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RF-11-1704-4 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 164567 Permit Number: RF -9 -11 -1704 Scheduled Inspection Date: October 07, 2011 Inspector: Bruhn, Norman Owner: DOWSON, DAVID AND NANCY Job Address: 65 NE 95 Street Miami Shores, FL 33138- Project: <NONE> Contractor: AKG INSPECTION SERVICES INC Permit Type: Roof Inspection Type: Final Roof Work Classification: Tile /Flat Phone Number (305)754 -1685 Parcel Number 1132060130710 Phone: (305)235 -5511 Building Department Comments RE ROOF FLAT AND TILE ROOF Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments October 06, 2011 For Inspections please call: (305)762 -4949 Page 6 of 15 • Lab Report No. S10-1644 FLORIDA TEC Providing Solutions to the Roofing Industry C.A. #: 26095 Lab Certificate: 09- 0715.02 CONCENTRATED UPLIFT LOAD TESTING ON ROOF TILE TO COMPLY WITH METRO -DADE COUNTY PROTOCOL TAS -106 PROPERTY ADDRESS: 65 NE 95 St. Miami OWNER: Dalson CONTRACTOR: AKG Inspection Services TILE TYPE: Flat ATTACHMENT.: PolyfoamTM / PolyproTM Testing Equipment: Digital Chatillon DFIS 200 Test Tabulation PERMIT No: RF9111704 ROOFING SQUARES: 17 ROOF PITCH.: 3:12 INSPECTOR INITIALS: AA TEST DATE: 10/6/11 Required Testing Force: 35 Ibs No. RESULT No. RESULT No. RESULT No. RESULT No. RESULT 1 -10 Passed 11 -20 Passed 21 -29 Passed THIS ROOF HAS: PASSED © FAILED❑ THE STATIC UPLIFT IN ACCORDANCE WITH MIAMI -DADE COUNTY TAS 106. Reviewed by: 6—tr Alberto Cardona, 1 E. -Lic #17138 10735 SW 2164' St. Unit 416 Miami, FL 33170 www.floridatec.net Tel: (305) 256 -4550 Fax (305) 256 -6833 NOTICE OF COMMENCEMENT A MOM) COPT MUT BEFOSTEll OM IR 400 WE AT OE OF AMITTIMSFECOOM ' AX FOU 04 -0 FRONT NO T 0 NO 4/. STATE OP FLORIDA! COUNTY OF MIAMI-PAD G - • • ThE UNDERSIGNED hereby gives notice that Improvemente will be made to *en sod property, and M etecesdance with Chapter 713, FieridaStatutes, the faiiewihy IrdemortIon is provided in this Nolte of OternmencemeM. 53 111111111111111111111111111111111111111111111 CFN 201 1RA:163167B OR Bk 27831 P9 4663; (1ps) RECORDED 09/20/2011 1225:03 HARVEY RUVIHr CLERK OF COURT MIAMI-DADE CDUNTYr FLORIDA LAST PAGE. 2. Description of Irnprovamen ofz_ 73431 3. Oster(s) -------VZrl--narrieismlesitkette: raw cy 0r....J 4' op.) ! -Z.5"-Z- &,..:47_,122-1,..._fiz__ intoseit in property: (.4 ni-er pra-, re 1 1 3 3 136 Name anel adebeas of fee simple titleholder: 4. Contractor% name, add= arid plane number: A k 6 1.44,51dec.--1-4,d Sertej (...._ 3,(, se-, 1 3 at c.i.- S. Surety! (Payment ixeid required by owner from cortratata, If 3nY3 Riems, address and ohone mother Amount Of bond O. Ler:dors name and add's= 1. Persons Men Meddle el Florida designated by Owner upon whom notion or ether documerds mew be flat‘tad as provided by Section 713.13(1)007., Florida StatuteS, Na address End phone number. '1-.1 1 &In Adamant° himself, OWneirs designates the fallowing person(s) ta receiv3 a oOpy ofthe fiances Notes ay an:A/Meat Section 113.12,(1)11c), Rorida-Sialutes. Name, address end *me ninfbar 345 5 afe...‘ ,3 33.:317 -17:61 9. Expiration date of et% NOlko 01 Cornmanoament Pie expiration daitteriWr viont tie silos et moraine urbane detente &AO teeni/K WARNINI3TOOWNMANT PAniertSMADFEY TWEOWNERAFTER TfiEEXPIRAiON °ME NIMGE OF CtetireEtICEMENT ARECONSIDERED IMPROPER meows maim attAFTER 713, PARN, sEarioni 713.13. FLORIOAROXVIYA AND OAN MOW is YOUR PAYING TWIDE FOR IMPROVEMiavrs TD YOUR PROPERTY. A NOME OF GONINIENOEMWT IA= as REDDRDEC AND POSTED CiN THE JOR SITE UFO* THE MST iNSPECTION. IF YOU INTEND TO OBTAIN FINANVINe, OONOULT WITH yourti-EMP OI OR AN ATTORNEY BEFORE OOmmaarala WORK OR RECOrdItia Y • - NOTICE OF COMMENCEmEtit • Sig nature(e) o Omega)* Authorized OftlaerarectOrtParaterAilartager Flawed By 4111/,',./ ProaredSY Print Name Prim Name ; Me/Office Nee/Office STATE OF FLORIDA OOLINrt OF MANI-DADE The foregoing Instrument UM orally known, or ij r,vc:ot;otel.. r I'i? g ,:1CT 3Ct- 111.1 41.4-v c( 33-'•s6 • E elopue 2 20 owinitaiwigildt1110f1030004 : of N , e. PAL) • /0 41'43.,.20 .4,1 ; ' .111.° Under penalties at perpirt I decline that I hews read MtatoregOing and. that the Mote stated loft ate trua, to the best of my karrokidge and belief. .1 aignidure(s or OwnerisY* Authorized Oficen/DIrtator/Partner./Manager who sighed above! By 11110 By' e:=J‘.1-; KAM. 41. 60111 STATE OF FLORIDA, COUNTY OF DADE '1 HEREBY CERTIFY thef this is %I.ra copy of the ,Jfigind filse in ' 'fiat • „dot' of A020 (/ WITNESS my hand a Mold Seat HARVEY RUVIN, CL of #and County Courts By. BUILDING T FRC 20 Miami Shores Village Building Dep : nt $OSO N,E 2nd Avenue, Miami Ste, Florida 33138 Teb MS) 995.2204 Fam (305) 756.8972 LT L 'MORMON'S PHONE Op 762.4049 )PTO 111 1 1 1 .. LICATION r Permit No. Permit: BUILDING ROOFING OWNER: Nam S1 p T��r. 40/7 Cd �h.. nowt 71 � a - city; rarait .... Tenandessee Naum; Smell: State: Pha . JO#tADD :_ &G . - c7 i =�' city: s1 cam: Miang Dad FoktolParceltfi - 32o6 - 013 -0710 • b the Itullding HistoxicI1y Yea NO e/<- 00ArtRACTOlti Company Name: v �v City: ti L.t i Qualifier N Sta cattificutitn arPegistration #: Contact bomb: 3v -338 bitectfikaineer: zip; ..3r. Flood zone: x tle- 6 -/l Phone* of -Z3S SS1I Certificate of Co nay#% Email MAc a:. ---- yhon: value (Morin for this Perna; $ I ZI 5 0 0 Stuarelleser Footage of Work: T *Merle erle .OAdifition CllAttea ion z :+- if/Replace o*+ ***s+rsu ++earassesagabeieeaweFoes+* °o Eaea sese« eaa•eamasemaaaareas Submittal F e e $ P e r m i t Wee $ ,N9©4) CO $ ' C O / C e $ ._.._- SeaDDiug bee $, Radon Bee $ $_ - . saws Notary $ Trubing/EltnaMlon Fee $._...._^.w- Tedtttolop Fee $ - — Doable Fee $ Strueta ral Review $ TOTAL FEE NOW ODE $ Ocean Company's Name (if applicable) Bonding Company's Address City State Mortpine Lender's Name (if applicable) Mortgage Landes Address *IIIM•■•■•••■•••,..***100 City 21p State VOSISIS• Zip Application is hereby Made to obtain a permit to do die work sad antaliatOni as Whom& 1 certify that no work or installed= has commenced prior to the issuance of a penult and that all work will be Ipedionned na meet the standouts of all laws regulating construction in this juriadirAion. understand that a separate permit must be seemed fat ELECTRICAL WO= PUMBING° S1°16' INSI.LS, POOLS, PURNAOSS, BOIIIIRS, WATERS, TANKS and AIR CONDITIONERS, ETC.— OWNER'S AiSTEDAVI'T: 1 otatify that all the foregoing information is accurate and that all work wilt be done in compliance with all applicable laws repeating constreetion and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECO A NOTICE OF COMMENCEMENT MAY s • N,ULT IN YOUR PAYING TWICE FOR VEMENTS TO YOUR, PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LEND s OR AN ATTORNEY R $ RE RECO : 1 G YOUR NOTICE OF COMMENCENIENT." 1 • Notice to Applicant: Ai a condition to the issuance ofa building permit with ein estimated value ceding asoo, the applicant MO promise in sand Nth azi a copy of the notice of comtnencentent and con on lien law brochure will be delivered to the person whose property is subject to attachment Also, a certtbd copy of the recanted mike 4tC0 fl57WeI0ThtJ posted at the job site for the firs: inspection which occurs seven (7) days (*el that building PeOii is is the peanut notice, the inspmen will not be > , roved and a reinspectlem fee will be charged. ! XStenettam* The f. :•,111 I day of who NOT Fkle: Print -0 )15-1-01 74 s 0 or Age* insnument was acknowledged before me this! 4-- Ilte fOre day of to me MAW tfs, P .1ic -4ate of Flor gokiavi -rrJMY omm. Commission # EE 18340 ............. A Oa , My 0:40111W1011Eapirest before me dais 16- who iB penonally • NOTARY Sign; My Ocaoraission lispires: tinteed:tr W ....,,tostY Poep, iftWili . treIthionda F. • '1 ,i. My Comm. Expires Aug 28, 2014 "4.00F fgt.', Commission # EE 18340 111414****** 01144.1044****4111 ...................................... 7., 3,.. .„2„?..../- p,......... : APPROYBO BY atevaal 0740/07)(Revisal 06/10/2069Xitsvissd WO) Strammal Review Zooing Cie& Property Information Map mta midade.gov; Property Information Map My Home Miami -Dade County, Florida Page 1 of 1 mmary Details: olio No.: 11-3206-01 0710 roperty: NE 95 ST Mailing ddress: NCY DOWSON Floors: c� NE91STMIAMI _lying Units: HORES FL Adj Sq Footage: 44 1 38 -31 29 Information: Prima ry Zone: 1100 SINGLE FAMILY RESIDENCE CLUC: 3001 RESIDENTIAL - SINGLE FAMILY Beds/Baths: 3/2 Floors: 1 _lying Units: 1 Adj Sq Footage: 1,853 .ot Se: 12,155 SO FT Year Built: 1947 0 /$249 348 1 53 41 6 53 42 MIAMI SHORES SEC 1 AMD _egal Description: PB 10 -70 LOT 20 & E15FT LOT 19 & W20FT i..OT 21 BU( 5 LOT SIZE : u /$249 348 RREGU ^7 4 Aerial Photography - 2009 This map was created on 9/7/2011 10:23:54 AM for reference purposes only. Web Site 02002 Miami -Dade County. All rights reserved. nt Information: Value Information: 2011 2010 and Value: $104 473 w 109 785 = uildins Value: $144875 4.14487 Market Value: $249 348 Value: ssessed Value: $249 348 ;2,v,111„.1,3- Value Information: Sale Information: ale Date: /1997 ale Amount: 0 ale O/R: 7. •5 -1768 ales ualification escri •''on: ales which are isqualified as a result of xamination of the deed Vkw •._itionai_ http: / /gisims2. miamidade.gov /myhome /printmap. asp? mapurl= http: / /gisims2.miamidade.gov... 9/7/2011 2011 2010 Applied .Ion/ P111"—plied Exemption/ Taxable Taxable Value: Value: eeTonal: 00/$249348 •/$254660 0 /$249 348 01$254 660 0/$249 348 04254660 • chool Board: : u /$249 348 + ./$254 660 Sale Information: ale Date: /1997 ale Amount: 0 ale O/R: 7. •5 -1768 ales ualification escri •''on: ales which are isqualified as a result of xamination of the deed Vkw •._itionai_ http: / /gisims2. miamidade.gov /myhome /printmap. asp? mapurl= http: / /gisims2.miamidade.gov... 9/7/2011 (ht TJ(z L Permit No: 11 -1704 Job Name: September 21, 2011 Miami Shores Village Building Department Building Critique Sheet 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 1) Section E is incorrect. P1, P2, and P3 are incorrect and the math is incorrect. Please correct pressures and math. The attachment resistance is is greater than the attachment method for the perimeter and corner. Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 /3//1 47.-)6,/tt 09/22/2011 15:10 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES 1 1001 * * * * * * * * * * * * * * * * * * * ** * ** TX REPORT * ** * * * * * * * * * * * * * * * * * * * ** TRANSMISSION OK TX /RX NO 1809 RECIPIENT ADDRESS 93059691469 DESTINATION ID ST. TIME 09/22 15:08 TIME USE 01'07 PAGES SENT 1 RESULT OK ..23E ,D1 a, Permit No: 11 -1704 Job Name: September 21, 2011 Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Building Critique Sheet 1) Section E is incorrect. P1, P2, and P3 are incorrect and the math is incorrect. Please correct pressures and math. The attachment resistance is is greater than the attachment method for the perimeter and corner. Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Norman Bruhn CBO 305 - 795 -2204 FAC.. 3CTS_c16 y(o, • ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Master Permit No. Contractor's Name Job Address ° ❑ New Roof Florida Building Code Edition 200 High Velocity Hurricane Zone Uniform Permit Application Section A t('± e � Process No. AVG 1 ec-- +I k-1 6S- N(-5 S s7 ROQ *ORV ❑ Mechanically Fastened Tile Li- Mortar /Adhesive Set Tile ❑ Metal Panel / Shingles ❑ Low Slope ❑ Asphaltic Shingles Low Slope Roof Area (SF) /00v 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. PLIANCE WITH ALL FEDFFlAI EGUI A1lONS Se�V i'L .e 5 ❑ Prescriptive BUR -RAS 150 ROOF TYPE ❑ Wood Shingles /Shakes L Reroofing ❑ Recovering ❑ Repair ROOF SYSTEM INFORMATION Stef laped Roo Area (SF) Section B /Reef Plan) 20 r 2 FLORIDA BUILDING CODE — BUILDING 3 0 1 Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Application Form Section C (Low $toped Roof System) Fastener Spacing for Anchor /Base Sheet Attachment oc 0 Lap, # Rows Z @ �_° oc Perimeter: 62 oo (t Lap. # Rows (f 0 6n oc Corner: 6 ' ec 'Lap: #E Rows 0 " ac Number of Fasteners Per insulation Board Field , Perimeter Corner Illustrate Components Noted and Details as Applicable: Woodbtocking, Cutter, Edge Termination, Stripping, Flashing. Continuous Cleat. Cant Strip, Base Flashing, Counter- Ftashing, Coping, Etc. indicate: Mean Roof Height, Parapet Height, Height of Base Flashing, Component Material, Material Thickness, Fastener Type, Fastener Spacing or Submit Nenutacturers Details that Z Comply with RAS 111 and Chapter 16. ¢ 4 V. -.4 Of\ ` L1Jc I c FTL b Parapet tHe1.9ht .. Fill in Specific Roof Assembly Components and tdentffy Manufacturer (If a component is not used. identity as 'NA') System Manufacturer: A f %V1 kW 2 t At- NOA No.: 0 -7- 1 2 t. . CO C1 Design Wind Pressures, From RAS 128 or Calculations: Pmaxl :y q• 2- Pmax2 :??t• 6Pmax3: i 2 f. Max. Design Pressure From the Specific NOA System: ^ -L. S' Deck: Tyoe: W000 Gauge/Thickness: 3! is' Slope: 1/Y 1' -- Anchor /Base Sheet & No. of Ply(s): AJ rA Anchor /Base Sheet Fastener /Bonding .Material: Insulation Base Layer: N / Base Insulation Size and Thickness: ._. I Base Insulation Fastener/Bonding Material: Top Insulation Layer: f ' Top insulation Size and Thickness: ___ _.... Top Insulation Fastener/Bonding Material: 1` Base Sheet(s) & No. of PIy(s): 6 A F 4 7 C 3- Base Sheet Fastener/Bonding Material: 1.2..5" i..S. 1+ Ati-S Pty Sheet(s) & No. of Piy(s)l____A .,i 1 y .5.) X'Z-/ Ply Sheet Fastener/Bonding Material: 1-yis�, (f 14e) +- A Spin c.t _. Top Ply: in iaerc.( SVr`fc.c.ecL Cup sfe..eef Too Piy Fastener /Bonding Material: i tiPe 4 Hat Aspko.('F Surfacing: 6 r t,' •t••• I c.r S WO a() o� Mean i Roof i Height r ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Application Form. SPr_tinn D (Stepp Slnppr1 Rnnf Syctpm) Roof System Manufacturer: vv, /e J /')t7rvj 2r Lyle /)te Notice of Acceptance Number: 0-1-0-111. O Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations): P1:- 6.08 P2T22-.S P3- 2-0.LI Maximum Design Pressure (From the Product Approval Specific System): 31. 3 Ro.Qf Slope: : 12 Stepp sloped Roof System Description \ Deck Type: $/5" of wOO� Type Underlayment: Ridge Ventilation Ai 4 Insulation: X30 ST /in 2i6 /V A Fire Barrier: Mean Roof Height: / S Iv A Fastener Type & Spacing: Adhesive Type: G 0_�, i.ts" �2, s. NA'' -.s 12 "ef.c rt ape AST v' (4o+ AspL Type Cap Sheet: IA ST-' Roof Covering: Type & Size Drip Edge: 3 QA'e5 FLORIDA BUILDING CODE — BUILDING Ps i�c)wS �.( ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 Q/ High - Velocity Hurricane Zone Uniform Permit Application Form. . J Section F (Tile CalmulationS) For Moment based tile systems, choose either Method 1 or 2. Compare the values for Mr with the values from Mr. If the MI values are greater than or Vequal to the Mr values, for each area of the roof, then the tile attachment method is acceptable. (fP /1 Method 1 "Moment Based Tile Calculations Per RAS 127" I :115 d . S a l 1 { . I) _ Mg: %, b3 = M~ G, O g Product Approval Mf 3 I. 2 C(p2g,6)2,.3(3730.e).Mg: .03 =M; 22.8 Product Approval Mf 3 i • (73 :1i6•24,°311 36.1)- Mg :S.U3 =M'28.1 Product Approval Mf3 I.3 Method 2 "Simplified Tile Calculations Per Table Below" Required Moment of Resistance (Mr) From Table Below Product Approval Mf M, re • aired Moment Resistance* Mean Roof Height -� Roof Slope 4, 3 :12 16' 20' 25' 30' 40' 36.0 37.4 39.8 4:12 30.4 32.2 33.8 36.1 37.3 5:12 28.4 30.1 31.6 32.8 34.9 6:12 26.4 28.0 29.4 30.5 32.4 *Must be used in conjunction with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based tile systems use Method 3. Compared the values 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 acceptable. Method 3 "Moment Based The Calculations Per RAS 127" (Pt: x L = x w: = _J - W: x cos 0 = Fri Product Approval F (P2: x L = x w: = _) - W: x cos 0 = F,2 Product Approval F' (P,: x L = x w• = ) - W: x cos B = F,z Product Approval Where to Obtain Information Description Symbol Where to find Design Pressure P1 or P2 or P3 RAS 127 Table 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 .. Product Approval Restoring Moment due to Gravity M g product Approval Attachment Resistance Mr. Product Approval Required Moment Resistance Mg Calculated Minimum Attachment Resistance F Product Approval Required Uplift Resistance Fr Calculated Average Tile Weight W Product Approval Tile Dimensions L = length W = width Product Approval All calculations must be submitted to the building official at the time of permit application. FLORIDA BUILDING CODE — BUILDING Miami Stores Viiiae Building Depa = rr# 10080 N.E2nd Avenue Miami ores, Florida 33138 Tel: (306) 7142204 Fax: (305) 753.8972 OWNERS'S AFFIDAVIT OF MPTIOl4 Roof To WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR E' QSTINS SITE= BUILT SINGLE FAMILY RESIDENTIAL 8Tf UCTURES PERSUANT TO SECTION 553.844 To: Mai Shores Village Bulking Dept 10050 NE2rd Ave DAM Shores, Fl 33138 Re. Owner's Name: Property Addteas: Iootktg Permk Number Dear 8ut(dtng Official: building bac8ise 1) PL 33 /SY certify that t am not required toiretrofitthe root to wail aonneotores f my ❑ The justvaluallon for the struotse for purpose of ad valorem taxation la $30D■400.O0. Pied" etch proof of ad valorem taxation, n The building veal eu nsbuoled In compliance will the provisions of the Ftodd Striding Code (FBC) or with the provisions of 1994 =_: +on of the South Fb f lda Biking Code (1994 SFBC) /i t �,,a/ Print Name: Signature Stabs of Florida County of lade The undersigned, be the first duly Duran, deposes and says that het 8gitarn to and subscribed be*r re me this Notary Pubic, Sate of Florida at Large When thslustysigebn Otto *tastes for SFBc . This yoy eau pmvidav bald* appikali4n owner for the above proFeitymentoned I'/ ,,':° `c's DAISHA ZANETTI Notary Public; - State o rids dc f, omm. Ex ires Aug 283 2014 o wad t4 Sep Ed4434004 Retsesas 91112008 astoc auttsdW1QF8GA0IB1GM SECTION HIGH VELOCITY HURRICANE ZONES r REQU1R 4 COWS:ERA 13 R44*2.43.4 Troops. As it pertains to the sewn, a la the with the required rnoting permit, and el ear to the owner the R4402 govern the minimum requirements end standards ofth$` Additionally, the fallowing items should be addressed as part contrackt The Mete ink in the deOgnaited space 1,3: )_ A rtehtp: he violets p that the r! oof system meth the wind resistance Aesthetics (appearance) are not a consideration vet such as corn or architectural appearance, that are not ' the *vowed between the owner and the contractor. 24 RenalSng wood decker When ring renulied in a000rdar with the current providers of to terming the extant; rod dsystem). r Common rods ate those unite (L0., tmenhouses, co donsdurne, ) In bindings owner er should notify the =treads driftage units of 4.X Exposed Celibrx Emend, beam be from below. The termer may wish to Tailgate t j penetration of the underside of the decking may not be erWirence* N- Agy GPs a system an & water: The current came ester to fond (accumulate) l to efeee Of distress and may require tie review of a professional ereectency and partormence of ma new roofing system. original roofing system i r removed. Pounding conditions 0.4 . ,.,ti a sewn outlet) It is r overloaded from a tip ofaster. Perimeter/edge wa1 overflow scuppers l outlets) we not provided. It may mince v;St the requirements of Sections 84402, R 7. X� ./ ,_Ve t Most mcf structures ahcutd interior of the serum assembly (the building Iisr#tt). ft may be benefit to consider sidtt onai NE RS NOTIFICATION FOR ROOFING lity of rooting contractor to provide the owner of the section. The provIskins of Section uetey far rooting system Ins yawned bean the ovmer ant the the item has been explained. die of Section R444}2 are for the purpose of water betrucdon performance standards. to wortmenetep proAsions. Aesthetic issues atoning code shoed be addressed as pat of the existing wood reef d mayhave to be R4403. (The mof deck is usually wasted prior hoe no visible delineation between nelghbothrg common nos, the roofing contractor andlor tom Brew here the underside of the roof decking can iteotural appearance; therefore, rodtg nos This; provides 'the + of =Making the ov ‘Lee—,4-6 s , desk of the building may not dein well and may rent. Founding can been indication of structure al engineer. Pounding may shorten the iKa ' unrinv condition& may not be evident until this d be waded. Redden 7N2009 ID that rainy/Merlons off so Methe roof Is not eler roof extension may bind this discharge if nesessery to Mad overflow scuppers in and RR4413, bli y to vent n utat alrttow through the . ad attic ventilation shd not be If in extendhe the service If of die ROOF ASSEMBLIES AND ROOFTOP STRUCTURES SECTION 4402.14 HIGH VELOCITY HURRICANE ZONES UNIFORM PERMIT APPLICATION Florida Building Code Edition 2007 High - Velocity Hurricane Zone Uniform Permit Application Form. INSTRUCTION PAGE COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING PERMIT APPLICATION FORM AND ATTACH THE REQUIRED DOCUMENTS AS NOTED BELOW: Roof System Low Slope Application Prescriptive BUR -RAS 150 Asphaltic Shingles Concrete or Cia Tile Metal Roofs Wood Shingles and Shakes Other Required Sections of the Permit Application Form A,B,C A,B,C A,B,D ABDE A,B,D A,B,D As Applicable Attachments Required See List Below 1.2,3,4,5,6.7 4,5,6,7 1,2,4,5,6,7 1234567 1,2,3,4,5,6,7 1,2,4,5,6,7 1,2,3,4,5,6,7 ATTACHMENTS REQUIRED: 1. 2. Fire Directory Listing Paqe From Product Approval: Front Page Specific System Description Specific System Limitations General Limitations Applicable Detail Drawings 3. Design Calculations per Chapter 16, or If Applicable, RAS 127 or RAS 128 4. Other Component of Product Approval 5. Municipal Permit Application 6. Owners Notification for Roofing Considerations (Reroofing Only) 7. Any Required Roof Testing /Calculation Documentation FLORIDA BUILDING CODE — BUILDING 'KA IA AA BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) GAF Material Corporation 1361 Alps Road Wayne, NJ 07470 MIAMI -DADE COUNTY, FLORIDA METRO -DADE FLAMER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 331304563 (305) 375 -2901 FAX (305) 375-2908 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by the BCCO and accepted by the Building Code and Product Review Committee to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have This product or material tested for quality assurance purposes• this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code and the Nigh Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: GAF Conventional Built-Up Roof System for Wood Decks. 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 request of the Building Official. This NOA renews and revises NOA No. 03- 0501.05 and consists of page 1 thro gh 19. The submitted documentation was reviewed by Jorge L. Acebo. APPROVED NOA Na: 07-1219..09 Expiration Date: 11/04113 Approval Date: 03/20/08 Page 1 of 19 Deck Type 1: Wood, Non - insulated Deck Description: 19132" or greater plywood or wood plank decks System Type E: Base sheet mechanically fastened. All General and System Limitations shall apply. Fire Barrier: FireOut M Fire Barrier Coating, VersaShield ®Non Asphaltic Fiberglass -Based (optional) Underlayment or SecurockTM. Base sheet: GAFGLAS® #80 ULTIMATM Base Sheet, STRATAVENT'' EliminatorTM Nailable, RUBEROID® Modified Base Sheet, RUBEROID® 20, RUBEROID® Heat- WeldTM Smooth or RUBEROID® Heat- We1dT1" 25 base sheet mechanically fastened to deck as described below; Fastening Options:. GAFGLAS® Ply 4, GAFGLAS® Flex P1yTM 6, OAFro approved annular ring sheet or any of above Base sheets attached to deck with app nails and tin caps at a fastener spacing of 9" o.c. at the lap staggered and in two rows 12" o.c. in the field. (Maxim unDesign Pressure —45 psf, See General Limitation #7) GAFGLAS® Ply 4, GAFGLAS® flex P1yTM 6, GAFGLAS® #75 Base Sheet or any of above Base sheets attached to deck with Drill -TecTM #12 standard, #14 or # 15 Screws and 3" Drill -TecTM steel plate or Drill -Teem AccuTrac Plates, 12" 0.0. in 3 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 12" o.c. in the field of the sheet. 5 S e ;frl 44,11...41.1_ ' GAFGLAS® Flex P1yTM 6, GAFGLAS® #75 Base Sheet or any of above Base sheets attached to deck with approved annular ring nails a rows 9tin c the a fastener spacing of 9" o.c. at the 4" lap staggered field. (Maximum Design Pressure —52.5 psf, See General Limitation #7) GAFGLA " #80ULTIMATM, RUBEROID" 20, RUB 011) Mop moo base sheet attached to deck with approved 1'A» annular ring shank nails and inverted 3" steel plate at a fastener spacing of 9" o.c. at the 4" lap and in two rows staggered with a fastener spacing of 9" o.c. in the center of the membrane. (Maximum Design Pressure —60 psf, See General Limitation #7) GAFGLAS® #75 Base Sheet or any of above Base sheets attached to deck with Drill -TecTM #12 standard, #14 or # 15 Screws and 3" Drill -TecTM steel plate or Drill- TecTm AccuTrac Plates, 12" o.c. in 4 rows. One row is in the 2" side lap. The other rows are equally spaced approximately 9" o.c. in the field of the sheet. (Maximum Design Pressure —60 psf, See General Limitation #7) Any of above Base sheets attached to deck approved annular ring shank nails and:3" inverted Drill -Teem insulation plates at a fastener spacing of 9" o.c. at the 4" lap staggered in two rows 9" in the field. (Maximum Design Pressure —60 psf, See General Limitation #7) NOA No.: 07- 1219.09 Expiration Date: 11/04/13 Approval Date: 03/20/08 Page 17 of 19 Ply Sheet Cap Sheet: Surfacing: GAFGLAS® #75 Base Sheet or any of above Base sheets attached to deck with Drill-Teem #12 standard, #14 or # 15 Screws and 3" Drill -Teem steel plate or Drill-Tecm AccuTrac Plates, 8" o.c. in 4 rows. One c e r in is in the held of the sheet The other rows are equally spaced approximately 1 12 One or more plies of GAFGLAS® PLY 4, #80 ULTIMA, RUBEROID® MOP , -11, -I • 11 •_ fit (Optional) One ply of GAFGLAS® Mineral Surfaced Cap Sheet or GAFGLAS® EnergyCapT, Mineral Surfaced Cap Sheet adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbsfsq. (Optional, required if RUBEROID® MOP Smooth or RUBEROID® 20 is top membrane) Install one of the following: 1. Gravel or slag applied at 400 Ibs.sq. and 300 lbs.sq. respectively in a flood coat of approved asphalt at 60 Ibs.sq. or applied in a flood coat of Leak Buster "M Matrix"' 103 Cold Process Adhesive applied at a rate of 3 galJsq. 2. GAFGLAS® Mineral Surfaced Cap Sheet, GAFGLAS® Energy Cap Mineral Surfaced Capsheet adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs. sq. 3. Leak Buster"' Matrix", 303 Premium Fibered Aluminum Roof Coating, at 1.5 gal./sq. 4. Leak Buster"( Matrix", 715 , Leak Buster", Matrix", 322, TOPCOAT® MB +, TOPCOAT® Fireshield Elastomeric Roofing Membrane, applied at 1 to 1.5 gal./sq. 5. Leak Buster"", Matrix", 602 MB Xtra Elastomeric at 1 Roofing 1.5 galisq. ga1 Membrane, EnergyCot� roof coating applied TOPCOAT® Surface Seal, TOPCOAT® Fireshield® SB Solvent based Elastomeric Roofing Membrane applied at Ito 1.5 galisq 7. Advance Green Technologies Photovoltaic Laminate solar energy collector auxiliary roof equipment installed in compliance with manufacturer's specifications and applicable Building Codes. Maximum Design Pressure: See Fastening Above NOA No.: 07- 1219.09 Expiration Date: 11/04/13 Approval Date: 03/20/08 Page 18 of 19 WOOD DECK SYSTEM LIMITATIONS: 1 A slip sheet is required with Ply 4 and Flex PIyTM 6 when used as a mechanically fastened base or anchor sheet. 2. Minimum 1/4" Dens Deck"' or W' Type X gypsum board is acceptable to be installed directly over the wood deck. GENERAL LIMITATIONS: 1. Fire classification is not part of this acceptance, refer to a current Approved Roofing Materials Directory for fire ratings of this product. 2. Insulation may be installed in multiple layers. The first layer shall be attached in compliant with Product Control Approval guidelines. All other layers shall be adhered in a full mopping approved applied within the EVT range and at a rate of 20-40 lbs./sq., or mechanically attached using the fastening pattern of the top layer approved 3. All standard panel sizes are acceptable for mechanical attachment. When applied in appro asp halt, panel size shall be 4' x 4' maximum. m 4. An overlay and/or recovery board insulation panel is required on all applications m li catutio the base sheet shall ns over closed cell foam when the base sheet is fully mopped. If no recovery board be applied using spot mopping with approved asphalt, 12" diameter circles, 24" o.c.; or strip mopped 8" ribbons in three rows, one at each sidelap and one down the center of the sheet allowing a continuous area of ventilation. Encircling of the strips is not acceptable. A 6" break shall be placed every 12 in each ribbon to allow cross ventilation. Asphalt application of either system shall be attaa minimum rate f f 12 lbs. /sq. Note: Spot attached systems shall be limited to a maximum design P value of sf. 5. Fastener spacing for insulation attachment is based on a Minimum Characteristic Force (F') lbf., as tested in compliance with Testing Application Standard TAS 105. If the fastener value, as field - tested, are below 275 lbf. insulation attachment shall not be acceptable. 6. Fastener spacing for mechanical attachment of anchor/base sheet or membrane attachment is based on a minimum fastener resistance value in conjunction with the maximum design value listed within a specific system. Should the fastener resistance be less than that required, as determined by the BuilditO� oral, a revised fastener spacing, prepared, signed and sealed by a Florida Registered Engineer, Registered Roof Consultant may be submitted. Said revised fastener spacing shall utilize the withdrawal resistance value taken from Testing Application Standards TAS 105 and calculations in compliance with Roofing Application Standard RAS 117. requirements of these areas. 7. Perimeter and corner areas shall comply with the enhanced uplift pressure Fastener densities shall be increased for both insulation and base sheet as calculated in compliance with Roofing Application Standard RAS 117. Calculations prepared, signed and sealed by a Florida tregistered Professional Engineer, Registered Architect, or Registered Roof Consultant (When this specifically referred within this NOA, General Limitation #9 will not be applicable.) 8. All attachment and sizing of perimeter nailers, metal profile, and/or flashing termination designs shall conform with Roofing Application Standard RAS 111 and applicable wind load requirements. 9. The maximum designed pressure limitation listed shall be applicable to all roof pressure zones (Le. field, perimeters, and corners). Neither rational analysis, nor extrapolation shall be permitted for enhanced fastening at enhanced pressure zones (i.e. perimeters, extended corners and corners). (When this limitation is specifically referred within this NOA, General Limitation #7 will not be applicable.) 10. . All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code and Rule 9B-72 of the Florida Administrative Code. END OF THIS ACCEPTANCE NOA No.: 07- 1219.09 Expiration Date: 11 /04/13 Approval Date: 03/20/08 Page 19 of 19 Pane 2of52 TGFU.R1306 - Roofing Systems The use of gypsum board under any of the following Class A, B cr C systems does riot adversely effect the rating. The use of Vie-in. minimum thick gypsum board is an acceptable alternate for minimum insulation over C -15132 thick root decks. The use of polystyrene insulation board between minimum 3/4-111. thick penile board and deck with rosin paper (periite,roein paper /POlystyrenerPerOte) is d suitable alternate for polyisocyanurate board in the toitowtng Class .A. B or C systems. a insulation in - EnergyGuard RA" or "Tapered 1iergyGuard RA" or "EnergyGUard Composite RA" may be substituted for any Atlas poly:socyarutrat any of the fotcwtng Classifications. Trumbull "Perms Mop" may be utilized with any of the folio ring "Asphalt Felt Systems rah Hot Roofing Asphalt ". "GAFGLAS :e. #80 Premium Base Sheet" may be used in any of the following systems. "GAFGIAS_y flee Pty 6" and "Tn -Plye Ultra-Flexible Ply 6" are suitable alternates to "GAFGLAS Ply 6". "GAFTEMP PermaUte Recover Board" may be used in lieu of any perlite insulation in any of the following NC Cla55ifioations. Unless otherwise Indicated, any of the °Asphalt Felt Systems with Hot Roofing Asphalt" may be surfaced with "Fireshield MB" at 23i: to 3- gal /103- 112. "Ruberold+ti.': Dual Smooth" may be used as an alternate to "Ruberoid - :k: Map Smooth" or "Ruberold :y :- 20" or "RUberotdiy.. 20 HT' "Ruberoid y Mop Smooth 1.5" may be used es an alternate to "Ruberuiddi, Mop Smooth" Class A,B and C Hot roofing asphalt, for use with organic and glass tens or modified bitumen :nembranes. "kuberoid( ?t Heat Weld" 555 roofing membrane may be used in lieu of "RUbetOtd:t: Flop" SBS products in any applicable {',la3eication. Class A Deck:. C-15/3.1 Insolation (Optional):. — One or more layers perute er wood fiber or glass fiberor polyisocyanurate.or urethane or to or phenolic, any °- hickne� perlite :Po!yisecyanUrdte composite or pedlte/urethane composite or wood ftber/POI OxYGA� ,. hot phenolic, - Ply Sheet: — Three or more plies Type 01 or "GAFGLAS:F. Ply 4" or "111•PIY fly Surlactn9: — Gravel, Incline: 3 ,,. 2. Deck: C-15/32 e or n phenolic, any thickness. Insulation (Optional): —One or more layers perfite or wood fiber or glass fiber or PolyisOtYanurate or urethane or perlite/polyis1Cyanurate composite or per'.,'te /urethane composite or wood flber!PQf i GA 1 to c Posit Ply Sheet: — Three or more plies Type 01 Or "GAFGLAS•°' Ply 4" ar"lri -Piyfe l; Cap Sheet — One ply Type G3 "GAFGIAS:e• Funeral surfaced Cap Sheet" Or 'Tn- Ply.K. Mineral Surfaced Cap Sheet " or "GAFGtASr. EnergyCars " BUR. Mineral Surfaced Cap Sheet." incline: 2 3. Deck: NC Insulation (optional): — One m more layers perlite, wood fiber, glass Boer, polyisocyanurate, urethane. peliitefpoly lanurate comp:see. Peritte /urethane composite, wood fiber /poIyISOCyannrate composite, phenolic, 2 -5n. maximum. Ply Sheet: — Two or rsane piles Type Gi "GAFGLAS..a• Ply 4 ", "Trl-Pty:) Ply r{ "SAFGLAS Mineral Suriaced Cep Sheet" or "GAFGS AS: : ti3 "GAI GLASP. Mineral Surfaced Cap Sheet" y `. Cap Sheet: —One ply Type F.nergycaP "" BUR t4merai Surfaced Cap Sheet." Incline: 2 4. Deck: C -15/32 Incline: 1 Slip Sheet (Optional): — :led rosin paper, nailed to deck. Insulation (optional): — My thickness periite or *rood fiber or glass fiber or polyisocyanurate mechanically fastened nr adhered with OMG inc. "OIyBOnd Fastening System' or any tie Classifed a s5la ion adhesive. (may nailed). Base Sheet: — One ply Type G2 "GAFGLAS,F. #75 Base Sheet" or "TM-PIT :is *75 Base Sheet" (, Y Ply Sheet: — One or more plies Type 52 "GAFGLASt;. Ply 4° or'Tri-PIy, =; Ply 4" cr GAFGIAS:& Ply 6 "• Cap Sheet: — One.pfy Type -G3 "GAPO ASs-- Mineral Surfaced Cap Sheet" or - T1 -PIy" Mineral Surfaced Cap Sheet' or "GAFGLAS :t EfergyeaP'" BUR. Mineral Surfaced Cap Sheet." Surfacing (optional): — "FOPCOAT.t EnergyC ew "" applied at a rate of 2 -clo1/ 100-ft2. mhnnl: file: / /C: \Lr sets \Rissell■Deslctop\Roofine\TGFC R1306 - Roofing Systems.mht 2/14/2011 MIAMI DADS 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 govTuildinai 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 (ii). 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 shalt 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 fried 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 these 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 request of the Building Official. This renews NOA# 06- 0201.02 and consists of pages 1 through 7. The submitted documentation was reviewed by Alex Tigera. NOA No.: 11- 0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 1of7 ROOFING COMPONENT APPROVAL: Category: Roofmg Sub Category: Roof tile 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 by applicable building code, does not exceed the design pressure values obtained by calculations in compliance with Roofing Application Standard RAS 127, for use with approved flat, low, and high profile roof tiles system using Polypro® AH 160. Where the attachment calculations are done as a moment based system for single patty placement, and as an uplift based system for double patty systems PRODUCTS MANUFACTURED BY APPLICANT: Product Dimensions Test Specifications Polypro AH160 N/A TAS 101 Foampro® RTF1000 ProPack® 30 & 100 N/A N/A Product Description Two component polyurethane foam adhesive Dispensing Equipment 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 file adhesive. PHYSICAL PROPERTIES: Property Density Compressive Strength Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability Closed Cell Content 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 lbsift.' 18 PS1 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% Note: The physical properties listed above are presented as typical average values as determined by accepted ASTM test methods and are subject to normal manufacturing variatibn. NOA No.: 11- 0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 2 of 7 EVIDENCE SUBMITTED: Test Agency Test Identifier Test Name/R.ePort 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 11/02/95 25- 7438 -7 SSTD 11 -93 25 -7492 SSTD 11 -93 12/12/95 Miles Laboratories NB- 589 -631 ASTM D 1623 02/01194 Polymers Division Ramtech Laboratories, Inc. 9637 -92 ASTM E 108 04/30/93 Southwest Research Institute 01- 6743 -011 ASTM B 108 11/16/94 01- 6739- 062b[1) ASTM E 84 01/16/95 Trinity Engineering 7050.02.96 -1 TAS 114 03/14/96 Celotex Corp. Testing Services 528454 -2 -1 TAS 101 10/23/98 528454 -9 -1 528454 -10-1 520109 -1 TAS 101 12/28/98 520109 -2 520109 -3 520109 -6 520109 -7 03102/99 520191 -1 TAS 101 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® AH160 roof tile adhesive with their tile assemblies shall test in accordance with TAS 101. 5. Roof Tile manufactures acquiring acceptance for the use of HANRI -STICK roof tile adhesive with their tile assemblies shall test in accordance with TAS 101 with section 10.4 as modified herein. W (-1-"i") MS NOA No.: 11-0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 3 of 7 INSTALLATION: 1. Polypro® Al-1160 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of Polypro® AH160. Application section and the 2. Polypro® AH160 shall be applied in compliance with the Component App corresponding Placement Details noted herein. The roof tile assembly's adhesive attachment with the use of Polypro® AH160 shall provide sufficient attachment resistance= expressed as an uplift based system, to meet or exceed the uplift resistance determined in compliance with Miami -Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA 3. Polypro® AH 160 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. approved and licensed by Polyfoam 4. Installation must be by a Factory Trained 'Qualified Applicator' approved applicators to the authority Products, Inc. Polyfoam Products Inc. shall supply list of having jurisdiction 5. Calibration of the Foamprot� 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): LO (B). The dispense tuner shall be set to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No other settings shall be approved. 6. Polypro® AH160 shall be applied with Foanipro RTF1000 or ProPaek® 30 & 100 dispensing equipment only. 7. Polypro® A13160 shall not be exposed permanently to sunlight. 8. Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after Polypro® AH160 has been dispensed. 9. Polypro® AH160 placement and minimum patty weight shall be in accordance with the Placement Details' herein. Each generic tile profile requires the specific placement noted herein Table 1: Adhesive Placement For Each Generic Tile Profile Tile Profile Placement Single Paddy Two Paddy Weight Detail Weight Min. per paddy Min. arcs Flat, Low, High Profiles High Profile (2 Piece Barrel) Flat, Low, High Profiles #3 LABELING: All Polypro® AH160 containers shall comply with the Standard Conditions listed herein. BUILDING PERMIT REQUIREMENTS: As required by the Building Official or applicable building code in order to properly evaluate the installation of this system. NOA No.: 11 -0124.04 Expiration Date: 05/10112 Approval Date: 04114111 Page 4 of 7 Nall through plastic cement WhitelaymeM eaed)(getmanhTile) Re toe FIRIca cinema AU *swami causeel see eke. Er uwe isendof pmeneceser Se are iaabef ewe line Eaveclosum Weephale Peale (oder IMO NOA No.: 11 -0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 5 of 7 ADHESIVE PLACEMENT DETAIL 2 GLE PATTY NOA No.: 11-0124.04 Expiration Date: 05/10112 Approval Date: 04/14111 Page 6 of 7 ADHESIVE PLACEMENT DETAIL 3 DOUBLE PATTY Faso Mph* Eavaeloaure Ddpedge Nall through plastic cement Single pad on top otitis END OF THIS ACCEPTANCE NOA No.: 11- 0124.04 Expiration Date: 05/10/12 Approval Date: 04 /14/11 Page 7 of 7 M I A M IDDADE BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) MonierLifetile, LLC 200 Story Road Lake Wales, FL 33853 MIAMI-DADE COUNTY, FLORIDA METRO -DADE FLAGLER BUILDING 140 WEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed by Miami -Dade County Product Control Division and accepted by the Board of Rules and Appeals (BORA) to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Division that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code and the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Saxony 900 (Shake, Slate & Split Shake) Concrete Roof 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 request of the Building Official. This revises NOA# 07-0228.03 and consists of pages 1 through 7. The submitted documentation was reviewed by Alex Tigera. NOA No.: 07- 0711.03 Expiration Date: 04/26/12 Approval Date: 09/07/07 Page 1 of 7 ROOFING ASSEMBLY APPROVAL Category: Sub - Category: Material: Roofing Flat Profile Roofing Tiles Concrete SCOPE: This new NOA approves a system using MonierLifetile Saxony 900 (Shake, Slate & Split Shake) Concrete Roof Tile, as manufactured MonierLifetile LLC and described 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 the installation section herein. The attachment calculations shall be done as a moment based system. PRODUCT DESCRIPTION Manufactured by Apulicant MonierLifetile LLC Saxony 900 Trim Pieces Dimensions 1 =17" w = 13" 1- 5/32" thick Slate 1- 9/32" thick Shake & Split Shake 1= varies w = varies varying thickness SUBMITTED EVIDENCE: Test Agency Redland Technologies 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 Specifications TAS 112 TAS 112 Test Identifier 7161 -03 Appendix III 94 -084 94-060A 25- 7183 -6 25- 7183 -5 Product Description Flat profile, interlocking, high- pressure extruded concrete roof tile equipped with two nail holes. For direct deck or battened nail-on, mortar set or adhesive set applications. Accessory trim, concrete roof pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tile profile. Test Name/Revert Date Static Uplift Testing Dec. 1991 PA 102 & PA 102(A) Static Uplift Testing May 1994 PA 101 (Mortar Set) Static Uplift Testing March, 1994 PA 101 (Adhesive Set) Static Uplift Testing Feb. 1995 PA 102 (2 Quik -Drive Screws, Direct Deck) Static Uplift Testing Feb. 1995 PA 102 (2 Quik -Drive Screws, Battens) NOA No.: 07- 0711.03 Expiration Date: 0426/12 Approval Date: 09 /07/07 Page 2 of 7 Test Agency The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. Redland Technologies Redland Technologies Redland Technologies Redland Technologies The Center for Applied Engineering, Inc. Atlanta Testing & Engineering, Inc. Celotex Corporation Testing Service Celotex Corporation Testing Service Walker Engineering, Inc_ Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Nutting Engineers Test Identifier 25- 7214 -1 25- 7214 -5 7161 -03 Appendix II Letter Dated Aug. 1, 1994 P0631 -01 P0402 Project No. 307025 Test #M C -77 R1.894 R2.894 R3.894 520109 -1 520111 -4 520191 -1 Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Calculations Evaluation Calculations 130 Test Name/Report Static Uplift Testing PA 102 (1 Quik -Drive Screw, Direct Deck) Static Uplift Testing PA 102 (1 Quik -Drive Screw, Battens) Wind Tunnel Testing PA 108 (Nail-On) Wind Tunnel Testing PA 108 (Nail-On) Wind Tunnel Testing PA 108 (Mortar Set) Withdrawal Resistance Testing of screw vs. smooth shank nails Wind Driven Rain PA 100 Physical Properties PA 112 Static Uplift Testing PA 101 Static Uplift Testing PA 101 25 -7094 25 -7496 25 -7584 25- 7804b -8 25 -7804-4 & 5 25-7848-6 25 -7183 Aerodynamic Multipliers Two Patty Adhesive Set System Restoring Moments Due to Gravity TAS 112 Date March, 1995 March, 1995 Dec. 1991 Aug. 1994 July 1994 Sept. 1993 Oct. 1994 Aug. 1994 Dec. 1998 March 1999 February 1996 April 1996 December 1996 March 1995 January 2007 April 1999 February 2007 January 2007 NOA No.: 07- 0711.03 Expiration Date: 04/26/12 Approval Date: 09/07/07 Page 3 of 7 LIMITATIONS: 1. Fire classification is not part of this acceptance. 2. For mortar or adhesive set tile applications, a static field uplift test shall be performed in accordance with RAS 106. 3. Applicant shall retain the services of a Miami -Dade County Certified Laboratory to perform quarterly test in accordance with TAS 112, appendix `A'. Such testing shall be submitted to the Building Code Compliance Office for review. 4. Minimum underlayment shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 5. 30190 hot mopped underlayment applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayment material manufacturers published literature. 6. This acceptance is for wood deck applications. Minimum deck requirements shall be in compliance with applicable building code. INSTALLATION: 1. MonierLifetile Saxony 900 (Slate, Shake & Split Shake) Concrete Roof Tile and its components shall be installed in strict compliance with Roofing Application Standard RAS 118, RAS 119, and RAS 120. 2. Data For Attachment Calculations Table 1: Average Weight (W) and Dimensions (I x w ) Tile Profile Weight -W (Ibf) Length -1 (ft) Width -w (ft) MonierLffetile Saxony 900 Slate, Shake & Split Shake 11.5 1.417 r N.—N-0—..— 1.08 _ Table 3: Restoring Moments due to Gravity - M, Table 2: Aer... amlc Multi . liers Tile Profile Tile Profile 3 ":12" X (ft3) Batten Application 0.289 �.. ?(ft ) Direct Deck Application 0.313 MonierLifetile Saxony 900 Slate, Shake & Split Shake or Dirreck Table 3: Restoring Moments due to Gravity - M, (ft-ibf) Tile Profile 2 ":12" 3 ":12" 4 ":12" 5 ":12° 6 ":12" 7 ":12° greater Battens or Dirreck Saxony 900 Slate, Shake & Split Shake Battens Direct Deck Batt = i - Direct Deck B >ttens Direct Deck Battens Direct Deck Battens _ Direct 7.16 8.12 7. ti : 8.03 ..97 7.91 6.82 7.74 6.65 7.55 6.46 7.34 NOA No.: 07- 0711.03 Expiration Date: 04126/12 Approval Date: 09/07/07 Page 4 of 7 Table 4: Attachment Resistance Expressed as a Moment - M1 (ft-Ibf) for Nail -On Systems Tile Profile Fastener Type Direct Deck (min 15132" plywood) Direct Deck (min. 19132" plywood) Battens Saxony 900 Slate, Shake & Split Shake 2 -10d Ring Shank Nails 30.9 38.1 17.2 1 -10d Smooth or Screw Shank Nail 7.3 9.8 4.9 2 -10d Smooth or Screw Shank Nails 14.0 18.8 7.4 1 .#8 Screw 30.8 30.8 18.2 2 . #8 Screws 51.7 51.7 24.4 1 -10d Smooth or Screw Shank Nail (Feld 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 31.9 32.2 Table 5: Attachment Resistance Expressed as a Moment Mt (ft -Ibf) oo : . ,.. , _ . , t_. Tile Profile Tile Application Minimum Attachment Resistance MonierLifetile Saxony 900 Slate, Shake & Split Shake Adhesive 31.3` 1 See manufactures component approval for installation requirements. 2 Dow Chemical TileBond Average weight per patty 13.9 grams. Polyfoam Product, Inc. Average weight per patty 8 grams. 40.4 A A A A Table 5B: Attachment Resistance Expressed as a Moment - Mt (ft-Ibf) for Mortar Set Systems Table 5A: Attachment Resistance Expressed as a Moment - Mt (ft-Ibf) for Single Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance MonierLifetile Saxony 900 Slate, Shake & Split Shake Polyfoam PolyPr0TM 118.9 Polyfoam PolyProTM 40.4 3 Large placement of 45 grams of PolyProl . paddy 4 Medium paddy placement of 24 grams of PolyProT"'. Table 5B: Attachment Resistance Expressed as a Moment - Mt (ft-Ibf) for Mortar Set Systems Tile Profile Tile Application Attachment Resistance MonierLifetile Saxony 900 Slate, Shake & Split Shake Mortar Set' 43.9b 5. Tile -Tde Roof Tile Mortar NOA No.: 07- 0711.03 Expiration Date: 04/26/12 Approval Date: 09 /07/07 Page 5 of 7 LABELING: All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo, or following statement: "Miami -Dade County Product Control Approved ". MONIERLIFETILE LLC, SAXONY 900 TILE (LAKE WALES FL PLANT 2) LOCATED UNDERNEATH TILE BUILDING PERMIT REQUIREMENTS: Application for building permit shall be accompanied by copies of the following: 1. This Notice of Acceptance. 2. Any other documents required by the Building Official or applicable building code in order to properly evaluate the installation of this system. PROFILE DRAWING WATERLOCK MONIERLIFETILE SAXONY 900 CONCRETE ROOF TILE (SLATE MODEL) NOA No.: 07- 0711.03 Expiration Date: 04/26/12 Approval Date: 09/07/07 Page 6of7 PROFILE DRAWING MONIERLIFETLLE SAXONY 900 CONCRETE ROOF TILE (SPLIT SHAKE MODEL) MONIERLIFETILE SAXONY 900 CONCRETE ROOF TILE (SHAKE MODEL) END OF THIS ACCEPTANCE NOA No.: 07- 0711.03 Expiration Date: 04/26/12 Approval Date: 09/07/07 Page 7 of 7 IVI lami Shores Viiiage 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 $30.00 FEE PER YEAR. IF CONTACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. / COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPTI D. ✓ COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTIONI IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: BUSINESS ADDRESS: / 76. /,51C l rrY iO4`4 STATE a . ZIP CODE 3 / J' BUSINESS PHONE: 1 �° /1.-/6 6 ' FAX NUMBER ( ) CELL PHONE ( ) '� `T' ,'QUALIFIER'S NAME: �'"� 0.7ce-o)__ d e_ - o ? QUALIFIER'S UC NUMBER: E -MAIL ADDRESS (IF APPLICABLE): 4( C /-/6.-c, go; M Created on 3119109 BY MLDV I RV 3126109 MLDV ALBUZICESSTAXR iMI ADE COUNTY STATE Or I EXPIRES SEPT 30 2012,` P DC DISPLAYED AT PLACE OF; T t1UN iY CHAPTER FIRST -CLAS U.S. POSTAG PAID MIAMI, FL PERMIT NO. 2i THIS IS NOT A BILL - DO NOT PAY RENEWAL Bu sfl eFec IRNSERVICES INC STATEir 042809 384767-1 14376 SW 139 CT 10 33186 UNIN DADE COUNTY n ; INSPECTION SERVICES INC. seclTigellterAi.TY BUILDING CONTRACTOR'` THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR LICENSE REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDERS QUALIFICA- TIONS. PAYMENT RECEIVED MIAMI -DADE COUNTY TAX COLLECTOR: aa 600200000124 000075.00 SEE OTHER SIDE DO NOT FORWARD AKG INSPECTION SERVICES INC JOSE H HERNANDEZ PRES 14376 SW 139 CT 10 MIAMI FL 33186 1usHH► II11I$ u11111 1$, IIH, 3lh11111111111110111111111111 SAM Aug 29 11 05:47p Employee rro uugc(Uuaou r•i ACC CERTIFICATE OF LIABILITY INSURANCE I AC1:- 1340039$ - 10374$$ PRODUCER THIS CERTIFICATE IS ISSUED AS A MITER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR Highpeint Risk Ssrvieea LLO 5501 LEIJ P'ASEWAY, 94222 1200 Dallas, TX 73240 (800) 728 -0623 (972) 404 -0380 Fazi (972) 404 -0380 CERTIFICATE NO. ! DATE 8/29/2011 412012430 A TFR Tuc 1"O ERAt2F AFPOPISEn RY 77.2E OAI I c R OW INSURERS AFFORDING COVERAGE • INSURED: pps 1 /c /f: AEG IR0PECTION SERVICES 13421 BM 10330 STREET MIANI, FL 93268 (308) 235 ■675C Tarr (305) 959 -1469 II JRERA: csavani ;r. Prcaperev and Casualty Tnnu-rance C INSURERS: $USURER C: INSURER D: INSURER E: COVERAGES THE ANY MAY POLICIES. 'stmt POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO.TaE INSURED NAMED AEOVB FOR THE POLY PSAIOD INDICATED. NOTWYITHBTANDINO RE OLIIREMENT, TERN OR CONDITION OP ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR PERTAIN, THE GESURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EiL LUSION8 AND CONDI710N8 OFSUCH AGGREGATE LIMITS MOWN MAY HAVE BEEN REDUCED 8Y PAID CLAIMS ` TYPE OF INSURANCE P • ..CY NUMBE- PO • = PEiA • WETS _-1 0EA'L TCERAL LfAEYUTY OIYI ERCV4. GENERAL LIABILITY CLAIMS MAOS OCCUR EACH OCCURRENCE $ FIRE CAVIAOE (My One Eke) $ MD ERR (AnY eM p Oa) $ PERSONAL & ADV INJURY 5 GENERAL AGGREGATE $ AGGREGATE UNIT APPLIBBPER POLICY n J914 r11-0C PRODUCTS • COW/CPAOG $ AUTOMOBILE — _ - — .� LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULEDAUTO6 HIRED AUTOS NON4OWNEDAUTO8 Memo fEe 886006 SINGLE LIST $ BODILY IHUURV 041( Man) $ BODILY LRY (per =Me l) $ PROPERTY DAMAGE (Per =WO $ `GARAGE — UABILPIY ANY AUTO AUTO ONLY -ea ACCIDENT TS OTHER TW N RA A'OC $ AUTO ONLY: AGE 5 EXCESS LIABILITY OCCUR CLAIMS MADE .. EACH OCCURRENCE s AGGREGATE $ 8 DEDUCTIBLE RETENTION $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILfTY OPB00120440050 01/01/2011 01/01/2012 XII Lx Mt- 0 e 1000000 1000000 r.L DOIWOaIDEN! E.L. o6eaale • � EMPLOYEE aL.DlsaosE.P000YUL$T 8 1o00c0Q OTHER U pui. uax IMUlltatTOTIM3ITRWCWAL in effect, provided the client's any em ..,oy for which the 0fpPT8 leased tc AFG Compensation 8 Employers liability M(,avinewailb account client is not INSPECTION SERVICES, as a i6 ia_g od re o_ -i4 g effective cc-employer LJMITs $ LIN'8 6tandin with P ?S H Res o P 01 01/20'1. under t e policy 4 2. For • Nr.awv min vr vrcam sanato noil ltJ van,b1„tytASAMI 1. This certificate ins :overage is no: provided for Applj.e$ to 100$ of the employees is red is afforded workers employees leased from PPS. CERTIFICATE HOLDER 1 1 ADDITIDNAL INSURED' ttrs RERLETTER: CANCELLATION MIAMI 230333 VILLAGE BUILDING DEPT. 10050 N.E. 2nd AVB. MIAMI SHORES, FL 23130 ACORD 264 (7107) SPORE, THt a WIRA H N4 DATE THEREOF, THU GRIM INSURER WIJ.ENDEAVOR TO sum. 30 DAYS MUTTON NOTIOE TO THE 08RTIPIWiTE HOLDER 31*00D TO THE LEFT, BUT FAILURE TO DO 50 MALL IMPOSE NO OBLdGAT1ON OR LUIBILITY OP ANY KM UPON THE INSURER, IT'S AGENTS oR REPRESENTATIVES. AUTNOR0:6D RP-PRESENTATIVE ®ACORD CORPORAT ON 1988 ACORD,., CERTIFICATE OF LIABILITY INSURANCE 1 DATE (MWDD Y) 08/29/2011 ADM. INSRD PRODUCER (305) 442 -1234 X101 GABLES ASSURANCE GROUP (FL) 7047 SW 47TH STREET MIAMI FL 33155- THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. INSURERS AFFORDING COVERAGE NAIC 8 INSURED AKG INSPECTIONS SERVICES 14376 SW 139TH CT BAY 810 MIAMI FL 33186- INSURER k MAXUM SPECIALTY INSURANCE X INSURER a PROASSURANCE COMMERCIAL GENERAL LIABILITY INSURER C: 12/03/2010 / / / / / / INSURER D: EACH OCCURRENCE INSURER E: X COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADM. INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDIYY) POLICY EXPIRATION DATE (MMIDDIYY) LIMITS A X GENEZALUABILITY COMMERCIAL GENERAL LIABILITY BD00043453 -02 12/03/2010 / / / / / / 12/03/2011 / / / / / / EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED PREMISES (Ea occurrence) 8 100,000 ICLAIMS MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL &ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE UNIT APPLIES PER PRODUCTS - COMP/OP AGO $ 1,000,000 7 POLICY "j I ISRE8f I I LOC DEDUCTIBLE 1,000 AUTOMOBILE L1ABIUTY ANY ALTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS / / / / / / / / / / / / / / / / COMBINED SINGLE UNIT dent) $ — BODILY INJURY (Per Peron) $ _ BODILY INJURY (Per $ _ _ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO / / / / AUTO ONLY - EA ACCIDENT $ 'R OTHER THAN EA ACC $ AUTO ONLY: AGO $ EXCESS/UMBRELLA UABIUTY / / / / / / / / EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ RETENTION 8 $ RDEDUCTIBLE $ $ WORKED COMPENSATION AND EMPLOYED' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below / / / / / / / / WC gT {� I TORY LIAMTITS I 1 ER EL EACH ACCIDENT $ EL DISEASE - EA EMPLOYEE $ EL DISEASE - POLICY UNIT $ B OTHER PROFESSIONAL LIAB ERRORS & OMMISSION PR008915309 12/03/2010 / / / / 12/03/2011 / / / / mum PROF INCIDENT 100,000 AGGREGATE 100,000 DEDUCTIBLE 5,000 DESCRIPTION OF OPERATIONSILOSATIONSNEHICLES IEXCLUSONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS MS INSPECTIONS INCLUDING WOO INSPECTIONS s ROOF REPAIRS/ ROOF REPLACEMENT /ROOFER- CCC042809 CERTIFICATE HOLDER CANCELLATION (305) 795 -2204 MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORES ( FL ) - 33138- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) INS025 (01 X8).06 ® ACORD CORPORATION 1988 Pagel of 2