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RF-11-2214Permit Number: RF -11 -11 -2214 1 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 169616 Inspection Date: February 02, 2012 Inspector: Bruhn, Norman Owner: DAILEY, RICHARD Job Address: 10402 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: CASTON ROOFING INC Permit Type: Roof Inspection Type: Final Roof Work Classification: Tile Phone Number (786)395 -3369 Parcel Number 1121360130650 Phone: (305)279 -0475 Building Department Comments RE ROOF TILE TO TILE WHITE COLOR THRU Passed Ocb—/e4 Inspector Comments CREATED AS REINSPECTION FOR INSP- 168522. CREATED AS REINSPECTION FOR INSP- 167142. Cap sheet must not be exposed to sunl ght. Closed valleys required. NB All previous inspection are required first. NB (-1C-- Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled re- inspection fee is paid. until February 03, 2012 For Inspections please call: (305)762 -4949 Page 1 of 1 win Shores Village . Building Department 050 NE,Nd Ave she. Maud Shores. Flotilla 33138 Tel: ( ) 795 F (3+ ) 7S3 29ti: Cr INSPECTIONS PRONE NUMBER: (305) 762.049 PERMIT APPLICATION FBC 20 Permit BUILDING ROOFING OWNT.11: Name (Fee Simple T . Finait:. D DEC 2 0 2011 Permit No - .:n -i1- 2 --. master Permit -3 - 33' Jon ADDREss4 1 0 .. err 9 A ;V& Is the Banding ifistorkally Designated: Yes NO Flood CONTR4Ci° y /I a _cam clok 100? City '1111.. Qualifier Name: /4.3, % .; .; P itconelt S Cen _.. ear Regi : ` I :e eV- l v z C - ^g. of Compete #: Ca -7 �i - -' 1 : 4...0,4 !12 :° " 1 -="es+ (sa a +.'s . DESIGNER: bi: tJEm : Value Work for this [::$ - . ScinareiLbsearatotageof Type of Work: a ' ;:. �Wpsa+4AX#iser!! Submittal Fee S Fee ��(od C • Scanning Fee S , Radon Fee .S DRPR $. Road Notary $ TralningfEdneation FeeS Technology Fees Double Fee Structural .Re $ SAL FEE NOW DUE r i% Bonding Company's. ` z (ifs ble) Bonding Company's Aire s Caw Spa Lender's Mortgage Islam tit applicable) Idemage Undoes .. Ntplitution is 'e . to do the work and instaatiters a $.i 1 that= or Wattled= bee to issuance end thee ail a 1 « the � all Iws rep intl - , . 1 -.. a . b f�:i�C.TR1CA . • -P s SIGNS WELLS ; FURNACE* 5 TANITSited l S 1 OWNEWS A VLT: 1 certify that aill t . feresattng inf .. is econneowd Abet tat worksal; �s "WARNING TO OWNER: YOUR Fly TO R .CO , , A NOTIPE COMMENCEMENT MAY RESULT IN O R PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY, IF YOU TO OBTA '+ FINANCING* CONSULT WITH YOUR LENDER R ATTORNEY BEFORI RECORDING YOUR NOTICE OF CO iENCE " Notice A a conditioa .. o,, a Entildbm pen/Wu* proonisei s good f. a copy e, rent ant .. whose pmperry lea w drra a e ' e fit. Air the '47) s:.4 er otte:d ... rertis d: �t a fre *rill be BCCEP$AFE 91{!l{!irt rmn!. €i1eIre Anna Puts Commission #DD758589 Expires: MAR. 31, 2012 BONDED THRU ATLANTIC BONDING CO., INC NOT-0Y PUBLIC: Val NiOpo n jttJpt y B R. \,.0 ,/ `,\' mie17ie / ",iii p pi,. •,F`ORIDP tUmo 69P71 atll=yttt: .69.0610.9 089904669 "0 iC! {its w • 0 A.0'9. }St tit /ciZa la gitviiICfI1Kiiill. Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Application Form Section D (Steen Sloped Roof System) Roof System Manufacturer ( 6-2-&' .1/f7;1-76 f,vci — Notice of Acceptance Number: //,32/. 02--- Minimum Design Wind Press res, If Applicable (From RAS 127 or Calculations): P1: mi `� l' P2: CS. /P3: en J Maximum Design Pressure (From the NOA Specific System): Method of tile attachment: � C. `% 7,2 /90,./ Roof Slope: :92 St = -- • Slo • = d Roof S stem Descri Deck Type: ype Underl nsulation: re Bawer: Ridge Ventilation? stener Type & Spacing:) / dhesive Type: ype Cap Sheet: oof Covering: PEA �nrs j� /Lvs' Cz . Type & Size Drip dge: Miami Shnrac v slag APPROVED BY RATE 370 ZONING DEPT BLDG DEPT 123?i:tiCtEiiici9 iMagV,IPLIANCE Wl'fl-1 ALL FEDERAL STATE AND CC hN IY ri(,LES AND REGULATIONS Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Application Form Section E (Tile Calculations) For Moment based tile systems, choose either Method 1 or 2. Compared the value for Mrwith the values from MI. If the Mr value are greater than or equal to the Mr values, for each area of the roof, then the the attachment method is acceptable. Method 1 "Moment Based Tile Calculations Per RAS 127" (P1: z A, m ) - Mg: = Md. NOA M1 (P2' z A. = Mg: = M,y NOA Mt (P3: z A, = __) — Mg: = Mr3 NOA Mt Method 2 "Simplified Tile Calculall Per Table Below" Required Moment of Resistance (111;) From Table Below � NOA 11h *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 "Uplift Based Tile Calculations Per RAS 127" (Pt• zI: = z w:= ) -W: z cos 8: = Fes: NOAF' (P2 : a l: = z w: = a cos B: = F,2: NOA F (P3: a is = a w: = )'- W: a cds 6: = Fes: NOA F Where to Obtain Information Mr Required Moment Resistance* Mean Roof Height Roof Slope ' ,1 Where to find `: ,15'' \ , ' 20' 25' 30' 40' — _ L. =-, t 2:2 Job Site AemdynamicAultiplier 34A NOA 38.5 38.2 38.7 42.2 3:12 Attachment Rice Mr NOA 32.2 Requ$odiMomentResistance 34.4 38.0 37.4 39.8 412 NOA Required Uplift Resistance 30A Calculated ," 322 33.8 35.1 37.3 5:12 w= width NOA 28A All calculations must be submitted to the Building Official at the time ofpe mitapplication. 30.1 31.6 328 34.9 6:12 26.4 28.0 283 30.5 32.4 7:12 24A 25.9 27.1 28.2 30.0 *Must be used in conjunction with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based tile systems use Method 3. Compared the values for F' with the values for Fr. If the F' values are greater than or equal to the Fr values, for each area•of the roof, then the tile attachment method is acceptable. Method 3 "Uplift Based Tile Calculations Per RAS 127" (Pt• zI: = z w:= ) -W: z cos 8: = Fes: NOAF' (P2 : a l: = z w: = a cos B: = F,2: NOA F (P3: a is = a w: = )'- W: a cds 6: = Fes: NOA F Where to Obtain Information DescriptiOA - Symbol Where to find Design Press= P1 orP2orP3 RAS 127 Table 1 or by en engineering analysis prepared by PE based onASCE 7 Mean Roof Height H Job Site Roof Slope g Job Site AemdynamicAultiplier 3, NOA Restoring Moment due to Gravity Ms NOA Attachment Rice Mr NOA Requ$odiMomentResistance Mr Calailated Minim= AttachmentResistanoe F' NOA Required Uplift Resistance Fr Calculated ," r Avemge Tile W= 1, ,1 W NOA w= width NOA All calculations must be submitted to the Building Official at the time ofpe mitapplication. 123_01 -48 12/09 PAGE 5 MIAMI COUNTY BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT (BNC) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Eagle Roofing Products LLC 1575 East C.R. 470 Sumterville, FL 33585 MIAMI -DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida33175 -2474 T (786) 315 -2590 F (786) 315 -2599 www.miamidade.aov/buildiaa/ 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 Veloc Hurricane Zone of the Florida Building Code. DESCRIPTIO 1 Air Double Eagle, Ponderosa, Ponderosa Double Eagle, Golden Eagle ow Profile Concrete Tiles 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. Wetly 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 #07- 1018.08 and consists of pages 1 through 9. The submitted documentation was reviewed by Alex Tigers ;APPROVED' NOA No.:11- 0321.02 Expiration Date: 10105/16 Approval Date: 05/12/11 Page 1 of 9 ROOFING ASSEMBLY APPROVAL Catcorv:, Sub Cateeorv: Material: Roofing Roofing Tiles Concrete 1. SCOPE: This approves a new roofing system using "Low Profile Concrete Tile" as manufactured by Eagle Roofing Products LLC in Sumterville, FL and described in Section 2 of this Notice of Acceptance. For locations where the pressure requirements, as determined by applicable Building .Code does not exceed the design pressure values obtained by calculations in compliance with RAS 127 using the values listed in section 4 herein. The attachment calculations shall be done as a moment based system. 2. PRODUCT DESCRIPTION: Manufactured b_v, Applicant Bel Air Concrete Tile Bel Air Double Eagle Concrete Tile Ponderosa Concrete Tile Ponderosa Double Eagle Concrete Tile Golden Eagle Concrete Tile Trim Pieces APPROVED Dimensions L= 17" W =12Y4" Thickness ='2 " L =17" W =12'4" Thickness = V2" L= 17" W =12'4" Thickness ='A" L =17" W =12'A" Thickness ='/," L= 17" W =12A" Thickness ='A" 1= varies w = varies varying thickness Test Snecificatattons TAS 112 TAS 112 TAS 112 TAS 112 TAS 112 TAS 112 Product Description Flat profile concrete roof tile equipped with two nail holes. For adhesive set, direct deck or battened nail -on applications. Flat profile concrete roof tile equipped with two nail holes. For adhesive set, direct deck or battened nail -on applications. Flat profile concrete roof tile with slate finish equipped with two nail holes. For adhesive set, direct deck or battened nail - on applications. Flat profile concrete roof tile with shake finish equipped with two nail holes. For adhesive set, direct deck or battened nail - on applications. Flat profile concrete roof tile brushed finish equipped with two nail holes. For adhesive set, direct deck or battened nail- on applications. Accessory trim, clay roof pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tile profile. NOA No. :11- 0321.02 Expiration Date: 10/05/16 Approval Date: 05/12/11 Page 2 of 9 3. LIA+IITATIONS: 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile applications, a static field uplift test in accordance with. TAS 106 may required, refer to applicable building code. 3.3 Applicant shall retain the services 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 ststectterwise by the underlayment materint nianufacturerspublished literature. 3.6 This acceptance is for wood deck applications. Minimum deck requirements shall be in compliance with applicable building code. 4. INSTALLATION 4.1 Eagle Roofing Products LLC Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle, Ponderosa Double Eagle Flat Concrete Roof Tiles and its comments shall be installed in strict compliance with Roofing Application Standard RAS 118, RAS 119 and RAS 120. 4.2 Data For Attachment Calculations Table 1: Average Weight (W) and Dimensions (I x w ) Tile Profile Weight W (Ibf) Length -I (ft) Wiidth -w (ft) Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle, Ponderosa Double Eagle Flat Tile 11.4 1.42 1.03 Table 2: Aerod namic Multi Hers - A ft Tile Profile A(ft Batten Application A( ) Direct Deck Application Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle, Ponderosa Double Eagle Fiat Tile 0.301 0.278 NOA No.:11- 0321.02 Expiration Date: 10/05/16 Approval Date: 05/12/11 Page 4 of 9 Table 3: Restoring Moments due to Gravity - IIIIn (ft -lbf) Tile Profile 3 ":12" 4 ":12" 5 ":12" 6 ":12" Greater than 7 " :12" Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle, Ponderosa Double Eagle Flat Tile Batten s Direct Deck Battens Direct Deck Battens Direct Deck Batten s Direct Deck Batten s Direct Deck 7.48 7.71 7.37 7.59 7.22 7.44 - - 7.05 _ 7.27 6.86 7.07 Table 4: Attachment Resistance Expressed as a Moment - Mf (ft -Ibf) for Nall -On Systems Tile Profile Fastener Type Direct Deck (min 15/32" plywood) Direct Deck (min. 19132" plywood) Battens Bel Air, Bel Air Double Eagle, Ponderosa , Golden Eagle, Ponderosa Double Eagle Flat 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 1. Installation with a 4" tile headlap and fastemers are located a min. of 214" from head of tile. I APPROVED I _ NOA No.:11- 0321.02 Expiration Date: 10/05/16 Approval Date: 05/12/11 Page 5 oi9 Table 5: Attachment Resistance Expressed as a Moment My (ft -Ibf) for Two Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle, Ponderosa Double Eagle Flat Tile Adhesive 31.33 1 See manufactures component approval for installation requirements. 2 Flexible Products Company TileBond Polyfoam Product, Inc. Average Average weight per patty 13.9 grams. weight per patty 8 gams._ Table 6 :: Attachment'Resistance for Single Pa Expressetas h Moment - Mi (ft ... . .. Adhesive Set Syste ms Tile Profile Tile Application Minimum Attachment Resistance Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle, Ponderosa Double Eagle Fiat Tile PolyPProT"° 118.9" PolyProTm 40.4b 3 Large paddy placement of 45 grams of PolyProT"°. 4 Medium paddy placement of 24 grams of PolyProTb'. Table 7: Attachment Resistance Expressed as a Moment - M,(ft -Ibf) for Mortar. or AdhesbaxiSeMistems. . Tile Profile Tile Application Attachment Resistance Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle, Ponderosa Double Eagle Fiat Tile Mortar Sete 43.9 s Tile -Tice Roof Tile Mortar. 5. LABELING : All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo (See Detail Below), or following statement: "Miami -Dade County Product Control Approved ". APPROVED! EAGLE'' FLORIDA NOA No. :11- 0321.02 Expiration Date: 10/05/16 Approval Date: 05/12/11 Page 6 of 9 6. BUILDING PERMIT REQUIREMENTS: 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 this Notice of Acceptance. 6.1.2 Any other documents required by Building Official or Applicable building code in order to properly evaluate the installation of this system. • PROFILE DRAWING BEL Am BEL Am DOUBLE EAGLE APPROVED NOA No.:11- 0321.02 Expiration Date: 10/05/16 Approval Date: 05/12/11 Page 8 of 9 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 167138 Permit Number: RF -11 -11 -2214 Scheduled Inspection Date: December 12, 2011 Inspector: Bruhn, Norman Owner: DAILEY, RICHARD Job Address: 10402 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: CASTON ROOFING INC Permit Type: Roof Inspection Type: Renailing Affidavit Work Classification: Tile Phone Number (786)395 -3369 Parcel Number 1121360130650 Phone: (305)279 -0475 Building Department Comments RE ROOF TILE TO TILE WHITE COLOR THRU Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. December 09, 2011 For Inspections please call: (305)762 -4949 Page 18 of 40 RE: Permit # /7r- //- (a -22-1Y Miami Shores Village Building Department INSPECTION AFFIDAVIT /Z, 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 DATE: licensed as a (n) Contractor / Engineer / Architect, (Print name and circle License Type) FS 468 Building Inspector License #: On or about /*/ /c2/ (Date &time) ©e( 72 Secondary water barrier work at Based upon that exa Manual (Based o 5 ination I h .844 F. , I did personally inspect the roof deck nailing and N Cr ? 1A14,441 14,4 1 4c-f (complete Job Site Address) ve determined the installation was done according to the Hurricane Mitigation Retrofit Signature State of Florida County of Dade: ,[[�;� - 7)adt The undersigned, being the first duly swom, deposes and says that he /she is the contractor for the above property mentioned. Swom to and subscribed before me this /0 day of ..Pee Notary Public, Sate of Florida at Large HUMBERTO PEREZ MY COMMISSION #DD813720 EXPIRES: SEP 13, 2012 Bonded through 1st State Insurance *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 it and address # clearly shown marked on the deck for each inspection Revised on 5/21/2009 '+t Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 168522 Permit Number: RF -11 -11 -2214 Scheduled Inspection Date: January 11, 2012 Inspector: Rodriguez, Jorge Owner: DAILEY, RICHARD Job Address: 10402 NE 2 Avenue Miami Shores, FL 33138- Project: <NONE> Contractor: CASTON ROOFING INC Permit Type: Roof Inspection Type: Final Roof Work Classification: Tile Phone Number (786)395 -3369 Parcel Number 1121360130650 Phone: (305)279 -0475 Building Department Comments RE ROOF TILE TO TILE WHITE COLOR THRU Passed 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- 167142. Cap sheet must not be exposed to sunlght. Closed valleys required. NB January 10, 2012 For Inspections please call: (305)762-4949 Page 29 of 37 F.I.E. FLORIDA INTERNATIONAL ENGINEERING &TESTING LAB INSIGHT•INNOVATION•INTEGRATION Florida International Engineering and Testing Lab LLC 16701 SW 117 Avenue, Miami, FL 33177 Telephone: (305) 378 - 1991 -Fax: (305) 378 -1997 Miami -Dade Lab Certification # 07- 0612.11 -State of Florida ca #27273 SITE SPECIFIC INFORMATION Owner's Name: apse Job Address: JP 4a2 2 iJ fit Roofing C o n t r a c t o r : 7 ' � ! /c 6491-r, AJ Permit Number: X 't// —i/ • Z 2./ 4 Type of Tile: Motel/ �t 5 H. Approximate Roof Height: 2 feet Slope: 3 4 f 2. Approximate Square Footage: Type of Access to Roof: Ladder OtherRequired Testing Force: 35 lbs. Testing Equipment: F.G.E. 100x Shimpo Instrument Date Installed: / Z--64' " 1 Date of Inspection: / °l' P/✓ TEST RESULTS P= PASS, F= FAIL Test Location P or F Test Location P or F Test Location P or F Test Location P or F Test Location P or F 1 j 21 ® 41 61 81 2 ' 22 42 " 62 82 3 23 43 63 83 4 24 44 64 84 5 25 45 65 85 6 26 46 66 86 7 27 47 67 87 8 28 48 68 88 9 29 49 69 89 10 30 50 70 90 11 31 51 71 91 12 32 52 72 92 13 33 53 73 93 14 34 54 7 74 94 15 35 55 75 95 16 36 56 76 96 17 37 57 77 97 18 38 58 78 98 19 39 59 79 99 •. 20 --, 40 60 80 100 I ACCORDANCE WITH THE CRITERIA OF PROTOCOL TAS 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST ADDITIONAL TEST INFORMATION Perimeter Width: j ft Area Units or ft2 No. of Tests Perimeter e. j 2, Field e® Corners VI Hips & Ridges ® 9 RESPECTFULLY SUBMITTED BY: Vma 12/05/2011 10:10 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES X1001 * * * * * * * * * * * * * * * * * * * ** * ** TX REPORT * ** * * * * * * * * * * * * * * * * * * * ** TRANSMISSION OK TX /R% NO 2019 RECIPIENT ADDRESS 93052730123 DESTINATION ID ST. TIME 12/05 10:10 TIME USE 00'34 PAGES SENT 1 RESULT OK 111511 t - v4N' Permit No: 11 -2214 Job Name: November 30, 2011 Miami Shores Village 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 B is incorrect. Provide a corrected sketch per instructions on section B. 2) Section C is incorrect. Provide the minimum design wind Toads from RAS 127. 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 FAQ 315- 2;1$ 0125 COMMENCEMENT CFN: 20 10819714 BOOK 27918 PAGE 1846 ,.:. , . • :'WP€artifE1[0F , . _. TE:1 07/2011.. 11:16:36 AM HARVEY WIN ;- CLERK ;OF COURT' MIXDADE CTY STATEOP.: .. TIE UNDERSIGNED hai>by* cisies ootioe that %r ern 1 *. o . propedy;atti acconterceoatith Onaptat 713. .Quit s '. pha`r i iO: ::... ...:_ ,..inapt: 1. Legal . y`y ty and 31. Iris Rife* taitpefrit sittame.- �. • 1700: by,' ids:., ... , .$... ,:: t t < + **on. 71113047.* j7., . . 6 . a. himself, Ownws . 'Mum. F *toe*. i . :F t date Iii ii Calef INAIUMTOOWNE* A tY PROMM WibellYTHE OWUERAFrof TF OOME NC OS OF PAYmalt$ onDER CHAPrEFf 113, PART L 713,1.S. rilatiO4 STICUTM .A 3 OAN 'Mal l 'YO PONS G 1V E 4 TO MUR PROPERTX A NOTICE OF oommaireSENT SAM St =VS= At40 Pd STD i ' FAST KSPEODOW IF`YOU intact I MINN ocetstwr vinuYOuR tIEWIew04,1.Attl ATTOMOY BERM t0a0.104:ege OR REOGREWS YOUR gig TilefOlfice SIVE OF FLORIDA CO J?- Y OF MIAM-OADE 1 _. By P • t y.� s a IratoliguaEy. Qr a as p • F 'YT!Ir4 pu /tit r= : {L R.4t A 6�[An a Unott mottos of yy i I have reef. lL ® o that s In it ste . to $ 'td } u 0 ✓ 0 t, .c ecd ... Denutv Clerk Miami Shores Village Building Department 1050 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: / 0 4-62__ NC— city: \KA \A-NA:\ Tenant/Lessee Name: ROOFING la NOV 2 9 20111 JLb Permit No.).P.- l l "414 Master Permit No. Phone#: . c 39S- K762 State: ZiP= Phone#: Email: JOB ADDRESS: \ 0 4-0 2- /U & AUQ_- City: Miami Shores County: _.,___ - Natal Dade. Zip• Folio/Parcel#: Is the Building Historically Designated: Yes NO ✓ Flood Zone: CONTRACTOR: Company Name: Address: IN area Phone#: ©S " gr711A 77 City: l y \ t V6NAA State: Qualifier Name: C� S State Certification or Registration #: cC C- / 217 Contact Phone#: ?6 2 7 '-'19(-01. Email Address: )7 Phone#:7o.( 2 7 f '-tx (7S Certificate of Competency #: (`fir -S i -0/✓ t f2 4 cam DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ 7 2 Sr Square/Linear r Footage of Work: 46. 11" Type of Work: OA. , 1 on lirAlterafion °Demolition Description of Work: /v WZA. Imo' t,.3 i r.3 C °New °Repair/Replace rn * * *** *** *** ***** * * * ****** ** * * * * *** Submittal Fee $ Permit Fee $ �i /J CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ Q G 1 • Appliereiva is hereby met to m paudt to do the wok and I certify essz site work or , prior cemeteneed tot the bistmee of a permit and Oat alt work iit be of 3 laws rep" in this kaisciiedon. a repwre, e permit MK f C L.4tF . RX ?WOWING. SE :. WELLS. POOLS, KAMM TEM TANKS OWNEWS ; I amity tit s#I the' trweiving inforraatioa laws, cowtmetiee and ° "WARNING TO OWNER, YOUR FAILURE TO RECORD A NOTTCE OF COMMENCEMENT Y RESIXT IN YOUR PAYING TwicE FOR IMPROVEMENTS TO YOUR P Y. IF YOU INTEND T OBTAIN FINANCING* CONSULT YOUR O ATTORNEY BEFORE RECORDING YOUR NOTICE OF COM E - Halo • Asa rwridibion ro the ant= e 4a &Mites pent* with on p ' *4 of the cadet of ONAMffzeirtent owl tOnSinitlian' 'wary is rubject attitat ccreificd copy of the r the first *polio; which OCCUTS SOW= 17) daYS . gfter the WON Prole a fie win be ishargost the applicant to the-pereol posted ter she Oatier Agent 1 azknoviledged day of NieN 20 iskaairsokkataitt vital * take oak NOTARY PUBLIC: Sipe: �- Print L-a' c , Ycapkagssipa EsOinasu • ..)ly i 'It 24 t 5 9,, APPROVED BY 9'd'J4'7 museum= Sugared Review (Revisal 07(1607.101evised CSrt ' LOURDES SUAREZ i Notary Public - State of Florida My Comm. Expires Jul 19, 2015 Commission • EE 114095 v15II , -v(AN) Permit No: 11 -2214 Job Name: November 30, 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 B is incorrect. Provide a corrected sketch per instructions on section B. 2) Section C is incorrect. Provide the minimum design wind Toads from RAS 127. 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 FA* 36 -215 - 0123 Miami Shores Vitiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNERS'S AFFIDAVIT OF EXEMPTION ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE - BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PERSUANT TO SECTION 553.844 F.S. To: Miami Shores Village Building Department Date: 10050 NE 2nd Ave Miami Shores, Fl 33138 A% Re: Owner's Name: K C LCD L Property Address: /eyoz E P4-- Roofing Permit Number: Dear Building Official/:1 /f I C�`t �v`- certify that I am not required to retrofit the roof to wall connections of my building because: /The just valuation for the structure for purpose of ad valorem taxation is less than $300,000.00. Please attach proof of ad valorem taxation. ❑ The buil.,'ng =s constructed in compliance with the provisions of the Florida Building Code (FBC) or with the provisions of 1994 a y- iti% of the South Florida Buil. ing Code (1994 SF BC) %I -D"ase-vi ja5c4iri Signatu 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. Sworn to and subscribed before me this a,9 day of • Notary Public, Sate of Florida at Large '/' CLAUDIA V. CUBIL '�'',,,,� Notary p�ltc -State of F 2O I - r vv4, L ExPltea S8P 23.2015 1 C o � _ MY Comm- EE 128810 - Commission pssn- 46 fill ;:��, Bonded Rirou4h tlational tJotary • When the just valuation of the structure for purpose of ad valorem taxation is equal to or more than $300,000.00, and the u • ing was not constructed with FBC nor a 1994 SFBC. Then you must provide a building application from a General Contractor for the Roof to Wall connection Hurricane Mitigation. Revised on 5/21/2009 Property Information Map My Home Miami -Dade County, Florida miat7ticiacie. g o Property Information Map Aerial Photography - 2009 0 28 ft This map was created on 11/29/2011 1:21:13 PM for reference purposes only. Web Site © 2002 Miami -Dade County. All rights reserved. Page 1 of 1 MIAMI-DADS Summary Details: Folio No.: 11- 2136 -113 -0650 Property: 10402 NE 2 AVE Mailing Address: RICHARD DAILEY PO BOX 521870 MIAMI FL 33152- Property Information: Primary Zone: 1000 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds /Baths: 3/1 Floors: 1 Living Units: 1 Adj Sq Footage: 1,341 Lot Size: 10,140 SQ FT Year Built: 1940 Legal Description: 36 52 41 31 52 42 MIAMI SHORES SEC 5 PB 10- 47 S1/2 LOT 4 - LOT 5 BLK 121 LOT SIZE 78.000 X 130 OR 10721- 1283 0480 1 COC 25009-1173 10 2006 1 Assessment Information: Year: 2011 2010 Land Value: $91,566 $91,566 Building Value: $96,031 $96,102 Market Value: $187,597 $187,668 Assessed Value: $187,597 ,$187,668, Exemption Information: Year: 2011 2010 Homes e� $25,000 $25,000 2nd Homestead: YES YES Taxable Value Information: Year: 2011 2010 $165,000 Applied Applied Taxing Authority: Exemption/ Taxable Exemption/ Taxable Value: Value: Regional: $50,000/ $137,597 $50,000/ $137,668 County: $50,000/ $137,597 $50,000/ $137,668 City: $50,000/ $137,597 $50,000/ $137,668 School Board: $25,000/ $162,597 _ $25,000/ $162,668 Sale Information: Sale Date: 5/2011 Sale Amount: $165,000 Sale O /R: 27693 -0133 Sales Qualification Description: Sales qualified as a result of examination of the deed View Additional Sales http: / /gisims2 .miamidade.gov /myhome /printmap. asp? mapurl = http: / /gisims2.miamidade.g... 11/29/2011 STA DEP OF FLORIDA 111/CENT OF BUSINESS. AND PROFESSIONAL REGULATION CON UCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TAL > RASSEE FL 32399 -0783 CAST CASTONN® MIAMI Congratulations! With Floridians licensed by Our professionals and b boxers to barbeque Every day we work to im For information about o There you can find more impact you, subscribe to Department's initiatives. Our mission at the Depa constantly strive to sery Thank you for doing bust AC# JASON L PING INC 99TH TER FL 33176 license you become one of the nearly one million Department of Business and Professional Regulation. nesses range from architects to yacht brokers, from ants, and they keep Florida's economy strong. dove the way we do business in order to serve you better. , please log onto www.myfloricialloense.com. ormation about our divisions and ulations that apartment newsletters and learn more about the arent is: License Efficiently, Regulate Fairly. We ou better so that you can serve your customers. in Florida, and congratulations on your new license! • DETACH HERE NUMBER 675090-6 0 11WWWWWIrlic THIS IS NOT A BILL — DO NOT PAY 10600 SW 99 TERR 33176 UNIN DADE COUNTY RENEWAL STATES 328702424-3 FIRST-CLASS U.S. POSTAGE PAID MIAMI, FL PERMIT NO. 231 OWNER CASTON ROOFING INC sec.Tm of Sue Inketk WORKERJS -196 SPECIALTY BUILDING CONTRACTOR 1 THIS IS ONLY A LOCAL BUSINESS TAX RECEIPT. IT 0055 001 PERMIT THE =OTOREQVATOIZNYMOIRY WWW LAWS W ma COUNTY OR CITIES. NOR NOE IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR mem REQUIRED BY LAW. THIS IS NOT A CERTIFICATION OF THE HOLDER'S QUALIFICA. TIMM PAYEIWIT RECEIVED MUMMOUM COMM TAX COLUMN: 09/30/2011 09010460001 000075.00 SEE OTHER SIDE DO NOT FORWARD CASTON ROOFING INC JASON L CASTON PRES 10600 SW 99 TERR MIAMI FL 33176 hahuOunilliflhOnuLHAAWAHAAAJ 11/28/2011 09:42 9546308114 PREMIER PROTECTION PAGE 01/01 CASTO -1 OP ID: CM A�� '' °� CERTIFICATE OF LIABILITY INSURANCE °"' 1/28 "' 11/28M1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES. NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BFLOW. 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the eeruflcats holder in lieu of such endorseme . s PRODUCER 561 -637 -3399 Insurance Services of Delray o Lauderdale, FL 33301 Douglas A. Levy 1 PLIONB FAX pm a �I °1 .. . INSURER(S) AFFORDING COVERAGE NAIC Tit INSURER A :Atlantic Casualty Insurance Co LIABB-ITY COMMERCIAL GENERAL LIADtLITY INSURED C a s t o n .Roofing, Inc. Ken Casten 10600 SW 99th Ter Miami. FL 33176 INSURER B: L174000213 -2 INSURER c 10/02112 INSURER D: $ 1,000,100 INSURER 5 • $ 50,000 INSURER F t 1 CLAIMS-MADE X ER: • • THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED I- EREIN IS SUBJECT TO ALL THE TERMS, AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. gEEXCLUSIONS IN TYPE OF INSURANCE ADDL INSR SUER WVO POLICY NUMBER M/DDNYTY) POLICY LIMPS A ORAL X LIABB-ITY COMMERCIAL GENERAL LIADtLITY L174000213 -2 10/02/11 10/02112 EACH OCCURRENCE $ 1,000,100 PIISES�Ba oaxurence) $ 50,000 1 CLAIMS-MADE X OCCUR MED EXP (Any � person) $ 1,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL. AGGREGATE $ 2,000,000 GLENI AGGREGATE LIMIT APPLIES PER: 5l ( POLICY n .ST n LOC PRODUCTS - COMP/OP AGO $ 1,000,000 S Au7OMORIL.E �'-' _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS — ^ SCHEDULED AUTOS NON -OWNED AUTOS { MBINED SINGLE LIMB 5 BODILY INJURY (Pet mown) $ BODILY INJURY (Per accident) 5 PROPERTY DAMAGE A acddent $ $ UMBRELLA LUG EXCESS MAD _ 'OCCUR CLAIMS -MADE EACH OCCURRENCE s AGGREGATE $ DED 1 1 RETENT ON $ 6 WORKERS COMPENSATION AND EIMPLOYERS LIABILITY Y / N ANY PROPRIETOR/PARTNE� OFFICER/MEMBER EXCLUDED? - If yyeess desalts under DESCRIPTION OF OPERATIONS below N 1 A WC $TATU• OTH- I TORY tIMrrs � 1 PR EL EACH ACCIDENT $ E L DISEASE- EA EMPLOYEE $ EL. DISEASE. POLICY LIMIT $ DinCINPTION OF OPERA71OIS / LACA7ION$ / WHIOLES (Attach ACM 101, Addtllanal Ramar s Sahadtdq H more space le retedrod) Roofinu Contractor CERTIFICA -- - Building Department 10050 NE 2nd Ave Miami Shores, FL 33138 -2304 BUILDIN ••nn..L, ...mt Ivn SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR=RRPRE$ENTATIVB ' ACORD 26 (2010/05) ®1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD QUESTIONS? 16501 413 -160 01 -31 -2011 JEFF ATWATER STATE OF FLORIDA ctHEF FINANCIAL. OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: PERSON: FEIN: 01/31/2011 EXPIRATION DATE: 01/30/2013 CASTON 010613136 BUSINESS NAME AND ADDRESS: CASTON ROOFING INC 10600 SW 89TH TERRACE MIAMI FL 33178 JASON L SCOPES OF BUSINESS OR TRADE 1- ROOFING 2- CERTIFIED ROOFING CONTRACTOR * IMPORTANT: Pursuant to Chapter 440 . 05(14), F.S., an officer of a corporation who elects exemption from this chapter by Filing a certificate of election amder this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.OS1121, F.S., Certificates of election to be exempt... apply only within tile scope of the business or trade listed on the notice of election to be exempt. Pursuant to Chapter 440.06(13), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named en the certificate to meet the requirements of this section. QUESTIONS? (650? 413 DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW EFFECTIVE 01/31/2011 EXPIRATION DATE: 01/30/2013 PERSON JASON L CASTON FEIN 010813138 BUSINESS NAME AND ADDRESS: • CASTON ROOFING INC 10600 SW 99714 TERRACE MIAMI, FL 33176 SCOPE OF BUSINESS OR TRADE: 1- ROOFING 2- CERTIFIED ROOFING CONTRACTOR IMPORTANT F Pursuant to Chapter 440.051141, F.S., an officer of a corporation who O elects exemption from this chapter by filing a certificate of election L under this section may not recover benefits or compensation under this D chapter. Pursuant to Chapter 440.051121, F.S., Certificates of election to be H exempt.. apply only within the scope of the business or trade listed o Rthe notice of election to be exempt E Pursuant to Chapter 440.05113), F.S., Notices of election to be exempt and certificates of election to be exempt shall be subject to revocatior if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer me the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section CUT HERE * Carry bottom portion on the job, keep upper portion for your records. DWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 LJ �aE 1 Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Penmlt Application Fonn 1 Section A (General In _ rmatlonl Master Permit No. Process No. Contractor'. Name Job Address w 0 cc w w 0 z 0 N [:111EIM. ,70 ( O w w H L C o 0 /O((O2/:2/4- - ROOF CATEGORY 81ops 0 Medrankwlly Fastened Tile jai Mort rlAdhesive Set Tile 0 Metal Panel/Shingles 0 Wood Shingles/Shakes Are there 0 Prescriptive BUR RAS 150 Gas Vent Stac s? Yes O N ROOF TYPE Type: Natural0 PGX] Roof pr Re.Roofing 0 Recovering 0 Repair 0 Maintenance ROOF SYSTEM INFORMATION Roof Area (SF) Steep Area (SF) Total (SF) /6' ngles 0 Q w w r�''gg Section B (Roof P__lan) Skew Roof Plan: glustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. Include dimensions of sections and levels, clearly Identify dlmensbns of elevated pressure zones and location of parapets. IMMMMMMMM■ IMMMMMMMM■■ MMMMMMMM■ M■ MMMM■ MMMMMMM■ ■MMMSMMIMMMMMMMMMMMMMMMMMMMMOM■ IMIMMMMMMM ■MMMMMMMMMMMMMMI.MM WOMMMMMrMMMMM■■ MMMMIM ■MMMMMMMMMMMMMMMMMMMMMMMM■ 1MMl ■ ■MMMMMSMM1 /■ ■ MMMl1M• 1r. MPAI MM■ MU11MMMMM■ MM ■MUlluUlMlM1MMMMUMlMMMMMMMMMM■ 11 ■■ MUM■ MMMM■ 1■ MMC1■ M. MM.%i EiMMMM. M■ MM■ MM1M■ lMMMM1 ■11MMMMMMMMMMMM ■MMMM ■MMMM■ IMMMMMM .IM.UMMMl■M ■l■MMMUMMlUUlumummmM■ IMIN �, EEEEEENNIMEMISI EEE::EENINUMOE c;; EEEEEMUMMU E:::EE ISMUMUE ,E■ulU11l■ ►1111111■ ■UU11•l %.I,U. ■■....■IMP IIII ■■IMMSIll111IIIUIM111U ■UMIUUMMI MuUM,I.Ul,\ MUM■■ M■ UUUMUM■ SMIb7.■ u.u. M. MM■ rsu■ 11 ■.MU.MuMSursGzIMU ■1•1111MSI000U IsMMMMII ■ ■■M7MMMMMMMMMMrrMMMIIrMM■MMMM■ rmAmmIMM■MMMrmirmwwillia MMSM■ ■MMMesI IM. 1■■ II■ lUlIl UU ■ ■ ■UUUUlUUlUi.l■U.U■UUlU%UUMUL' - ∎.UU.m!11MUU1sU ■UMI■ l■■ 1M■ I. M...i.■ MM.... MM..■ r. 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MG■ rI1UMM.■ MM ■MMIII ■UMMUMUMMUMIMMUUUIMUMMMM■ M. %MMUUMMUUMUIIIM ■ IN 1 1MMMmM==nrirl■ MMMMMMM■MMM MMMMMMM1rr MMMMM ■ ■MMMMMMMCmMMUMMMMMMMMrM■I ■�■ E 1lU1. :::::1mummu ACCammor simmumC::::ummom C::::: ismonummumni .�:�:: I�.'IIApDia.IrUlrU.■Ml■ ■M MSS■■ U1■■ UUUlU UUU U1UUIU1M10001U■1MM11111MS■11MM ■ h■ W;IM?3rr. 1I liAllM ...UU ■UU.SU■ ■.UlS..■ sin■ ■■ ■■ ■UMUM ■U1U1U1U ■■ ■111 ■11111 ■s1.sr ■ t .:iI.A'iM 1xIlw"`►' s1mM11MMMiMMMMin1MMO MMMM1MrMMMM■ MMMMMMMI ■Mp ■■1■■■M■■■■■■ ■r■M1■■■ 1 1., 1 ' Eir' NU lUll UUU lUr1UUUUlUUUU lUUUUUUU1::rmmu:::M:E muse Cmommi momm Ifig ?Mr�■■Iolli \M M im ■Mr1mmai mrMM� i ummummonsimiAmi� ■m IrmmisIMF u mommMs dUL■ Bum 11 En ■■MUUMUU ■:UUUU.lU:MUUU. MMU1■1111S■M: ■.Cl1M11M1 11111■CMSI l■:.M ■:Cm ■C:u tumor s::: :::::::: ■C:::CCM::::E::: "IC ■EE: 'au:C:: ■l■ :U:r::1:■::::::::C:or 123_01-48 12/09 PAGE 2 SECTION R41102.13 HIGH VELOCITY HURRICANE ZONES — MUM OWNERS NOTIRCATION CONSICERATIONS 13.1 Ash . to tom' ._� Ora .n tramenntterr .rr, .:; be attiihmett as the ROOFING accardarve meat the _ }. ' % rack Canthaln fads ere thcie4 ants of Evosed Cam: Egvsed, open beam :« are vim tve underside dale roof decking esa teem Tte owner may s the of etedecIfing any ci &tress gut may Was _ new a evpsdancy end perithrtme et the P:Y 7E"iv'n.. 101. not the be aclthe r X43 Florida Building Code Edon 2007 High Velocity Harriman Zone uniform Permit App Form Vcr? /vler-7Z. of Acceptance Number: IP 7- %/t e; Design Wind Pressures, if Applicable (From RAS 127 or Calculations): P1: ^ % fly 132: Mum Design Pressure iF ' 'n the NOA pie it'd of the aftachmenC 1-6 / , ,44/6e9 Steep Sloped Roof Svstem Description V: Mean lieof A- A/Pc-- Type & spacing: y r "7lcj c EJ dhealvs Typal ype Cap Sheet ‘1:04.54, roja.cri r . oof covering: I 110/W64 SWOT Type & Size Drip 1 Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Application Form Section E (Tile Calculations) For Moment based tile systems, choose either Method 1 or 2. Compared the values for Mrwlth the values from Mr. If the Mt values are greater than or equal to the Mr values, for each area of the roof, then the tile attachment method is acceptable. Metliod 1 y o '; nt B Tile Cale o7 Per RAS 127" (P1• z I , f as L.Y _ — Mg = Mrl ° NOA M, (P2: z 1� t . � m — M g i m IA NOA M, (P3: z = ' 1 - Mg : = h1,621,4_ C. NOA Mt Method 2 "Simplified The Calculation Per able Below" /i/ /417 .9 Required Moment of Resistance (Mr) From Table Below 4' NOA *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 the 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 tale attachment method is acceptable. Method 3 "Uplift Based Tile Calculations Per RAS 127" (PI : z l: = z w: = ) — W: z cos @: = Fry: NOA F' (P2: z 1: = z w: = ) — W: X COS 0: = Fr2: NOA F' w:= )—W. z cos 0: = Fra: NOA F' Where to Obtain Information Description Design Pressure Symbol Where to find P1 or P2 or P3 RAS 127 Table 1 orbyan engineering analysis prepared by PE based on ASCE 7 Mean Roof Height Job Site Roof Slope 8 Job Site Aerodynamic Multiplier 7L NOA Restoring Moment due to Gravhy MR NOA Attachment Resistance Mr NOA Required Moment Resistance Calculated hilinimum Attachment Recinacce F NOA Required Uplift Resistance Ft Calculated A Tile Weight Tile Dimensions w NOA i✓ length w= width NOA All calculations muatbe submitted to the Building Official at the time ofpermitapplication. 123_01 -48 12/09 PAGE 5 1 Ronda Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Application Form Section D (Steep Sloped Roof System) Roof System Manufacturer: / */1-11) 6--/* Notice of Acceptance Number: (97- 71'i' ®'5 Minimum Design Wind Pressures, if Applicable (From RAS 127 or Calculations): Pi:" 122: 1 } L p3: , .5 Maximum Design Pressure (From the NOA Specific System): Method of tile attachment: 7 ®� / / ,4/4/6 Steep Sloped Roof System Description, 123_01 -48 12/09 PAGE 4 MIAMI E 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, Florida33175 -2474 T (786) 315.2590 F (786) 315 -2599 volt, dicta e.gov/haildiaa/ 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) maw the right to have this product or material tested for quality assurance purposes. If this product or dial 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® A11160 LABELING: Bach 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- 0201.82 and consists of pages 1 through 7. The submitted documentation was reviewed by Alex Tigera. NOA No.: 11-0124.04 Expiration Data 05/10/12 Approval Data 04114/11 Page 1 of 7 • ROOFING COMPONENT APPROVAL: Category: Roofing 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 am 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 T Saecificatlons Polypro® AH160 N/A TAS 101 Foampro® RTF1000 N/A ProPack® 30 & 100 N/A Product Description Two component polyui thane 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 tile adhesive. PHYSICAL PROPERTIES: Prouerty Density Compressive Strength Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability CIosed Cell Content T,tt ASTM D 1622 ASTM D 1621 ASTM D 1623 ASTM D 2127 ASTM E 96 ASTM D 2126 ASTM D 2856 Rmuhs 1.6 lbs./ft.3 18 PSI Parallel to rise 12 PS1 Perpendicular to rise 28 PS1 Parallel to rise 0.08 Lbs./Ft2 3.1 Perm / Inch +0.0794 Volume Change @ 40° F., 2 weeks +6.0% Volume Change (a 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 variation. NOA Na:114124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Paget of 7 EVIDENCE SUBMITTED: Test Airencv Test Identifier Test Name/Reuort pega Center for Applied Engineering #94 -060 TAS 101 04/Q894 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 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® A11160 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 tile adhesive with their tile assemblies shall test in accordance with TAS 101 with section 10.4 as modified herein. 1APPROYED� 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 the assembly having a current NOA that lists uplift resistance values with the use of Polypro® A11160. 2. Polypro® AH160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof the assembly's adhesive attachment with the use of Polypro® AH160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed the uplift resistance determined in compliance with Miami -Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA 3. Polypro® AH160 roof tile adhesive and its components shall be installed in accordance with Roofing Application Standard RAS 120, and Polyfoam Products, Inc. Polypro®AH160 Operating Instruction and Maintenance Booklet. 4. Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by Polyfoam Products, Inc. Polyfoam Products Inc. shall supply a list of approved applicators to the authority having jurisdiction. 5. Calibration of the Foampro® dispensing equipment is required before application of any adhesive. The mix ratio between the "A" component and the "B" component shall be maintained between 1.0- 1.15 (A): 1.0 (B). The dispense timer shall be set to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No other settings shall be approved. 6. Polypro® AH160 shall be applied with Foampm RTF1000 or ProPack® 30 & 100 dispensing equipment only. 7. Polypro® A11160 shall not be exposed permanently to sunlight. & Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes alter 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 Mail Single Paddy Weight Min. (grams) Two Paddy Weight per paddy Min. (grams) Fla Low, Hi . • 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® A11160 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. GI r1:11.• 101117:1,1TirilTo APPRO‘:CD1 NOA No.: 11-0124.04 Expiration Date: 05/10/12 Approval Date: 04/14111 Page 4 of 7 ADIirsIVE PLACEMENT DETAIL 1 SINGLE PATTY I APPROVED NOA No.: 11-0124.04 Expiration Data 05/10/12 Approval Date: 04/1411 Page 5 of 7 ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY APPROVED j NOA No.: 11-0124 O4 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 6 of 7 ADHESIVE PLACEMENT DETAIL 3 DOUBLE PATTY END OF THIS ACCEPTANCE NOA No.: 11-0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Pagel of7 i MI 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 SImet, Room 208 Miami, Florida 33175 -2474 T (786) 315 -2590 F (786) 315 -2599 www.miamidade.Eov/buildine Polyglass USA Inc. 150 Lyon Drive Fernley, NV 89408 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: Polyglass Polystick Underlayments 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 and revises NOA # 09- 0806.07 and consists of pages 1 through 8. The submitted documentation was reviewed by Alex Tigers NOA No.: 11-0601.10 Expiration Date: 09/13/16 Approval Date: 09/15/11 Page 1 of 8 ROOFING COMPONENT APPROVAL Category: Sub - Category: Material:, Roofing Underlayment SBS, APP Self- Adhering Modified Bitumen PRODUCTS DESCRIPTION: Product Polystick MTS underlayment Manufacturing Location #2 Polystick IR Xe underlayment Manufacturing Location #1 & #2 Polystick TU underlayment Manufacturing Location #1 & #2 Polystick TU Plus underlayment (Facer of Membrane with surface printing) Manufacturing Location #1 & #2 Polystick TU P underlayment Manufacturing Location #2 Polystick Tile Pro Manufacturing Location #2 Dimensions. Roll: 65'8"x3'3-3/8" 60 mils thick Roll: 65' x 3'33/$" Or 65' x 3' 80 mils thick Roll: 32'10" x 3'3 -3/8" 100 mils thick Roll: 65' x 3'33/$" 80 mils thick Roll: 32' I0" x 3'33/g" 130 mils thick Roll: 61' x 3'3-3/8" 60 mils thick Test Product Specification Description, TAS 103 A homogeneous, rubberized asphalt waterproofing membrane, glass fiber reinforced with polyolefmic film on the upper surface for use as an underlayment for metal roofing, roof tile, slate tiles and shingle underlayment. TAS 103 and ASTM D 1970 TAS 103 and ASTM D 1970 TAS 103 and ASTM D 1970 TAS 103 and ASTM D 1970 TAS 103 and ASTM D 1970 A fine granular /sand top surface self - adhering, APP polymer modified, fiberglass reinforced, bituminous sheet material for use as an underlayment in sloped roof assemblies. Designed as an ice & rain shield and as a flat roof tile underlayment. A heavy granuled surface self adhering, APP polymer modified, fiberglass or polyester reinforced, bituminous sheet material for use as an underlayment in sloped roof assemblies. Designed as a a roof tile underlayment. A non - wicking fabric surfaced, self- adhering, APP polymer modified, fiberglass reinforced with a high strength polyester fabric, bituminous sheet material for use an an underlayment in sloped roof assemblies. Designed as a metal roofing and roof tile underlayment. A rubberized asphalt waterproofing membrane, glass-fiber/polyester reinforced, with a granular surface designed for use as a tile roof underlayment. A rubberized asphalt self - adhering, glass - fiber /polyester reinforced waterproofing membrane. Designed as a metal roofmg and roof tile underlayment. NOA No.: 11. 0601.10 Expiration Date: 09 /13/16 Approval Date: 09/15/11 Page 2 of 8 PRODUCTS DESCRIPTION: Pj2i bat Polystick Dual Pro Manufacturing Location #2 Dimensions Roll: 61' x 3'33/$» 60 mils thick MANUFACTURING PLANTS: 1. Hazeiton, PA 2. Winter Haven, FL EVIDENCE SUBMITTED: Test Agency Exterior Research & Design, LLC Trinity I ERD PRI Asphalt Technologies Momentum Technologies, Inc. Test Specification ASTM D 1970 Test Identifier 11756.04.01 -1 11756.08.01 -1 02202.08.05 P5110.08.07 P10870.09.08 -R1 P10870.04.09 P33360.06.10 P33370.03.11 P36900.09.11 PRI01111 PUSA - 005 -02 -01 PUSA -018-02 -01 PUSA -035 -02 -01 PUSA -033 -02 -01 PUSA -055 -02 -02 PUSA -083 -02 -01 PUSA - 089 -02 -01 JX20H7A RX14E8A DX23D8B DX23D8A Product Descniution A rubberized asphalt self-adhering, glass - fiber /polyester reinforced waterproofing membrane, specific for use as a high temperature underlayment. Designed as a metal roofing. Test Name/Report TAS 103 ASTM D 1970 TAS 103 TAS 103 TAS 103 TAS 103 /ASTM D4798 & G155 ASTM D1970 TAS 103 TAS 103 /ASTM D4798 & G155 ASTM D 4977 ASTM D 4977 ASTM D 2523 TAS 103 ASTM D 1970 TAS 103 TAS 103 TAS 103 /ASTM D4798 & 0155 TAS 103 /ASTM D4798 & G155 TAS 103 /ASTM D4798 & 0155 TAS 103 /ASTM D4798 & G155 TAS 103 /ASTM D4798 & G155 Date 04/27/01 08/14/01 08/29/05 08/29/07 12/04/08 04/13/09 07/01/10 03/02/11 09/01/11 04/08/02 01/31/02 07/14/03 09/29/06 01/12/06 12/10/07 06/30/08 07/06/09 04/01/08 11/09/09 02/18/10 02/18/10 NOA No.: 11- 0601.10 Expiration Date: 09/13/16 Approval Date: 09/15/11 Page 3 of 8 INSTALLATION PROCEDURES: Deck Type 1: Wood, non - insulated Base Sheet: One or more plies of ASTM D 226 Type II or ASTM D 2626. Fastening: Per FBC 1518.2 & 1518.4 Nails and tin caps 12" grid, 6" o.c. at a minimum 4" head lap. (for base sheet only) Membrane: Polystick membranes self - adhered. Surfacing: None 1. All nails in the deck shall be carefully checked for protruding heads. Re- fasten any loose decking panels, and sweep the deck thoroughly to remove any dust and debris prior to application. 2. Place the underlayment over metal drip edge in accordance with RAS 111. 3. Place the first course of membrane parallel to the eave, rolling the membrane to obtain maximum contact. Remove the release film as the membrane is applied. . All side laps shall be a minimum of 3 -' /a" and end laps shall be a minimum of 6." Roll the membrane into place after removing the release strip. Vertical strapping of the roof with Polystick is acceptable. Membrane shall be back nailed in accordance with applicable building code. 4. When applying the membrane in the valley, start at the low point and work to the high point, rolling the membrane from the center outward in both directions. 5. For ridge applications, center the membrane and roll from the center outward in both directions. 6. Roll or broom the entire membrane surface so as to have full contact with the surface, giving special attention to lap areas. 7. Flash vent pipes, stacks, chimneys and penetrations in compliance with Roof Assembly current Product Control Notice of Acceptance. 8. All protrusions or drains shall be initially taped with a 6" piece of underlayment. The flashing tape shall be pressed in place and formed around the protrusion to ensure a tight fit. A second layer of Polystick shall be applied over the underlayment. NOA No.: 11- 0601.10 Expiration Date: 09/13/16 Approval Date: 09/15/11 Page 4 of 8 GENERAL LIMITATIONS: 1. Fire classification is not part of this acceptance. 2. Polystick MTS, TU Plus, and Tile Pro may be used in asphaltic shingles, wood shakes and shingles, non- structural metal roofing, roof tile systems and quarry slate roof assemblies. IR-Xe, TU, and TU P may be used in all the previous assemblies listed except metal roofing. Dual Pro may be used in all the previous assemblies listed except roof tile systems. 3. Deck requirements shall be in compliance with applicable building code. 4. Polyglass Polystick membranes shall be applied to a smooth, clean and dry surface. The deck shall be free of irregularities. 5. Polyglass Polystick membranes and underlayments shall not be adhered directly over a pre- existing roof membrane as a recover system. 6. Polyglass Polystick membranes shall not be left exposed as a temporary roof for longer than the amount of days listed in the table below after application. Polyglass reserves the right to revise or alter product exposure times; not to exceed the preceeding maximum time limitations Exposure Limitations (days) Polystick MTS MTS IR-Re TU TU Plus TU P The Pro Dual Pro Winter Haven, FL. 180 180 180 180 180 180 180 Hazelton, PA, N/A 30 30 180 N/A N/A N/A 7. 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. 8. In roof tile application, data for the attachment resistance of roof tiles shall be as set forth in the roof tile manufacturer's Notice of Acceptance. Polystick TU and TU Plus may be used in both adhesive set and mechanically fastened roof tile applications. Polystick IR-Xe, and Tile Pro are limited to mechanically fastened roof tile applications. Polystick MTS is limited to mechanically fastened with battens roof tile applications. Polystick TU P may be used in both adhesive set and mechanically fastened roof tile applications with the exception of mortar set tile applications. 9. The maximum roof slope for use as roof tile underlayment for (direct-to-deck) tile assemblies shall be as follows: (See Table Below) Tile Profile Polystick MTS Polystick IR-Xe Polystick TU, TU Plus, TU P, Tile Pro Flat Tile Prohibited without battens 5:12 No limitation Profiled Tile Prohibited without battens Prohibited No limitation The above slope limitations can be exceeded only by using battens and counter battens in accordance with the Approved Tile System Notice of Acceptance and applicable Florida Building Code requirements. Battens are required for both loading and installation of tiles at all times. NOA No.: 11-0601.10 Expiration Date: 09 /13/16 Approval Date: 09/15/11 Page 5 of 8 GENERAL LIMITATIONS: (CONTINUED) 10. Care should be taken during the loading procedure to keep foot traffic to a minimum and to avoid dropping of tile directly on the underlayment. Refer to Polyglass' Tile loading detail below for loading procedure for all underlayments except Polystick MTS which shall be loaded onto battens. a 0 a CD Ref Deck prepared vita, POL'STICKTU Plus Roofing Tiles (6 Max. Per Suck) 11. Refer to prepared roofing system Product Control Notice of Acceptance for listed approval of this product with specific prepared roofing products. Polystick MTS, IR-Xe, TU, TU Plus, TU P, Dual Pro and Tile Pro may be used with any approved roof covering Notice of Acceptance listing Polystick MTS, IR-Xe, TU, TU Plus, TU P, Dual Pro and Tile Pro as a component part of an assembly in the Notice of Acceptance. If Polystick MTS, IR-Xe, TU, TU Plus, TU P, Dual Pro and Tile Pro is not listed, a request may be made to the Authority Having Jurisdiction (AHJ) or the Miami -Dade County Product Control Department for approval provided that appropriate documentation is provided to detail compatibility of the products, wind uplift resistance, and fire testing results. LABELING: 1. All membranes or packaging shall bear the imprint or identifiable marking of the manufacturer's name or logo, city and state of manufacturing facility and the following statement: "Miami -Dade County Product Control Approved" or the Miami Dade County Product Control Seal as shown below. {APPROVFw1 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 materials. NOA No.: 11- 0601.10 Expiration Date: 09/13/16 Approval Date: 09/15/11 Page 6 of 8 POLYGLASS GENERAL APPLICATION GUIDELINES FOR POLYSTICK MEMBRANES: 1. Polyglass does accept the direct application of Polystick underlayment membranes to wood decks. Installers are cautioned to refer to applicable local building codes prior to direct deck installation to ensure this is acceptable. Please also refer to applicable Product Data Sheets of the corresponding products. 2. All rolls, with the exception of Polystick TU Plus should be back-nailed in selvage edge seam as per Polyglass Back Nailing Guide. Nails shall be, 11 gauge ring shank type, applied with a minimum 1" metal disk as required in Dade County or simplex type nail as otherwise allowable in other regions, at a minimum rate of 12" o.c. Polystick TU Plus should be back nailed in designated area marked "nail area, area para clavar" on the face of membrane, with the above stated nails and/or disks. The head lap membrane is to cover the area being back-nailed. (Please refer to applicable local building codes prior to installation.) 3. All seal lap seams (selvage laps) must be rolled with a hand roller to ensure full contact. 4. All fabric over fabric; and granule over granule end laps, shall have a 6" wide, uniform layer of Polyglass Polyplus 55 Premium Modified Flashing Cement, Polyglass Polyplus 50 Premium MB Flashing Cement, Polyglass PG500 MB Flashing Cement, Mule -Hide 241 Premium Modified Flashing Cement, Mule -Hide 251 Premium Wet/Dry Elastomeric Flashing Cement, or Mule -Hide 421 Mod Bit Flashing Adhesive Trowel Grade mastic, applied in between the application of the lap. The use of mastic between the laps does not apply to Polystick MTS. 5. A maximum of 6 tiles per stack are allowed when loading tile on the underlayments. Refer to the Polyglass Tile Loading Guidelines. See General Limitations #9 and #10. 6. Battens and/or Counter - battens, as required by the tile manufacturers NOA' s, must be used on all projects for pitch/slopes of 7 "/12" or greater. It is suggested that on pitch/slopes in excess of 6'A "/12 ", precautions should be taken, such as the use of battens to prevent tile sliding during the loading process. 7. Minimum cure time after membrane installation & before loading of roofing tiles is Forty Eight (48) Hours. 8. Polystick membranes may not be used in any exposed application such as crickets, exposed valleys, or exposed roof to wall details. 9. Repair of Polystick membranes is to be accomplished by applying Polyglass Polyplus 55 Premium Modified Flashing Cement, Polyglass Polyplus 50 Premium MB Flashing Cement, Polyglass PG500 MB Flashing Cement, Mule -Hide 241 Premium Modified Flashing Cement, Mule-Hide 251 Premium Wet/Dry Elastomeric Flashing Cement, or Mule -Hide 421 Mod Bit Flashing Adhesive Trowel Grade mastic to the area in need of repair, followed by a patch of the Polystick material of like kind should be set and hand rolled in place over the area needing such repair. Patching membrane shall be a minimum of 6 inches in either direction. The repair should be installed in such a way so that water will run parallel to or over the top of all laps of the patch. 10. All self- adhered membranes must be rolled to ensure full contact with approved substrates. Polyglass requires a minimum of 40 lbs for a weighted roller for the rolling of the field membrane. Hand rollers are acceptable for rolling of patches or small areas of the roof. Brooming may be used where slope prohibits rolling. 11. All approved substrates should be dry, clean and properly prepared, before any application of Polystick membranes commences. An approved substrate technical bulletin can be furnished upon request. It is recommended to refer to applicable building codes prior to installation to verify acceptable substrates. 12. The Polyglass Miami Dade Notice of Acceptance (NOA) approval for Polystick membranes and PolyProtector UDL can be furnished upon request by our Technical Services Department by calling 1 (800) 894 -4563. NOA No.: 11- 0601.10 Expiration Date: 09/13/16 Approval Date: 09/15/11 Page 7 of 8 13. Questions in regards to the application of Polyglass products should be directed to our Technical Services Department at 1 (800) 894 -4563. 14. Polyglass recommends that applicators follow good roofing practices and applicable procedures as outlined by the National Roofing Contractors Association (NRCA). PLEASE CHECK WITH LOCAL BUILDING CODES REGARDING LIMITATIONS OF SPECIFIC APPLICATIONS. LOCAL CODES MAY SUPERSEDE POLYGLASS REQUIREMENTS AND RECOMMENDATIONS. END OF THIS ACCEPTANCE NOA No.: 11- 0601.10 Expiration Date: 09/13/16 Approval Date: 09/15/11 Page 8 of 8 MIAM BUILDING CODE COMPLIANCE OFFICE (BCCO) PRODUCT CONTROL DIVISION ML4MI DADE COUNTY, FLORIDA METRO -DADE FLAGIER BUILDING 140 VEST FLAGLER STREET, SUITE 1603 MIAMI, FLORIDA. 33130 -1563 (305) 375 -2901 FAX (305) 375 -2908 NOTICE OF ACCEPTANCE (NOA) MonierLifeti%, LLC 200 Story Road Lake Wales, FL 33853 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 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 (ART). 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 ART (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 mans 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.: 07-071L03 n Date: 01/26/12 Approval Date: 09/07/07 Page 1 of 7 ROOFING ASSEMBLY APPROVAL Catorv:. ,Sub - Category: Ma rlal: 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 Applicant Dimensions MonierLifetile LLC 1= 17" Saxony 900 w = 13" 1- 5/32" thick Slate 1- 9/32" thick Shake & Split Shake Trim Pieces 1= varies w = varies varying thickness SUBMITTED EVIDENCE: Test Aaencv, Rolland 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 Descriotion 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/Report Static Uplift Testing PA 102 & PA 102(A) Static Uplift Testing PA 101 (Mortar Set) Static Uplift Testing PA 101 (Adhesive Set) Static Uplift Testing PA 102 (2 Quik-Drive Screws, Direct Deck) Static Uplift Testing PA 102 (2 Quik-Drive Screws, Battens) Dec. 1991 May 1994 March, 1994 Feb. 1995 Feb. 1995 NOA No.: 07- 0711.03 Expiration Date: 04/26/12 Approval Date: 09/07/07 Page 2 of 7 Test Aencv 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 "Ater Dated Aug. 1,1994 P0631 -01 P0402 Project No. 307025 Test #MDC-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 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: 04f26/12 Approval Date: 09-07-07 Page 3 of 7 LIIVIITATIONS: 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. 30/90 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 (1 x w Tile Profile Weight W (Ibf) Length -I (ft) Width-vs (ft) MonierLifetile Saxony 900 Slate, Shake & Split Shake 11.5 1.417 1.08 Table 3: Restoring Moments due to Gravity - M, Table 2: Aerodynamic Multipliers - I. (ft) Tile Profile Tile 3 °:12° I (ft) 5 °:12° A. ( Profile or Direct Deck Batten Application Direct Deck Application Monierlfetile Saxony 900 Battens 0289 Battens 0.313 Slate, Shake & Split Shake Direct Deck Battens Direct Deck 7.16 Table 3: Restoring Moments due to Gravity - M, (ft Ibf) Tile Profile 2 0:12° 3 °:12° 4 ":12° 5 °:12° 6 0:12° 7 ":12" greater Battens or Direct Deck Saxony 900 Slate, Shake & Split Shake Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck 7.16 8.12 7.08 8.03 6.97 7.91 6.82 7.74 6.65 7.5.5 6.46 7.34 NOA No.: 07-0711.03 Expiration Date: 04/26/12 Approval Date: 09/07/07 Page 4 of 7 Table 4: Attachment Resistance Expressed as a Moment - M, (obi for Nall -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 -1 Od 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 (Field Clip) 24.3 24.3 242 1 -10d Smooth or Screw Shank Nail (Eave Clip) 19.0 19.0 22.1 2 -10d Smooth or Screw Shank Nails Clip) 35.5 35.5 34.8 � __ .(Field - -- _ 2 -1 Od Smooth or Screw Shank Nails Eave C0 31.9 31.9 322 Table 5: Attachment Resistance Expressed as a Moment M, (ft -lbf) for Two Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance MonierLifetile Saxony 900 Slate, Shake & Split Shake Adhesive 31.32 1 See manufactures component approval for installation requirements. 2 Dow Chemical TileBond Average weight per patty 13.9 grams. P o . < Produc Inc. Ave .,,. wel,ht • -r ,.: 8 ! rams. Table 5A: Attachment Resistance Expressed as a Moment - M, (ft-lbf) for Single Patty Adhesive Set Systems Tile Profile 1110 Application Minimum Attachment Resistance MonierL tethe Saxony 900 - -----,°2 Slate, Shake & Split Shake Poiyioam PotyProTM 118.93 Polytoam PotyProul 40.4 3 Large paddy placement of 45 grew of PotyPromt. 4 Medium paddy placement of 24 grams of PotyProlm. Table 5B: Attachment Resistance Expressed as a Moment - M,(ft Ibf) for Mortar Set Systems Tile Profile Tile Application Attachment Resistance Monierlifetite Saxony 900 Slate, Shake & Split Shake Mortar Set' 43.93 5. Tile-Tite Roof Tile Mortar __ NOA No.: 07- 0711.03 Expiration Date: 04/26/12 Approval Date: 09/07/07 Page 5of7 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 ". MONIERLIFETII.E LLC, SAXONY 900 TILE (LASE 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.: 074711.03 Expiration Date: 04/26/12 Approval Date: 09/07/07 Page 6 of 7 4 PROFILE DRAWING MON>ERLIPKTILE SAXONY 900 CONCRETE Roo TILE (SPLIT SHAKE MODEL) MONLERLIMILE SAXONY 900 CONCRETE Roof TILE (SHAKE MODEL) END OF THIS ACCEPTANCE NOA No.: 07- 0711.03 Expiration Date: 04f26/12 Approval Date: 09107107 Page 7 of 7 11/28/2011 14:34 9546308114 PREMIER PROTECTION PAGE 01/01 CASTO -1 OP ID: CM 414' '�"- CERTIFICATE OF LIABILITY INSURANCE 1 °�'1 11!26/19 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(Ies) must be endorsed. If SUBROGATION 16 WAIVED, subject to the farms and conditions of the policy, cestsln pandas may require an endorsement. A statement on this certificate doss not Confe . rights to the certificate holder in lieu of such endorsement __ _ . . Peccume 581437 -3399 Insurance Services of Delray 409 SE 7th St Fort I at o , FL 33301 Douglas A. Levy �� eas 1(N5. NtBi .° MENEM _.. mums] A/0 0 MOWER IAtiantiC Casualty Insurance Co INSURED Casten Roofing, Inc. Ken Caston 10800 SW 9Sit1 Ter Miami, FL33176 • 1N 81 INEWER °: PISURERDI INSURER S - • 13ER: ER: A THIS 1S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT To WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN I8 SUBJECT TO ALL THE TERM$, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TM OF INIMIRANCE GENERAL LIASILDY X IAA, SENERAL UADILITY OLNSAS -MDE Q OCCUR BERL AGGREGATE RUNIT AMASS PER 1 POLICY n tEirt n Lee L114000213 -2 10102/11 10102112 EACH 000tRRfNOE $ s 1,000,E , tu HssNltU $ (Co ocowrmr+a? 0 50,000 M6D Ian (Ageene paean) $ 1,000 PERSONAL & ADV INJURY ''$ 1,1140s000 GENEYI,ALAceREsAra S 2,000,000 ?R, DUms- 0ONProPA0o $ 1,000,000 8 AUTOMOBILE LIAINUTY ANYAUTO ALL OWNED AUTOS HIRED AUTOS umeiLA uAe EXCESS LIAR SCHEDw.ED AUTOS AUTOS BODILY mow Oyer petan) S BODILY WJURYcParaccident) $ $ D D RRi NTIONS OCCUR CLAIMS4ADE EACH OCCURRENCE 8 A SSREfAATE 8 SIMMS COMPERSATION AND ISEPLWEBIEr MAMMY ANYAROPRETIONPARTNERMOUVE EXCLUDER ry NN) O ON OF OPERATIONS balm NIA E.L EACHAcctoENT E.L. MAN - EA EMPLOYEE $ _EL. MIME uufr f ORSDR1P1ION DP OPESAIIOA1s r L OATIDNS r Vr IA1mmDI AOQRO 101, Addlemal Remarks Sahedtdo It mars spas Is mimeo Roofing Contract CERTIFICATE HOLDER BUILDIN MIIsmi Shores Building Department 10050 NE 2nd Ave Miami Shores, FL 33130-2304 C/ NCELLAT1ON__ SHOULD ANY OF THE ABOVE DESCRIBED PDLSCNEB 8$ CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE YWU. BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AU1I{DA20D RESPRZSMiTATIVB ACORD 25 (2010105) 1988.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD