 01 2005 1 Assessment Information: Year: 2010 2009 Land Value: $51,170 $106,049 Building Value: $100,975 $107,973 Market Value: $152,145 $214,022 Assessed Value: 52,145 % $214,022 Exemption nformation: Year: 2010 2009 Homestead: $25,000 $25,000 2nd Homestead: YES YES Taxable Value Information: Year. 2010 2009 Taxing Authority: Applied Exemption/ Taxable Value: Applied Exemption/ Taxable Value: Regional: $50,000/$102,145 $50,000/$164,022 County: $50,000/$102,145 $50,000/$164,022 City: $50,000/$102,145 $50,000/$164,022 School Board: $25,000/$127,145 $25,000/$189,022 Sale Information: Sale Date: 5/2010 Sale Amount: $180,000 Sale O /R: 27314 -0030 Sales Qualification Description: Sales qualified as a result of examination of the deed View Additional Sales [Close window], [Clic ILere•to filar" •• •• • • •• • • • ' •• • • . • ••• • • This report was created on 7/20/2011 10:16:15 AM for reference purposes only. • ••i • ' s i 'i' Web Site © 2002 Miami-Dan coup. All,rgirtVeseved, • • • • • • • ;•• • • • • • • •• • ••• •• • � , ••• • : . • • • • ••• • • • • • • • • •• • • http: / /gisims2. miamidade. gov/ myhome /proptext_print.as�•olio =' 1121 • ••• • • • • • • • ' • •• 'i 3.6'0070470 &cmd = 7/20/2011 MIAMI DH COUNTY BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT (BNC) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Polyfoam Products, Inc. 11715 Boudreaux Road Tomball, TX 77375 MIAMI -DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 33175 -2474 T (786) 315 -2590 F (786) 315 -2599 www.miamidade.eov /building/ SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed and accepted by Miami -Dade County BNC - Product Control Section 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 Section (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. BNC reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Section 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: Polypro ' AH160 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 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 distributors and shall be available for inspection at the job site at tjle request•ottlf 1 :etlding Official. .• This renews NOA# 06- 0201.02 and consists or pages 3 tt►rqu�h 7.: • • • • • The submitted documentation was reviewed by0(lex=Pigeld. • MIAMI•DADE COUNTY APPROVED ••• • • • •• • • ••• .. • • • • • • • • • • • • • • • • • • • • • • •• • • •.' ••• • • • • • • • ••• • • .•. • • • • • • • • • • • ••• • • • • • • • •.••• •.• •• • • •• •• ••• • NOA No.: 11- 0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 1 of 7 ROOFING COMPONENT APPROVAL: Category: Sub Category: Materials: Roofing Roof tile adhesive Polyurethane 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 Product Description Specifications Polypro 0 AH 160 N/A TAS 101 Two component polyurethane foam adhesive Foampro® 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 Density Compressive Strength Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability Closed Cell Content Note: Test ASTM D 1622 ASTM D 1621 ASTM D 1623 ASTM D 2127 ASTM E 96 ASTM D 2126 ASTM D 2856 Results 1.6 lbs. /ft.3 18 PSI Parallel to rise 12 PSI Perpendicular to rise 28 PSI Parallel to rise 0.08 Lbs./Ft2 3.1 Perm /Inch +0.07% Volume Change ® -40° F., 2 weeks +6.0% Volume Change @158 °F., 100% Humidity, 2 weeks 86% The physical properties listed above are presented as typical average values as determined by accepted ASTM test methods iqd Are sobbec to potnaAr manufacturing variation. • . . •• • •• •• ••i • . • •• •.• ••• •• • • • • • • • • MIAMI •DADE COUNTY APPROVED • ••• ••• ••. • • • • • • • • • • • • •. •• • • • • • • • • • • ••• • • • •• ••• • • .•. • • • • • • • • • • • ••• • • • • • • ..•0• � • • •:• • • • . : 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[1j 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 03/02/99 520109 -2 -1 LIMITATIONS: 1. Fire classification is not part of this acceptance. Refer to the Prepared Roof Tile Assembly for fire rating. 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. 4. Roof Tile manufactures acquiring acceptance for the use of Polypro® AH 160 roof tile adhesive with their tile assemblies shall test in accordance with TAS 101. S. 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) • • ••: • • • • • I • • • —W • ; "' • F'— ..' • • : • • : • • • • • MS • • ••• • • • ••• •.• . • • • • • • • • • • • • • • • • • • • • • • • •• • •• ... • • • • • .•• • • . • • • . ••• • • • • • •• •' •. • • • • ••• • •' • • • • • • • • • • • • •• • •• ••• • • NOA No.: 11- 0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page3of7 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® AH 160 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. Polyprog AH160 shall be applied with Foampro RTF1000 or ProPacko 30 & 100 dispensing equipment only. 7. Polypro® AH 160 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® AH 160 placement and minimum patty weight shall be in accordance with the 'Placement Details' herein. Each generic tile profile requires the specific placement noted herein. Table 1: Adhesive Placement For Each Generic Tile Profile Tile Profile Placement '. Detail Single Paddy Weight Min. (grams) Two Paddy Weight per paddy Min. (grams) Flat, Low, Hit Profiles #1 35 N/A High Profile (2 Piece Barrel #1 17 /side on cap and 34/ • an N/A Flat, Low, Hi : Profiles #2 24 N/A Flat, Low, Hi : h Profiles #3 8 LABELING: All Polyproit AH160 containers shall comply with the Standard Conditions listed herein. BUILDING PERMIT REQUIREMENTS: As required by the Building Official or appJiiabletbitiltlit g code In craer to property evaluate the installation of this system. • • • • • ••• •.• '•• '• • . •. MANMADE COUNTY APPROVED • • ••• • • • • •.• ••. • • • • • • • • • • • • • • • • • • • • • • • • •• •• ••• ••• ••• • • • • ••• • • • • • • • • ••• • • ; • • • • :• •• • 000 • . NOA No.: 11- 0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 4 of 7 ADHESIVE PLACEMENT DETAIL 1 SINGLE PATTY Nall through plastic cement Underlaymeol 1 Paddy (Beneath III.) 10 In. Ems Course Emanate Fascia Eave coma onty Kelp adhesive approx. 41a. up frem mephitis Nall through plastic cement Undrulayment Paley (Binsath 10 In. Erm Course Ewe course only: Keep adtmales approx. 4 le. up horn weephotes • MIAMI-DAD COUNTY APPROVED Fuels Eva Co. 1) Place enough adhesNe to taloa 1710 23 .°1448 axijsfor ,... square Indies In total with Ms pen Ille "'"" 1".""." 2)Tual novas upside down. Place adhuhre 112 In. To 1 In. From outstrip adge of come.. Than Inaid the Se. Mal through plastic tenni (1)P Porilori MN eye mums COY& Ele. Abut lo second coats* of pan Elm Ensure we end of pan OKI war Mei are ftush at ewe line. Ewe dome Wriphote Pada (mortar shown) • • • • • • . • • .. ° • °° ° °°°°°° • • ° • • • °°°°°°°°° • • • • • • • • • " • • * • • • • • • • •S� • • • • • • • • 1 • • • • • • • • • • • • . • • • • • • • • • • • • • • • • • • 111 • • • • 111 • • • • 111 • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 111 • • NOA No.: 11-0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Pap 5 of 7 ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY Nall through plastic cement Underlaymant 71n. In. Paddy (Beneath Tile) Eave Course Fascia Pleephole Eave closure Drip adp •• MIAMIOADE COUNTY APPROVED ••• • • • • • •• • • • • • ••• ••• '•. ••• • • •• • • • ••• • • • ••• • +• • • • • • • • • • • • • • • • • • • • • • •• •• • ••• •. • ••• • • • .•• • • • • • • • • •.• • • • • • • • • ••• • • • ••• • • • • • • • • • •.'•• ••• • • NOA No.: 11- 0124.04 Expiration Date: 05/10/12 Approval Date: 04 /14/11 Page 6 of 7 ADHESIVE PLACEMENT DETAIL 3 DOUBLE PATTY Nail through plastic cement Paddy (between tile) Paddy (under tilo) S in x 3 In. Single paddy an under- layment Single paddy under tale Single paddy on top of We e course M. X 7 in. medium size paddy eave Fascia course only MIAMIOADE COUNTY APPROVED Nall through plastic cement Nall through plastic cement Single paddy under tile Underiayment Single paddy between the 2 In. x 7 in, medium size paddy only course only *in.x3in. Single 41n. paddyon under• layment Single paddy on top of tile Cause Fascia Weephole Eave closure Drip edge Single paddy between tile Pilln.x 3 In. Single paddy onundedayment Single paddy on top of the Eave Course Eave Closure 2 In, x 7In. medium size paddy eave course only Fascia END OF:'� � 'T* CE • • • • • ••• ••• • • • ••• • • • NOANo.:11- 0124.04 • • •• • • ' • • • • • • • • • • • • • Expiration Date: 05 /10/12 Approval Date: 04/14/11 Page 7 of 7 .•• • •••'•• • • • • • ••• • • • ••'•• • • •:. ••••• ••• • • • Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 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: 10050 NE 2nd Ave Miami Shores, Fl 33138 Re: Owner's Name: ,< gA- /# 1/ - 141-K0 r/ Property Address: / 7 # W 10 757`F- T 11i2.e g Roofing Permit Number: Dear Building Official: i )' /,Cl /.1g ✓..9 f ,i<d /rtify 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. o The building was constructed in compliance with the provisions of the Florida Building Code (FBC) or with the provisions 6 lirffi Sig !turfI w r of 1994 editi: n of the S th Flo ' a Building Code (1994 SFBC) State of Florida 4' -- K ' 4$5 /,x./ /' s. $ Z /IA V Print Name ��Pµtn „d,,. County of Dade The undersigned, being th Ir � word, ° t he /she is the owner for the above property mentioned. Swom to and subscribed before me this day of -,./11/ 2-ew DIANEYSIS HARD Notary Public - State of Roue • My Comm. Expires May 23, 2015 Notary Public, Sate of Florida at Large /44 • When the just valuation of the structure for purpose of ad valorem t: ; . n Is equal to or more than $300,000.00, and the building was not constructed with FBC nor a 1994 SFBC. Then you must provide a building application from a General Contractor for the Roof to Wan connection Hurricane Mitigation.