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RF-11-18190 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: I NSP- 167055 Permit Number: RF -10 -11 -1819 Scheduled Inspection Date: November 29, 2011 Inspector: Bruhn, Norman Owner: LLOYD - GODSK, JOE Job Address: 120 NW 105 Street Miami Shores, FL 33150 -1244 Project: <NONE> Contractor: MIAMI ROOFING SYSTEMS INC Permit Type: Roof Inspection Type: Final Roof Work Classification: Flat Phone Number Parcel Number 1121360131300 Building Department Comments TEAR OFF EXISTING FLAT ROOF, FURNISH AND MECHANICALLY FASTEN AT BASE SHEET, TORCH - INSTALL AND MODIFIED BITUMEN. Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 165106. Zc- November 28, 2011 For Inspections please call: (305)762-4949 Page 17 of 20 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RE: Permit # ee to" I t 1 ' -I DATE: I0j?1 it I INSPECTION AFFIDAVIT 1 -Some,/ IR Q a✓loaz licensed as a (n) Contractor / Engineer / Architect, (Print name and circle License Type) License #: l.JCC O-J1 300 FS 468 Building Inspector On or about 101•911.1 11 , I did personally inspect the roof deck nailing and (Date & time) 'r Secondary water barrier work at IIan J (jJ 105 -Y_ � (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) ignature 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 *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 # dearly shown marked on the deck for each inspection Revised on 5/21/2009 Lab Report No. S10 -1743 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: 120 NW 105 St. Miami Shores OWNER: Joe Lloyd -Godsk CONTRACTOR: Miami Roofing Systems TILE TYPE: Flat ATTACHMENT: PolyfoamTM / PolyproTM Testing Equipment: Digital Chatillon DFIS 200 Test Tabulation PERMIT No: RF 10 -11 -1819 ROOFING SQUARES: 33 ROOFPITCH: 3:12 INSPECTOR INITIALS:, AA TEST DATE: 11/17/11 Required Testing Force: 35 Ibs No. RESULT No. RESULT No. RESULT No. RESULT No. RESULT 1 -5 Passed 21 -25 Passed 41-44 Passed 6 -10 Passed 26 -30 Passed 11 -15 Passed 31 -35 Passed 16 -20 Passed - 36-40 Passed THIS ROOF HAS: PASSED FAILED ❑THE STATIC UPLIFT IN ACCORDANCE WITH MIAMI -DADE COUNTY TAS 106. "RO5 ' SEI'CH' I 4 3 r 39 8 4 // 10 'Reviewed by: q///tl Alberto Cardona, P.E. -Lic #17138 10735 SW 216th St. Unit 416 Miami, FL 33170 www.floridatec.net Tel: (305) 256 -4550 Fax (305) 256 -6833 OCT 14 2fli j r Miami Shores Village Building Department (0050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 BUILDING 10tu PERMIT APPLICATION FBC 2004 Permit Type (circle): Building Permit No. Pi 'q ?dc Master Permit No. Owner's Name (Fee Simple Titleholder) J � � Phone # 305 2 i & — C5 SG: Owner's Address I (O 5 6 1 City r°T fy A')C1,1�e`,- State B Zip 50 Tenant/Lessee Name j °) Phone # Job Address (where the work is being done) GO N VU JO5 ' City Miami Shores Village County Miami -Dade FOLIO / PARCEL # ) I Z a 3(6 0 t ; 100 Is Building Historically Designated YES Contractor's Company Name Contractor's Address City Vr Qualifier Name cik teir State Certificate or Registration No. Zip 3Es 5D %n10Q34- State F f Zip 53/ GO n Phone # & ).5) 5,-/- 555V V NO (r1 hone #( 3nJ f)54-5359 559 Architect/Engineer's Name (if applicable) rr� Value of Work For this Permit $ I E, Type of Work: ❑Addition D yciiibeWork: - Ctr cfc f y tL it iC ❑Alteration YO L: 1- Certificate of Competency No. Phone # Square / Linear Footage Of Work: ['New 3p 9917 Repair/Replace ❑ Demolition ******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** *Fees * * * * * * * * * * * ** Submittal Fee $ Notary $ Scanning $ Radon $ DPBR $ Bond $ Code Enforcement $ Structural Review. $ Total Fee Now Due $ .(53 Permit Fee $ Training/Education Fee $ * * * * * * * * * * * ** * * * * * * * * * * * * * * ** CCF $ CO /CC Technology Fee $ Zoning $ Double Fee $ See Reverse side --+ r Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged Signature Owner or Agent The foregoing instrument was acknowledged before me this The foregoin instrument was acknowledged before me this day of a a„20 u.4 , by -71Cle, z't I , day of / 201/ , by '(E 'Y ' who is personally known to me or who has rop duced � L. who is personally known tome �r who has produced As identification and who did take an oath. NOTARY PUBLIC: Si P My as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Co * * * * * * * * * * * * * * * * * * * * * * * * * * * * ***, Oak**************** **************************** **** * * **** *** * *** *** *** ***** * ** APPLICATION APPROVED BY: (Revised 07/10/07) Plans Examiner Engineer Zoning ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Application Form. Sprtinn A (General Information) 2011 Master Permit No. (� o �n Process No. Contractor's Name I`�1tAM1 G4S Job Address lan N v V ❑ Low Slope ❑ Asphaltic Shingles �I05`'" s ❑ Mechanically Fastened ❑ Metal Panel/Shingles ❑ Prescriptive BUR -RAS ROOF TYPE ❑ New Roof ®'Reroofing ❑ Recovering ROOF SYSTEM INFORMATION Miami Shores Village e ' • APPRO'frr . r . es ve e BY e DATE ZONING DEPT 150 BLDG DEPT SU13JE TE103 OMPLIAMattagi fe DERAL STATE AND COUNTY RULES AND REGULATIONS Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) X01 Section R (Roof plan) Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scu Include dimensions of sections and levels, clearly identify dimensions of elevated pres parapets. FLORIDA BUILDING CODE — BUILDING I T I1Ii: I I I I I ,v...___4, V r k`°` ._„LiArok Allii, ' '1 511 • FLORIDA BUILDING CODE — BUILDING ROOF ASSEMBUES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 High- Velocity Hurricane Zone Uniform Permit Application Form. Sermon D (Stee) Sloped Roof System) Roof System Manufacturer: rri rGWo , I !e Notice of Acceptance Number: 'O ^ iac . 01 Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculation11: _ y 5. / p2: — r7 ci, (o P3: —11(0,01 Maximum Design Pressure (From the Product Approval Specific System): 3 � 3 S c� t7crI4Y Roof Slope: 1_5_: 12 ,Stepp Slnpprl Rnnf Rystpmliesrrin_tton Deck Type: Type Underlayment: Ridge Ventilation? Insulation: 4frao /1-smi N 1,i- \ Fire Barrier: i_ N`T, \ Fastener Type & Spacing: Mean Roof Height: ha \ Adhesive Type: I ` rhi 45 i /. no4- (noped Type Cap Sheet: 90ftTM Roof Covering: FI a4 -4-i Ie \ Type & Size Drip Edge: 3 eWi G FLORIDA BUILDING CODE — BUILDING ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 High - Velocity Hurricane Zone Uniform Permit Application Fonn. Section F (Tile Calrulations) For Moment based tile systems, choose either Method 1 or 2. Compare the values for Mr with the values from Mr. 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. Method 1 "Moment Based The Calculations Per RAS 127" (Pt ~7�5yy.Ixa•net _ /r'3..a3)_Mg: r7/.7gp =Mrt t7'at%Q (PZ 1O• �x x .as? .a9.1 . Mg: .. %q� / 5 (P371/&• °z 1l •t910 5 D) . Mg: /. 9.M3 d5•- Product Approval Mf aLy Product Approval Mf 31. A.3 Product Approval Mf • 5 Method 2 "Simplified Tile Calculations Per Table Below" Required Moment of Resistance (Mr) From Table Below Product Approval M Mean Roof Height -> Roof Slope 2:12 3:12 4:12 5:12 6 :12 7:12 Mr re uired Moment Resistance* 16' 20' 25' 34.4 36.6 38.2 32 2 34.4 36.0 30.4 7 33 R 28.4 30.1 31.6 26.4 26.0 29.4 24.4 26.9 27.1 30' 40' 39.7 42.2 37.4 39.8 35.1 37.3 32.8 34.9 30.5 32.4 28.2 30.0 *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 for F with the values for Fr. If the F' values are greater than or equal to the Fr values, for each area of the roof, then the tile attachment method is acceptable. Method 3 "Moment Based Tile Calculations Per RAS 127" (Pi: x L = x w: = ______) - W: x cos 0 = Fri (P2: x = x w: = ______) - W: x cos0 =Fi2 (P: x L = x w: _ - W: X cos 0 = Fr; Product Approval F Product Approval F Product Approval F' Where to Obtain Information Description Symbol Where to find Design Pressure PI 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 x Product Approval Restoring Moment due to Gravity M8 Product Approval Attachment Resistance My Product Approval Required Moment Resistance MB Calculated Minimum Attachment Resistance F Product Approval Required Uplift Resistance Fr Calculated Average The 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 MIAMID COUNTY BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION NOTICE OF ACCEPTANCE (NOA) 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 Entegra Roof Tile, Inc. 1289 NE 9th Ave Okeechobee, FL. 34972 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 High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Plantation 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 No. 10- 0804.15 and consists of pages 1 through 5. The submitted documentation was reviewed by Alex Tigera. NOA No.: 10- 1202.01 Expiration Date: 12/08/15 Approval Date: 12/30/10 Page 1 of ROOFING ASSEMBLY APPROVAL Category: Roofing Sub Category: Roofing Tiles Material: Concrete 1. SCOPE: This renews a roofing system using Entegra "Plantation" concrete roof tile, as manufactured for Entegra Roof Tile, Inc. in Okeechobee, FL as described in Section 2 of this Notice of Acceptance. For the locations where the pressure requirements, as determined by applicable Building Code, does not exceed the values listed in section 4 herein. The attachment calculations shall be done as a moment based system, 2. PRODUCT DESCRIPTION: Manufactured by Test Product Applicant Dimensions Specifications Description Plantation Tile Length: 161/2" Flat concrete roof tile for direct deck or Width: 13" TAS 112 batten nail -on. Trim Pieces Length: varies Accessory trim, concrete roof pieces for Width: varies TAS 112 use at hips, rakes ridges and valley Thickness: varies terminations 3. LIMITATIONS: 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. 33 Applicant shall retain the services of a Miami -Dade County Certified Laboratory to perform quarterly test in accordance with TAS 112, appendix `A'. Such testing shall be submitted to the Building Code Compliance Office for review. 3.4 Minimum underlayment shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.5 30/90 hot mopped underlayment applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayment material manufacturers published literature. 3.6 This acceptance is for wood deck applications. Mini/num deck requirements shall be in compliance with applicable building code. 4. INSTALLATION: 4.1 Entegra Roof Tile, Inc.'s Plantation Flat Tile and its components shall be installed in strict compliance with Roofing Application Standard RAS 118,119, & 120 4.2 Data For Attachment Calculations MIAMI•DADE COUNTY APPROVED NOA No.: 10-1202.01 Expiration Date: 12/08/15 Approval Date: 12/30/10 Page 2 of 5 Table 1: Average Weight (W) and Dimensions (1 x w ) Tile Profile Weight W (lbf) Length -1 (ft) Width -w (ft) Plantation Tile 11.6 1.375 1.08 Table 3: Restoring Moments due to Gravity - Mg (ft-Ibf) Table 2: Aerodynamic Multipliers - X (ft3) 2 ": 12" 3 ":12" ": Tile ": X (ft3) Profile 38.1 17.2 4 12" Profile 6 12" Batten Application Direct Battens 1 ation Plantation Tile Battens 0.267 Battens 0.289 Battens Direct Table 3: Restoring Moments due to Gravity - Mg (ft-Ibf) file 2 ": 12" 3 ":12" ": ": ": Greater than Profile 38.1 17.2 4 12" 5 12" 6 12" 7 ": 12" 2 -10d Smooth or Screw Shank Nails Battens Direct Battens 1 #8 Screw Battens Direct Battens Direct Battens Direct Battens Direct 24.3 24.3 Deck 1 -10d Smooth or Screw Shank Nail (Eave Clip) 19.0 19.0 Deck 2 -10d Smooth or Screw Shank Nails (Field Clip) Deck 35.5 Deck 2 -10d Smooth or Screw Shank Nails (Eave Clip) Deck Plantation 7.22 7.91 6.85 7.79 6.75 7.67 6.61 7.52 6.44 7.32 6.26 7.04 Tile Table 4: Attachment Resistance Expressed as a Moment - Mf (ft -Ibf) For Nail -On Systems Tile Profile .Fastener Type Direct Deck (Min 15132" plywood) Direct Deck (Min. 19/32" plywood) Battens Plantation Tile 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 Screw 51.7 51.7 24.4 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 31.9 32.2 2 -10d Ring Shank Nails.' 50.3 65.5 48.3 Installation with a 4" tile headlap and fasteners are located a minimum of 2/" from the head of tile. MANMADE COUNTY APPROVED NOA No.: 10-1202.01 Expiration Date: 12/08/15 Approval Date: 12/30/10 Page 3 of 5 Table 5: Attachment Resistance Expressed as a Moment Mf (ft-lb For Two Patty Adhesive Set Systems Tile Profile Tile Application Mini um Attach ent Resistance Plantation Tile Adhesive 31.33 2 See manufactures component approval for Installation requirements. 3 Flexible Products Company TileBond Average weights per patty 13.9 grams. Polyfoam 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 Plantation Tile PolyProTM 118.94 PoIyProTM 40.4b 4 Large paddy placement of 45 grams of PolyProTM. 5 Medium paddy placement of 24 grams of PolyProTM. Table 7: Attachment Resistance Expressed as a Moment - Mf(ft-Ibf) for Mortar Set Systems Tile Profile Tile Application Attachment Resistance See specific mortar manufacturer's Notice of Acceptance. 5. LABELING 5.1 All tiles shall bear .the imprint or identifiable marking of the manufacturer's name or logo as seen below or following statement: "Miami -Dade County Product Control Approved ". 5.2 Entegra Roof Tile, Inc.'s Plantation Roof Tile bears the following markings: USA "E" USA, "E ", Entegra "E ", where the E is a stylized logo. 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Any other documents required by the Building Official or applicable Building Code in order to properly evaluate the installation of this system. 7. MANUFACTURING LOCATIONS 7.1 Okeechobee, FL MADE COUNTY APPROVED NOA No.: 10-1202.01 Expiration Date: 12/08/15 Approval Date: 12/30/10 Page 4 of 5 PROFILE DRAWING PLANTATION FLAT CONCRETE TILE END OF THIS ACCEPTANCE MIAMI DADE COUNTY APPROVED NOA No.: 10-1202.01 Expiration Date: 12/08/15 Approval Date: 12 /30/10 Page 5 of 5 MIAM2 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 -25999 www.minmidademov/buildine/ Polyfoam Products, Inc. 11715 Boudreaux Road Tomball, TX 77375 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed 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 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. 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: Roofing Sub Category: Roof tile adhesive Materials: Polyurethane SCOPE: This approves Polyprofq 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 Product Description Specifications Polypros? AH160 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 PS1 Parallel to rise 12 PS1 Perpendicular to rise 28 PS1 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 and are subject to normal manufacturing variation. MIAMIOADE COUNTY APPROVED 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/Report Date Center for Applied Engineering #94 -060 TAS 101 04/08/94 257818 -1PA TAS 101 12/16/96 25- 7438 -3 SSTD 11 -93 10/25/95 25- 7438 -4 25- 7438 -7 SSTD 11 -93 11/02/95 25 -7492 SSTD 11 -93 12/12/95 Miles Laboratories NB -589 -631 ASTM D 1623 02/01/94 Polymers Division Ramtech Laboratories, Inc. 9637 -92 ASTM E 108 04/30/93 Southwest Research Institute 01- 6743 -011 ASTM E 108 11/16/94 01- 6739- 062b[1) ASTM E 84 01/16/95 Trinity Engineering 7050.02.96 -1 TAS 114 03/14/96 Celotex Corp. Testing Services 528454 -2 -1 TAS 101 10/23/98 528454 -9 -1 528454 -10 -1 520109 -1 • TAS 101 12/28/98 520109 -2 520109 -3 520109 -6 520109 -7 520191 -1 TAS 101 03/02/99 520109 -2 -1 LINIITATIONS: 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 HANDI -STICK roof the adhesive with their tile assemblies shall test in accordance with TAS 101 with section 10.4 as modified herein. r2 E) — W MIAMMDADE C APPROVED NTY F'— MS NOA No.: 11-0124.04 Expiration Date: 05 /10/12 Approval Date: 04 /14/11 Page 3 of 7 INSTALLATION: 1. Polypro® AH160 may be used with any roof tile assembly having a current NOA that Iists uplift resistance values with the use of Polypro® AH160. 2. Polypro® AH160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof tile assembly's adhesive attachment with the use of Polypro® AH160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed the uplift resistance determined in compliance with Miami -Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA 3. Polypro® 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. 4. Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by Polyfoam Products, Inc. Polyfoam Products Inc. shall supply a list of approved applicators to the authority having jurisdiction. 5. Calibration of the Foampro® dispensing equipment is required before application of any adhesive. The mix ratio between the "A" component and the "B" component shall be maintained between 1.0- 1.15 (A): 1.0 (B). The dispense timer shall be set to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No other settings shall be approved. 6. Polypro® AH160 shall be applied with Foampro RTF1000 or ProPack® 30 & 100 dispensing equipment only. 7. Polyproo AH160 shall not be exposed permanently to sunlight. 8. Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after Polypro® AHI60 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 Detail Single Paddy Weight Min. (grams) Two Paddy Weight per paddy Min. (grams) Flat, Low, High Profiles #1 35 N/A High Profile (2 Piece Barrel) #1 17 /side on cap and 34 /pan N/A Flat, Low, High Profiles #2 24 N/A Flat, Low, High Profiles #3 8 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. MIAMI.DADE COUNTY APPROVED 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 NaU through plastic cement Paddy (Bans% Tile) UiuIaymenI 1 Eave COM Ease Closure Fascia Eno course only: Keep Woke approx, 4hLupfromwespols Options PAs for 1) Place enough adhesive to whine 1T to 23 steep pitali application square inches In contact %alb the pan tile Tum covers upside down. Place adhesive 112 In\ To 1 la. From outside edge dower tilo. Then Install the tTe. Underlaymant Nall through Ask cement MIAMIOADE COUNTY APPROVED 110°P Poll °fin ono course cover tile. Abut found course of pantiles. Ensure emend of PO SO COW tllel OTO flush at eave Ilne. Me closure Weephote Fascia (oda shown) Pointvp Ikalar on lonpullnal edges des NOA No.: 11-0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 5 of 7 ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY Nall through plastic cement Underlayment Paddy (Beneath Tlla) 7 ht. Ewe Course MIAMIOADE COUNTY APPROVED Faecla Eon Closure 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 Nall through plastic cement Paddy (between tile) Paddy (under tile) 0 • Single paddy 3 In- under the x 3 in. Single paddy on under- layment Single paddy on top of We 0 COMO in, X 7 in, medium size paddy eave Fascia course only Nall through plastic cement Nail through plastic cement Underlayment 1 Single paddy under tile Single paddy between the 2 in. x 7 In. medium size paddy eave course only ett- re- in.x 3 In. 4 In. Single paddy on under- layment Single paddy on top of tile Eave Course Fascia Wormhole Eave closure Drip edge Single paddy between tile Pekin.x 31n. Single paddy on underlayment Single paddy on top of the Eave Cause Eave Closure 2 in. x T In. medium eke paddy eave course only Fascia END OF THIS ACCEPTANCE MIAMMADE COUNTY APPROVED NOA No.: 11-0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 7 of 7 Miami Shores Village ET 0 4 2011 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 Permit Type: BUILDING OWNER: Name (Fee Simple Titleholder): Address: IaO IQ S ROOFING :roe_ Gn3s( Master Permit No. Phone #: City: Ttc&yYi1 14107es State: F I Zip: 45..5 1 OC) Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: 1130 N N Io b City: Miami Shores County: Miami Dade Zip: 35160 Folio/Parcel #: 11— al? iD- 013- I 0 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: M IQIiy t y le_/m Address: Nw )O1 �� Phone #: %Cob 95 '4'' SsSSt City: 11n1Cty State: '1—t Qualifier Name: 361/4V 1e r 1 ae-- iir12Z State Certification or Registration #: Contact Phone #: Email Address: rnietrni Zip: '-ejN 6O Phone #: ?6 95q 555(4 Certificate of Competency #: inn f2YnesA 000. Car% DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 3, 850 . 00 Square/Linear Footage of Work: 001 Type of Work: DAddition ❑Alteration �,i ❑Newr DRepair/Replace ❑Demolition Description of Work: �,QCvY � .P X iv-i oc\ rbb-P 4 - vvrrn{ , cold. vw c- irtein'i CQ - c-Ci4e.n .) -1-` d YCIr1 - 1 n a Cl ***** xx((**** x: **** * *a��ax:�a�a�r�ax�x��x+xx *** *x�+�****Feo* x�****a�x�x�mx�+xu�a: *+xx�+xx�: + a�wx�x� +x *�rx�u� ****x�x�****+a*** Submittal Fee $1l�' Permit Fee $ DP CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ rdNga • �� Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not approved and a reinspection fee will be charged. Signature Owner or Agent ± -�/ The foregoin in trument was acknowledged before me this 0/'+ day of 20 IL, by -TOE G. who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Signature �z / Contractor The foregoing instrument was acknowledged before yie thi day of , 20 _, by 141.1/e/ le /Jay4 a is personally known to me or who has produced as identification and who did take an oath. **** **+ x***** s,**** ***** +x**** **** * *** * ***+x+x ***** six* x: *+ x*** **s:x:+x******s,****** **** : *****s, **a: s: *******+n************ APPROVED BY �C�-7�� ( Plans Examiner Structural Review (Revised 07 /10/07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk 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: CI G--) 10050 NE 2nd Ave Miami Shores, Fl 33138 Re: Owner's Name: SURF'_ Gad-1 . Property Address: lap n1\N I 0 5 r viarni einore- f1 v3► 5b Roofing Permit Number: Dear Building Official: `` I �e c2 cx3 certify that I am not required to retrofit the roof to wall connections of my building because: 1fhe just valuation for the structure for purpose of ad valorem taxation is Tess than $300,000.00. Please attach proof of ad valorem taxation. ❑ The building was constructed in compliance with the provisions of the Florida Building Code (FBC) or with the provisions of 1994 edition of the South Florida Building Code (1994 SFBC) Print Name State of Florida County of Dade The undersigned, being the first duly swom, deposes and says that he /she is the owner for the above property mentioned. Swom to and subscribed before me this 1 " day of Sepetn62,v O)1 Notary Public, Sate of Florida • When the just valuation of the s SFBC. Then you must provide a builig appf Revised on 5/21/2009 an $300,000.00, and the building was not constructed with FBC nor a 1994 to Wall connection Hurricane Mitigation. Property Infgrmation,Map Property Information Map http: / /gis ims2.miamidade. gov /myhome /printmap. asp ?mapurl =http: / /gi... My Home Miami -Dade County, Florida Aerial Photography - 2009 0 .®. 28 ft This map was created on 9/29/2011 10:44:20 AM for reference purposes only. Web Site © 2002 Miami -Dade County. All rights reserved. 1 of 1 'Year: MIAMIDADE 1 Summary Details: Folio No.: iling dress: Pro 11- 2136 - 013 -1300 120 NW 105 ST MARGARITA LLOYD -GODSK &H JOE J 120 NW 105 ST MIAMI SHORES FL 33150 -1244 e Information: Primary Zone: LUC: 0800 SINGLE FAMILY RESIDENCE 0001 RESIDENTIAL - ISINGLE FAMILY Beds /Baths: 13/2 Floors: 11 ILiyin Units: 1 j Sq Footage: 2,294 ;Lot Size: J12,200 SQFT ear Built: 1951 MIAMI SHORES SEC 5 PB 10-47 LOTS 3 & 4 BLK Legal Description: 126 LOT SIZE 100.000 X 122 OR 16382 -0416 0594 1 OR 16382 -0416 0594 00 Assessment Information: ear: Land Value: Building Value: $203,519 Market Value: $263,494 $271,633 ,Assessed Value: f $138,790 $136,739 Exemption Information: 2011 $59,975 2010 $66,858 204,775 2011 2010 Homestead: $25,000 $25,000 ;2nd Homestead: YES YES Taxable Value Information: Year: f 2011 2010 Applied axin g Exemption/ thorny: Taxable Value: Applied Exemption/ Taxable Value: Reeional: $50,000/$88,790 $50,000/$86,739 oun : $50,000/$88,790 $50,000/$86,739 ity: chool Board: $50,000/$88,790 25 000/$113,790∎25,000 $50,000/$86,739 /$111,739 Sale nformation: 'Sale Date: 5/1994 [Sale Amount: $124,000 Sale O /R: 16382 -0416 Sales uglification Sales which are qualified Description: View Additional Sales 9/29/2011 10:46 AM ROOF ASSEMBLIES AND ROOFTOP STRUCTURES .:FlkCtic Miami Shores Village APPROVED Florida Building Code Edition 2097 ING DEPT HIgh - Velocity Hurricane Zone Uniform Permit Appllcata itilThelDEPT BY cis DATE Section A (General InfonnationyUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AND REGULATIONS Master Permit No. Procass No' Contractor's Name MOM; CR00'f1Yt 61 Job Address I (D taw iD'E ICANe ern s gLow Slope 0 Asphaltic ( gies 1 Area (SF) ❑ Mechanically Fastened Tile ❑ Metal Panel /Shingles 0 Prescriptive BUR -RAS 150 ROOF TYPE XReroofing 0 Recovering ROOF SYSTEM INFORMATION Steep Sloped Roof Area (SF) Section B (Roof Plan) Sketch Roof Plan: illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. Include dimensions of sections and levels, clearly Identify dimensions of elevated pressure zones and location of parapets. ❑ Mortar /Adhesiv le ❑ Wood Shingles/ a es � 73 OCT 042011 Dpi 0 Repair ❑ Maintenance Total (SF) Zoe 19: 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 as "NA ") �< <et317ane System Manufacturer: Product Approval No.: JO– I' (• Design Wind Pressures, From RAS 128 or Calculations: Pmax1 ry9.9 Pmax2: -2a Pmax3: i2LI.3 Max. Design Pressure, from the spec b fic Product Approval system: —5;11)., Deck: Type: W cod. Gauge/Thickness: Slope: /14 Anchor /Base Sheet & No. of Ply(s): NI 14 Anchor /Base Sheet Fastener /Bonding Material: NIA Insulation Base Layer: N ! A Base Insulation Size and Thickness: �i A Base Insulation Fastener /Bonding Material: 00 Top Insulation Layer: Top Insulation Size and Thickness: NIA NIA Top Insulation Fastener/Bonding Material: N IA Base Sheet(s) & No. of PIy(s):(d) ply o-r' i ret-N4Dre (has Pape Sheet Faste er/ n ng Ma erial ecb,ant`cpl�y �c I1J ilto1s Ply Sheet(s) & No. of Ply(s): N I A Ply Sheet Fastener /Bonding Material: Top Ply: Q`f Ave 170 Pe Top Ply Fastenglaondipg Material: O�YC.P FLORIDA BUILDING CODE — BUILDING Surfacing: hi IA Fastener Spacing for Anchor /Base Sheet Attachment: rr Field: w " oc © Lap, # Rows a @ " oc Perimeter: 47 " oc @ Lap, # Rows @ (a " oc Comer: Le " oc @ Lap, # Rows q @ W " oc Number of Fasteners Per Insulation Board: Field NIA- Perimeter NIA- Comer IU %A-' 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 Wood 3x5 drip ecbC y d� �ciresbne aPMAr R Wits qn.sirif o.f' Mod B;+ ( i ) Ply A?p t'® FR -f ch Parapet 1 Height Mean Roof Height • BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT (BNC) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Firestone Building Products Company, LLC 250 East 96th Street Indianapolis, IN 46240 -3702 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.gov /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 by Miami -Dade County Product Control Section 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 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. BORA 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 and the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Firestone Modified Bitumen Roof Systems over 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 NOA No. 08- 0118.07 and consists of pages 1 through 27. The submitted documentation was reviewed by Jorge L. Acebo. MIAMFDADE COUNTY APPROVED NOA No: 10- 1230.02 Expiration Date: 03/08/16 Approval Date: 03/24/11 Page 1 of 27 Membrane Type: APP Deck Type 1I: Wood, Non - insulated Deck Description: 19/32' or greater plywood or wood plank fasten to supports with #8 x 1 -5/8" wood screws at a maximum spacing of 6" o.c. System Type E(3): Base sheet mechanically fastened. All General and System Limitations apply. One p1v of Firestone MB Base or MB Base M mechanically fastened to the wood deck as described below: Fastening #1: Fastening #2: Ply Sheet: Base sheet shall be lapped 4" and fastened with Firestone #14 AP fasteners 3" Round Metal Plates 12" o.c. in the lap and two rows staggered in the center of the sheet 12" o.c. Base sheet shall be lapped 4" and fastened with approved roofing nails and tin caps 6" o.c. at the lap and two rows staggered in the center of the sheet 6" o.c. SOptional) One or more plies of Firestone MB Base Sheet, Type IV, Type IV M, Type VI or Type VI M ply sheet or other listed base sheet applied in a full mopping of approved asphalt applied within the EVT range and at a rate of 20 -40 lbs. /sq.; or one ply Firestone APP 160 or APP 170 torch applied. Membrane One ply of APP 160, APP 170, APP 180 or A P 180 FR torch applied parallel to the base ply, with overlaps staggered 12 ". Surfacing: (Optional) Install one of the following: 1. Gravel or slag at 400 Ib. and 300 Ib., respectively, set in a flood coat of type III or IV asphalt at 60 lb./sq.. 2. Karnak No. 97, No. 97 AF or No. 169 at an application rate of 1Y2 gal./sq.. 3. Fields F900 emulsion, Gilsonite Durakote # 151, Gibson Homans #6192 -900 applied at 6 gal. /sq. with 60 lbs. of roofing granules set in the wet coating. Maximum Design Pressure: —52.5 psf (See General Limitation #7) MIAMMADE COUNTY APPROVED NOA No: 10- 1230.02 Expiration Date: 03 /08/16 Approval Date: 03/24/11 Page 25 of 27 WOOD DECK SYSTEM LIMITATIONS: 1. A slip sheet is required with Ply 4 and Ply 6 when used as a mechanically fastened base or anchor sheet. 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 compliance with Product Control Approval guidelines. All other layers shall be adhered in a full mopping of approved asphalt 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 3. All standard panel sizes are acceptable for mechanical attachment. When applied in approved asphalt, panel size shall be 4'.x 4' maximum. 4. An overlay and/or recovery board insulation panel is required on all applications over closed cell foam insulations when the base sheet is fully mopped. If no recovery board is used the base sheet shall 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 at a minimum rate of 12 lbsisq. Note: Spot attached systems shall be limited to a maximum design pressure of -45 psf. 5. Fastener spacing for insulation attachment is based on a Minimum Characteristic Force (F') value of 275 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 Building Official, a revised fastener spacing, prepared, signed and sealed by a Florida Registered Engineer, Architect, or 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. 7. Perimeter and comer areas shall comply with the enhanced uplift pressure requirements of these areas. 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 registered Professional Engineer, Registered Architect, or Registered Roof Consultant. (When this limitation is 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 MIAMI•DADE COUNTY APPROVED NOA No: 10- 1230.02 Expiration Date: 03/08/16 Approval Date: 03/24/11 Page 27 of 27 TGFU.R9516 - Roofing Systems file: / / /C:/ Users / Jose / Documents /Wor10/020 %23 %202 %20(Miami ONLINE CERTIFICATIONS DIRECTORY Page Bottom TGFU.R9516 Roofing Systems Roofing Systems See General Information for Roofing Systems FIRESTONE BUILDING PRODUCTS CO L L C 250 W 96TH ST INDIANAPOLIS, IN 46260 USA R9516 References to Type G1 and Type G2 ply and base sheets include "Type N", "Type VI" (Type G1), "Ply N (4) M" (Type G1), 'Ply VI (6) M° (Type G1), "MB Base Sheet M" (Type G2), "MB Base Sheet° (Type G2) in any of the following Classifications. °Firestone Venting Base Sheet" (Type G3) may be used in lieu of any Type G2 base in any applicable non - combustible Classification. "SBS Poly Base Sheet" can be used in any non - combustible deck system which utilizes a Firestone SBS cap sheet. "ISOGARD" and "ISO 300" are acceptable altemates to "ISO 95 +" in any applicable Classification. °I.S.O.FIX Adhesive° may be used in any of the following Classifications to adhere insulation to the roof deck. "I.S.O. Spray "' S° may be used in any of the following Classifications to adhere insulation to both non - combustible roof deck substrates and other insulation layers including wood fiberboard and G -P Gypsum Corp. "Dens -Deck® Roofboard° or "DensDeck Prime® Roofboard° or "DensDeck DuraGuard'" Roofboard." "Tapered ISO 95 +CAN" may be substituted for "ISO 95 +CAN" in any of the systems listed below. "ISO 95 +CAN° may be perforated on one side for use as the contact side for BUR or modified bitumen membrane. ASPHALT FELT SYSTEMS WITH HOT ROOFING ASPHALT Class A 1. Deck: NC Incline: 3 Insulation: — "ISO 95 +FK°, "GL ", "GW° or "Rhoflex Isocyanurate FK °, "GC, "GW ", any thickness, mechanically fastened or adhered with hot mopping asphalt. Ply Sheet: — Two to four layers Type 15, G1 or G2, any combination. Surfacing: — Gravel. 2. Deck: NC Incline: 3 Insulation: — "ISO 95 +Composite °, "Rhofiex Isocyanurate Composte° or °ISO 95 +Wood Fiberboard Composite ", mechanically fastened or adhered with hot mopping asphalt, 1.5 to 3.5 in. thick. Insulation (Optional): — Perlite, 1 In. thick. Ply Sheet: — Three to four layers Type 15, G1 or G2, any combination. Surfadng: — Gravel, slag or crushed stone. 3. Deck: NC Incline: 3 Base Sheet: — "MB Base Sheet ", mechanically fastened or hot mopped. Insulation (Optional): — Any UL Classified (EPS must be covered with 1/2 in. thick min glass fiber, wood fiber or periite), any thickness, mechanically fastened or hot mopped. Ply Sheet: — One or more layers ° MB Base Sheet " or Type 61, any combination. Surfadng: — Gravel, crushed stone or crushed slag, In a flood coat of hot roofing asphalt. 4. Deck: C-15/32 Indine: 1 Insulation (Optional): — any UL Classified, any thickness. Ply Sheet: — One or more plies Type G1, G2 or "SBS Base Sheet °, mechanically fastened or hot mopped, any combination. Membrane: — °SBS Smooth', "SBS Premium° or "SBS" (modified bitumen), hot mopped. Surfacing: — Gravel, crushed stone or crushed slag, in a flood coat of asphalt. 5. Deck: NC Indine: 1 -1/2 Insulation (Optional): — any UL Classified, any thickness. Ply Sheet: — One or more pees Type 61, G2 or "SBS Base Sheet°, mechanically fastened or hot mopped, any combination. Membrane: — °5BS Smooth °, "SBS Premium" or "SBS" (modified bitumen), hot mopped. Surfacing: — Gravel, crushed stone or crushed slag, in a flood coat of asphalt. 6. Deck: NC Incline: 3 Insulation (Optional): — Firestone "ISO 95 +GL ", "FlberTop B ", "C', "E °, "S ", wood fiberboard, polyisocyanurate, fiberglass, perilte, any combination, any thickness, mechanically fastened, hot mopped or attached with any UL Classified cold adhesive. Base Sheet (Optional): — One or more plies Firestone °MB Base Sheet °, mechanically fastened or hot mopped. `-� Ply Sheet: — One or more plies Firestone "Ply N Felt" or °Ply VI Felt °, mechanically fastened or hot mopped. Surfadng: — Gravel, crushed stone or crushed slag In a flood coat of asphalt. 7. Deck: C -15/32 Incline: 3 1 of37 11/16/2010 12:28 TG FU. R9516 - Roofing Systems file: / / /C: /Users /Jose /Documents /Work%20 %23 %202 %20(Miami' 72. Deck: NC Indfne: 1/4 Insulation: — Perlite, glass fiber or wood fiber, 3/4 to 2 in. Membrane: — "FR- EPDM ", "W -EPDM" or "G- EPDM ", 45 or 60 mil, fully adhered to insulation with Uniroyal °Royal M6504" roofing adhesive at 1 gaVsq. 73. Dedc: NC Iodine: 1/4 Insulation: — Glass fiber, perlite or wood fiber, 3/4 to 2 in. Membrane: — "EPDM" or "Triumph EPDM ", 45 or 60 mil. 74. Deck: NC Incline: 1/2 Insulation: — EPS, any thickness, covered with USG "Structodeck °, 1/2 to 1 In. Membrane: — °FR EPDM ", 45 or 60 mil. 75. Deck: NC Incline: 1/2 Insulation: — Poyisocyanurate, any thickness. Barrier Board: — Wood fiberboard, 1/2 in. min. Membrane: — "W- EPDM ", "R -EPDM° or °Triumph Reinforced EPDM ", 45 or 60 mil, fully adhered with Uniroyal °Royal M6504" adhesive at 75 sq ft/gal. The membrane laps are sealed with Uniroyal "Royal M6365° adhesive at 1/2 gal /100 sq ft and the lap edges are caulked with Uniroyal "Royal M6389 ". 76. Dedc: NC Incline: 1/2 Insulation: — Polystyrene, any thickness. Barrier Board: — Wood fiberboard, 1 in. min, or one of the following boards at 1/2 in. min: Celotex wood fiberboard, Georgia- Pacific °Sturdi -Top" or Huebert Fiberboard fiberboard. Membrane: — °R -EPDM " or °Triumph Reinforced EPDM °, 45 or 60 mil, fully adhered with Uniroyal "Royal M6504° adhesive at 75 sq ft/gal. The membrane laps are sealed with Uniroyal 'Royal 6365° adhesive at 1/2 gal /100 sq ft and the lap edges are caulked with Uniroyal "Royal M6389 ". 77. Dedc: NC Indfne: 1/2 Insulation: — One of the following (any thickness): 1. Atlas Roofing °ACFoam II °. 2. Apache Products "Apache PYROX ", °Apache White Line ", °Apache Tapered Pyrox ". 3. Johns Manville "ENRGY 2A ", °ENRGY 2G °. Membrane: — "FR" EPDM, 45 to 60 mils, fully adhered with one of the following: 1. Uniroyal bonding system. The membrane 5 adhered with °Royal M6504" bonding adhesive, applied at 60 sq ft/gal. The membrane laps are sealed with "Royal M6365° lap adhesive, applied at 75 sq ft/gal. The lap edges are caulked with °Royal 6346 ". 2. Ashland Chemical bonding system. The membrane Is adhered with "PLIOBOND 2375° bonding adhesive, applied at 60 sq ft/gal. The membrane laps are sealed with "PLIOBOND 9053° lap adhesive at 131 En ft /gal. The lap edges are caulked with °PLIOBOND 5533 °. 78. Deck: NC Indine: 1/4 Insulation: — Polystyrene or poyisocyanurate, any thickness. Barrier Board: — Wood fiberboard, 1 In. min, or one of the following boards at 1/2 In. min: Celotex wood fiberboard, Georgia- Pacific "Sturdi -Top" or Huebert Fiberboard fiberboard. Membrane: — °EPDM °, 45 to 60 mil, fully adhered with Uniroyal °Royal M6504" adhesive at 75 sq ft/gal. The membrane laps are sealed with Uniroyal °Royal M6365 " adhesive at 1/2 gaV100 sq ft and the lap edges are caulked with Uniroyal °Royal M6389 ". 79. Deck: C -15/32 Indfne: 1/2 Insulation (Optional): — Perlite or glass fiber, 15/16 in. thick min, or poyisocyanurate, 2 in. thick min, joints In insulation offset 6 in. with joints in deck. Base Sheet: — Two or more plies "MB Base Sheet" (Type G2) or any Type G2 weighing a min of 23 lbs/sq, mechanically fastened, spot or fully mopped. Ply Sheet (Optional): — "APP 160° or "APP 170" (modified bitumen), heat fused. Membrane: — "APP 180 FR° or °RhoFlex FR" (modified bitumen), heat fused. 80. Deck: NC Incline: 1 Insulation: — Polystyrene (1 to 2.5 lbs/cu/ft), 1 in. min. Slip Sheet: — Atlas Roofing "FR -10 °. Membrane: — °UltraPly° (TPA), 40 -100 mil. 81. Deck: NC Indfne: 1 Insulation: — Perlite, any thickness. Membrane: — °UltraPly° (TPA), 40 -100 mil. 82. Deck; NC Incline: 1 -1/2 Insulation (Optional): — Polystyrene (tapered or uniform thickness) or Dow.Chemical °Styrofoam LG, PD, RM, SM, TG or STYROIB" , any thickness or glass fiber, any thickness. Insulation: — Wood fiber (Huebert) 1 in. or °FiberTop B°, ° FiberTop E °, °FlberTop C" or "FiberTop S ", 1/2 in. min. Membrane: — "UltraPly° (TPA), 40 -100 mil. 83. Deck: NC Incline: 1 Insulating Concrete: — Deck covered with either of the following insulating concretes (poured in place): cellular, vermiculite, perlite, gypsum or structural. Optionally, a base concrete deck may be used if all exposed surface joints are grouted. Membrane: — "UltraPly" (TPA), 40 -100 mil. 84. Deleted. 85. Deleted. 86. Dedc: C -15/32 Incline: 1/2 - Insulatfon (Optional): — Perlite or glass fiber, 15/16 in. thick min, or poyisocyanurate, 2 in. thick min,,Joints in insulation offset 6 in. with joints in de Type G2) or any Type G2 weighing a min of 23 lbs/sq, mechanically fastened, spot or fully embrane: — "APP 180 FR" (modified bitumen), heat fused. bitumen), heat fused. 87. Deck: NC Indfne: 1/4 13 of37 11/16/2010 12:28 PI SECTION 1524 HIGH VELOCITY HURRICANE ZONES -- REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 Scope. As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of this section. The provisions of Chapter 15 of the Florida Building Code, Building govern the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner and the contractor. The owner's initial in the designated space indicates that the item has been explained. 1. Aesthetics- workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane Zone) are for the purpose of providing that the roofing system meets the wind resistance and water intrusion performance standards. Aesthetics (appearance) are not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the agreement between the owner and the contractor. 2. Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Building Code. (The roof deck is usually concealed prior to removing the existing roof system). A ' 3. Common roofs: Common roofs are those which have no visible delineation between neighboring units (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofmg contractor and/or owner should notify the occupants of adjacent units of roofing work to be performed. 4. Exposed ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be viewed from below. The owner may wish to maintain the architectural appearance; therefore, roofmg nail penetrations of the underside of the decking may not be acceptable. The owner provides the option of maintaining this appearance. 5. Ponding water: The current roof system and/or deck of the building may not drain well and may cause water to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural distress and may require the review of a professional structural engineer. Ponding may shorten the life expectancy and performance of the new roofmg system. Ponding conditions may not be evident until the original roofing system is removed. Ponding conditions should be corrected. 6. Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not overloaded from a build up of water. Perimeter /edge walls or other roof extensions 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: Chapter 15 and 16 herein and the Florida Building Code, Plumbing. 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. Exception: Attic spaces, designed by a Florida- licensed engineer or registered architect to eliminate the attic venting, venting shall not beequired. Owner's /Agent's Signature: Contractor's Signature: Property Address: Date: / Permit Number: 12C, N\N__lo "COI¢°'' CERTIFICATE OF LIABILITY INSURANCE I ta'c1 THIS CERTIFICATE 18 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 policy (les) must be endorsed. If SUBROGATION IS WAIVED, subject to the temps 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 endorsementfe). PRODUCER FRANKCRUM INSURANCE AGENCY, INC. 100 S. MISSOURI AVE. CLEARWATER FL. 33756 ' Fd+Iwadk It .NE , INSURER(S) AFFORDING COVERAGE NAM INSLERA: FRANK WINSTON CRUM INSURANCE, INC. 11800 INSURED FrankCrum 1-800-277-1620 100 S MISSOURI AVENUE CLEARWATER FL 33756 INSURER IS- INSURER C: INSURER CC INSURERS INSURER F COVERAGES CERTIFICATE NUMBER: 126000 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICESOF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORME POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERI IHCATE HAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIESDESCRBED HEREIN:18 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. am TYPE OP INSURANCE AWL PSBR BURR VNI) - POLICY NUXSER 1 EJT IIOPOPA'TYT) PDIL`YI IP scene rn LOS e GENERAL LLARLTIY .., GENERAL HAMM OCCURRENCE $ ..... DAUAGETORENTED PREMISES (EA ooMlgim> $ =- CIAWSYADE _OCCUR WO EIP(Assam Pawn) $ PERSONAL & ACAS MIRY - GENERALAVT%'CVTE $ cum AGATE LINT AMUSE, PER ;DUCT 1111, mom= PRODUCTS -CONPSOP AGG $ umury ANY AUTO ALL OWNED AUTOS HIRED AUTOS ■AtROg - SCHEDULED AUTOS NON -OWNED SINGLE (EA «mdena $ 11111 BWILY INJURY (Pa pgmn) $ BOOSTRY(Pet=AP S $ $ - IMII LS48 EXCESS In CLAM-MADE AGGREGATE $ - DM - RETENTION! $ A : COMPENSATOR AND EMPLOYERS' LIABILITY PROPRIETOR/PARTNER/EXECUTIVE rani Wow N/A WC201100)00 1/112011 1(112012 - WCWAnI' X TORY =TS 0 H rR ER - ELL EACH ACCIDENT 81.000,000 OFFICERAIESABER EXCLUDED? WOO V yft aerate urger DESCRIPTION OF CPEFUGIONS EL DISEASE• EA EMPLOYEE $1,000.000 EL DISEASE -P000Y LN'T $1 000000 DESCRIPTOR OF OPERATIONS ILOCATION SfvDOCIES (Atls,ACOAD 101,AdIpk .IReeelb SalwMM,E more Rea, Is l THIS CERTIFICATE REMAINS IN EFFECT PROVIDED THE CLIENTS ACCOUNT IS IN GOOD STANDING WITH Frank0rum. COVERAGE IS NOT PROVIDED FOR ANY EMPLOYEE FOR WHICH THE CLIENT IS. NOT REPORTING HOURS TO FrankCrum. COVERAGE IS NOT PROVIDED FOR STATUTORY EMPLOYEES OF THE CLIENT. EFFECTIVE 051172/2025, APPLIES TO 100% OF THE EMPLOYEES OF FrarLkCrum LEASED TO MIAMI ROOFING SYSTEMS, INC. 305- 7645332 CITY OF MIAMI SHORES ATTN: BUILDING DEPT, 10050 NE 2ND AVE. MIAMI SHORES, FL 33138 SHOULD ANY OF THE ABOVE. DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PBDVISIIONS. AUTHORIZED REPRE/ERTAIS/a i4--- ACORD 25 (201010E) The-ACORD none end logo ere registered masks of ACORD ®10882010 ACORD CORPORATION. All rights reserved. ZOPEL 11FTE OF LIAB !TY IMRANAE 0 MGM m= INSWINNcE SERVICE 14t21 S. 1031E SWY PAUtarTQ BLY, FL 43176 (304254.2140 Demo 14/314/ ROOFING 311 711516 ' ME I ANY ot �CP ANY OR ME q tGE AFFOROM BY POLICAEu ►PEREw 1S SU63EO`T nouces_A Tgiavrss� ombliwwwe t�Rr . kV attRei We CF.OSIRNSE Pewee NUMBER I A 1 a .$111 1 D =97300 AN/0 010 667 NW 101 STRENT 1d14MI , 8Z 33250 Zfk 1-0c 01I, j11 01i QOO.. 0OO oc„tu 50,000 s 1 Oil a r Asuoir OP44 00' #$ K0 3 ,004 Aurcato Atumememurros smammoott PoPffiflAUTOB NOR•CO PEDAUTQS ROIREYROURY c UCEROOMRRROA IMAM OCCUR Or iE s AUTQO*Y AGO Rconoot waCuimecompooknaNANu EltRARIOUr WAR* RPRSRRRAMOCIORtucen + ARCAREOMRSRR . CORM tetaRipnottctoostAirmittLoanconiaitaes +# 31Bi i"S,A BYEID0AWAFNMPECKPROft,t9 COONVARItOtimit 44E* 4.4 �4f9P•PClL�GYbNA!'1` ' ORKONMA- SHOULD ANY fNfS ftEt EDP RIR' ELFW8 WOPIRATiOC1 ROCCCA TOThE[ 8 4DcD@R* 1OThE,lEff. BtA'.P: 'is CORO Stw. ROM 04,0444004 OR,gOttmeR .t�NY ',I. 'r < < 4F$mais6:CRR • • .4 1 ATE EATCH NUMBER Tr-N.:at - 1,O(054 2' 4. !i,12 Ya R70 iW 546622-2 BUSINESS NAME LOCATION MIAMI ROOFING SYSTEMS INC 667 NW 101 ST 33150 UNIN DADE COUNTY THIS IS NOT A BILL - DO NOT PAY RENEWAL RECEIPT NO. 570624-8 STATE* CC058322 OWNER MIAMI ROOFING SYSTEMS INC See. Typo of Business FIRST-CLASS U.S. POSTAGE I PAID MUWAI„FL PERMIT NO. 231 WORKER/5 196 SPECIALTY BUILDING CONTRACTOR 3 THIS IS ONLY A LOCAL spmes- TAX BEDEW. FT DOS NOT MINT niN HOLDER TO MLA= ANY MOM REGINATORY ON ZOOMS LAWS TIT TOE COUNTY CIA,_11C111A, NOR ITEFOIINGITATWOOnal NEMO Olt =NEE foggwom BY lAW. TINS IS tAziT ituniRCERTIrouT.10 OP PAYAIITIT cRIECIArn„ Tmx 07/06/2011 60030000522 000075.00 SEE OTHER SIDE .• " DO NOT FORWARD MIAMI ROOFING SYSTEMS INC JAVIER MARTINEZ PRES 667 NW 101 ST MIAMI FL 33150 11 111111111111 111111111 111111611111 1111 II 1111 III g 1