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RF-12-249Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 169950 Permit Number: RF -2 -12 -249 Scheduled Inspection Date: March 08, 2012 Inspector: Bruhn, Norman Owner: BENSOUSSAN, JEAN Job Address: 543 NE 102 Street Miami Shores, FL 33138- Project: <NONE> Contractor: MR. SANCHEZ CARPENTRY INC Permit Type: Roof Inspection Type: Final Roof Work Classification: Tile Phone Number Parcel Number 1132060170970 Phone: (786)355 -0212 Building Department Comments REPLACE ROOF TO ROOF TILE COLOR THRU Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments 0e-- March 07, 2012 For Inspections please call: (305)762 -4949 Page 9 of 33 Miami Shores Viipage Building Department RE: Permit# arc 2- \2 -2{g INSPECTION AFFIDAVIT 1 Mic -��i. licensed as a (n (Print name and circle License Type) License #: c CC \3Zc\ i, 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 DATE: 272_342 FS 468 Building Inspector / Engineer / Architect, On or about 2../721/ R-- \O' , I did personally inspect the roof deck nailing and (Date & time) Secondary water barrier work at C11-3 \dZ eR- \N�\ (Complete Job Site Address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S) Signature State of Florida County of Dade: The undersigned, being the first duly sworn, deposes and says that he /she is the contractor for the above property mentioned. Swom to and subscribed before me this 2...3r3° day of ehC 1 a ty , ? o \ L 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 # clearly shown marked on the deck for each inspection Revised on 5/21/2009 4 GEOTECHNICAL ENVIRONMENTAL HYDROGEOLOGY ASBESTOS ,III_ W- \`�t�� TESTING LABORATORIES DRILLING SERVICES INSPECTION SERVICES ROOFING DYNATECH ENGINEERING CORP.. CONCENTRATED UPLIFT LOAD TESTING ON ROOF TILE TO COMPLY WITH METRO -DADE COUNTY PROTOCOL TAS -106 MIAMI, March 7, 2012 CLIENT: M. R. SANCHEZ CARPENTRY, INC. PROPERTY ADDRESS: 543 North East 102 °a Street, Miami, FL TILE TYPE /ATTACHMENT: Flat concrete roof tiles foam adhesive set. Inspected By: S.C. Testing Equipment: Humboldt Scale Model H -4620 The test results presented here reflect the condition of the roof system at the time of the test. These results are time and sample dependent since roof condition are continuously changing due to the exposure to the element and roof top traffic. Test No. Test Location 1 -24 Perimeter & Corner See Attached Diagram 25 -47 Field See Attached Diagram 48 -52 Ridge caps See Attached Diagram Field Uplift Pull Test > Than 35 LBS > Than 35 LBS > Than 35LBS ROOF TILE UPLIFT IN ACCORDANCE WITH MIAMI -DADE COUNTY TAS -106 ROOF SKETCH Sincerely yours, Naamani, P.E. ATECH ENGINEERING CORP. Florida Reg. No. 39584 Special Inspector No. 757 Certificate of Authorization No.: CA 5491 Test Result Passed Passed Passed NAAPb e a s nn a _ 9 4 :PLOa� 4 ,�-e, 750 West 84 Street, Hialeah, FL 33014 -3618 ° Phone: (305) 828 -7499 ® Fax: (305) 828 -9598 E -Mail: Dynatech @Bellsouth.net Printed on Recycled Paper 1 TAS -106 TILE UPLIFT TEST SINGLE FAMILY ONE STORY RESIDENCE 12 13 29 11 21 22 26 20 25 27 30 32 31 28 14 33 50 23 24 16 37 17 15 34 36 18 51 35 62 54 10 44 38 46 42 19 45 43 39 47 6 5 8 7I 0.1 XW= 0.1X55 =5.5 0.4XH= 0.4X14 =5.6 PERIMETER USE 5.6 PERIMETER & CORNERS 24 TESTS FIELD 22 TESTS RIDGE 8 TESTS 1 1 2 52 40 53 41 4 3 Dynatech Engineering Corp Client: Scale: SANCHEZ RESIDENCE N.T.S. Project: Date: 543 NE 102 ST MIAMI, FL 3-8-12 r BUILDING 3156 , co 76 Miami Shores Village 3a3ryk ,-=- -- 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 PE • - • PPLICATION FBC Permit ype: BUILDING ROOFIN Permit No. 1 12s+ 2-49 Master Permit No. 3 ®S - ' %9 -64a55 OWNER: Name (Fee Simple Titleholder): `� �., g 1- j� j i Phone #: O s - rJ c------71.. I Address: T 3 , g, 1 0 of S-ti.t City: t-i,L , Sii- r) ixe]�CS State: N L ()g.i sb j Zip: 53 13g Tenant/Lessee Name: Phone #: Email: 'e Ice L rykka @ „rz Lcsc) - (',ev,,). JOB ADDRESS: 4* t. 1 a glraLsIt City: Miami Shores County: Miami Dade Zip: -S 3 1 ,2, g F /Parcel #: \ \° 62 o - 0 \ ci - c°aak qc) Is the Building Historically Designated: Yes NO ✓ Flood Zone: /T CONTRACTOR: Company Name: c\\ f \vim Phone #:' -`cQ -?,SS- 02. Address: \--`-k (00 (N e City: £A State Zip: 632" Qualifier Name: �oC� vyNc. \\et Phone #: o`l- State Certification or Registration #: C: C \32.ejty (© - Certificate of Competency #: Contact Phone #:C30S s3 -,CV* Col Email Address: 'N ' (0 � ('J , C_041N. DESIGNER: Architect/Engineer: 0 v ( - Phone#: t\3 f Value of Work for this Permit: $ 0 0 0 (Ssi_areXinear 0 Footage of Work: \c\ S Type of Work: UAddition DAlteration UNew aRepair �g VS ❑Demolition Description of Work: i �e_q\ --ix- �e C,L� `-e `-"--`Al`''*"‘ Submittal Fee $ voi.61.0.14:*************Fees******************************4.*Ne********** lCJ Permit Fee $ -7J Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF $ CO /CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $rJ(� • 4 c Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) 4V 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 r 2. day of r�, 201 , by jean Ben�c�USSran who is personally knowns me or who has produce 1® 652 530-5) -25ts identification and who did take an oath. NOTARY PUBLIC: Sign: Print: (,S a My Commission E M, Garda). * * * * * * * * * * * * * ** Signature e" ��L- Contractor The foregoing instrument was acknowledged before me this (o day of " , 20 by si.1ae —cei SNwcAlt.L , who is personally known . me or who has produced as identification and who did take an oath. NOTARY PUBLIC: * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY d Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Zoning Clerk IVliami S Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNERS'S AFFIDAVIT OF EXEMPTION ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE - BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PERSUANT TO SECTION 553.844 F.S. To: Miami Shores Village Building Department Date: D2 \ LI 12- 10050 NE 2nd Ave Miami Shores, Fl 33138 Re: Owner's Name: kl 5-0 Cp PrO Property Address: `- 3 Al p °�.� t. �`� . 5 (-toles 5 3 (3.8 o Roofing Permit Number: Dear Building Official: I, Sijk; 6 certify that I am not required to retrofit the roof to wall connections of my building because: mil he just valuation for the structure for purpose of ad valorem taxation is Tess than $300,000.00. Please attach proof of ad just P rP P 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 6k" C 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 all/A t2., day of 2.(3, Notary Public, Sate of Florida at Large • When the just valuation of the structure for purpose of ad valorem taxation is equal to or more than $300,000.00, and the building was not constructed with FBC nor a 1994 SFBC. Then you must provide a building application from a General Contractor for the Roof to Wall connection Hurricane Mitigation. Revised on 5121/2009 sa 4k'gfd '�64z� L. Property Information Map midade. ' 0 Property Information Map Page My Home Miami -Dade County, Florida Aerial Photography - 2009 This map was created on 2/13/2012 10:17:33 AM for reference purposes only. Web Site © 2002 Miami -Dade County. All rights reserved. ••• ••• • • • • • •. • • • • • • • • • • • • • • • • • • • • ••• ••• • ••• ••• • • • • i • • • • • • • ••• • • • • • • • • •• • • • • •• • • • • • • • • • • • ••• • • • • • • • • • •• • ••• • • • ••• • • • • • • • ••• • • • • • • • • • • • • • • • • • ••• • • Summary Details: Folio No.: 11 -3206- 017 -0970 Pro•ert : 543 NE 102 ST Mailing JEAN BENSOUSSAN • ddress: 1 Living Units: 543 NE 102 ST MIAMI Adj Sg Footage: SHORES FL Lot Size: 33138 -2454 Property Information: Primary Zone: 1000 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds /Baths: 2/2 Floors: 1 Living Units: 1 Adj Sg Footage: 1372 Lot Size: 9,225 SQ FT Year Built: 1936 MIAMI SHORES SEC 4 AMD PLAT PB 15 -14 Legal LOT 18 & E1 /2 LOT 17 Description: BLK 93 LOT SIZE 75.000 X 123 OR 15339 -2433 1091 4 OR 15339 -2433 1091 01 Assessment Information: Year: 2011 2010 Land Value: $115,690 $144,612 13uildin• Value: $104,493 $104,493 Market V Hue. 5220,183 $249,105 Assessed Value: 9105,852 $104.288] Exemption Information: 2011 S25.000 2010 $25.000 Taxable Value Information: Year: I 2011 2010 Applied Applied Taxing Authority Exemption, Exemption, Taxable Taxable Value: Value: Regional. County: City: School Bcard: $.50.000/ 3.55,852 850,000/ $55,852 350,000. $55,852 325,000! 380,852 $50,000/ $54,288 S50,000' $54,288 $50,000% 554,288 $25,000;' 4 $79,288 Sale Information° Sale Date: 10/1991 Sale Amount $0 Sale 0, R: Sales Sales which are Qualification disqualified as a result of Desch •t.ion: examination of the deed ddYon _Saes http: / /gisims2 .miamidade.gov /myhome /printmap. asp? mapurl = http: / /gisims2.mramidade.go... 2/13,%2012 SECTION R4402.13 HIGH VELOCITY HURRICANE ZONES — REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS R4402.13.1 Scope. As it pertains to the section, it is the responsibility of roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of the section. The provisions of Section R4402 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 ant the contractor. The owner's initial in the designated space indicates that the item has been explained. 1. i,:. Aesthetics- Workmanship: the workmanship provisions of Section R4402 are for the purpose of ', viding that the roof system meets the wind resistance and water instruction performance standards. Aesthetics (appearance) are not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the agreement between the owner and the contractor. 2. Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be nailed in accordance with the current provisions of Section R4403. (The roof deck is usually concealed prior to removing the existing roof system). 3. ,. Common roofs: Common roofs are those which have no visible delineation between neighboring ms`s (i.e., townhouses, condominiums, etc.) In buildings with common roofs, the roofing contractor and /or wner should notify the occupants of adjacent units of roofing to be performed. Exposed Ceiling: Exposed, open beam ceilings are where the underside of the roof decking can viewed from below. The owner may wish to maintain the architectural appearance; therefore, roofing nail penetration of the underside of the decking may not be acceptable. This provides the option of maintaining the appearance. Ponding water: The current roof system and /or deck of the building may not drain well and may use water to pond (accumulate) in low -lying areas of the roof. Pounding can be an indication of structural distress and may require the review of a professional structural engineer. Pounding may shorten the life expectancy and performance of the new roofing system. Pounding conditions may not be evident until the origi al roofing system is removed. Pounding conditions should be corrected. 6. Overflow scuppers (wall outlets): It is required that rainwater flows off so that the roof is not rloaded from a buildup of water. Perimeter /edge wall or other roof extension may block this discharge if yellow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance with the requirements of Sections R4402, R4403 and R4413. 7. > Ventilation: Most roof structures should have some ability to vent natural airflow through the enor of the structure assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting which can result in extending the service life of the oof. er/Agent's Signature Date Revised on 7/9/2009 LD Contractor Signature 24/ r Date ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 High- Velocity Hun*icane Zone Uniform Permit Application Fonn. $erfion A (General Information) Master Permit No. Process No. Contractor's Name . Q- . �?saUC �e't �.PccQz.� �ti 11cJ Job Address 5-4-‘3 Ck"\INR•' S -eSjN- L73313$ 0 Low Slope ❑ Mechanically Fastened Tile Mortar/Adhesive Set Tile 0 Asphaltic ❑ Metal PaneUShingles ❑ Wood Shingles/Shakes D New Roof ❑ Prescriptive BUR -RAS 160 ROOF TYPE ,Reroofing ❑ Recovering ❑ Repair C3 Maintenance ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) & action R (Roof Plan) Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drahis. Include dimensions of sections and levels, clearly identify dimensions of elevated pressure zones and location of Pipets. 72-k V0 SL '-0 s IC FLORIDA BUILDING CODE — BUILDING Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Application Form - Section - R ,Roof Syst - _ . . of System Manufacturer: ,Q / @"C' /Z No ;e of Acceptance Number: //--.//- Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations): Pmaxl :a1. 2-% cePmax2: 9.1513' Pmax3: //,� •� S Maximum Design Pressure (From the NOA Specific System): Method of Tile Attachment: / )Y� /..4 Roof Slope: : 12 eck Type: Sloped System Description ype Underlayment: I nsulation: Ridge Ventilation? .540 Fire Barrier: I Mean Roof Height: ALof alet Fastener Type & Spacing: I 4f/ � ~.7c, I dhesive Type: I y/ ype Cap Sheet: I /b�yy4 i oofing Covering: I .,,, ,p Type & Size Drip age: 1 313 24, alocrWl Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Application Form For Moment -based tile systems, choose either Method 1 or 2. Compared the values for Mr with the values from M1. If the Mr 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 Tile Calculations Per RAS 127" ` / a, '4 ) - Mg: , = Mn ,-i2-74° NOA M, (Pl. x .2.03- = A, OJ ' ) - Mg: 4L = M2_91 NOA M� A' (P2 Lx . _ , A = Mr3 NOA Mr (P3:!�D. x 12e1.S = .72.)-Mg: /4.$S Method 2 "Simplified Tile Calculations Per Table Below" Required Moment of Resistance (M) From Table Below NOA Mr Mr Required Moment Resistance* Mean Roof Height Roof Slope 15' 20' 25' 30' 40' 2:12 34.4 36.5 38.2 39.7 42.2 3:12 32.2 .34.4 36.0 37.4 39.8 4:12 30.4 32.2 33.8 35.1 37.3 5:12 28.4 30.1 31.6 32.8 34.9 6:12 26.4 28.0 29.4 30.5 32.4 7:12 24.4 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 F1 with the values for F� If the F1 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" I: - W:_ x cos 0: = Fri: NOA F' (Pi:_ x _ = _ x w: = _) I: - W:_ x cos 0: = F,: NOA F' (P2: x _ = _ x w: = _) W:_xcos 0: =F, NOA F' (P3:_ xI: _ =_xw:= _)- Where to Obtain Information Description Symbol Where to find Design Pressure P1 or P2 or P3 RAS 127 Table 1 or by an engineering analysis prepared by PE based on ASCE 7 Mean Roof Height H Job Site Roof Slope a Job Site Aerodynamic Multiplier x NOA Restoring Moment due to Gravity Mn M NOA NOA Attachment Resistance Required Moment Resistance Mr F' Calculated NOA Minimum Attachment Resistance Required Uplift Resistance F, Calculated Average Tile Weight W NOA Tile Dimensions I = length w = width NOA All calculations must be submitted to the Building Official at the time of permit application. MIAMI COUNTY BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT (BNC) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Entegra Roof Tile, Inc. 1289 NE 9th Ave. Okeechobee, FL. 34972 MIAMI -DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 33175 -2474 „15:2590 ` (786)375:2599 —`_. __.� www.miamidade.eov /building/ SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed and accepted by Miami -Dade County BNC - Product Control Section to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Section (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product. or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BNC reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Bermuda Concrete Flat 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 renews NOA # 10- 0518.01 and consists of pages 1 through 6. The submitted documentation was reviewed by Alex Tigera. NOA No. 11-0414.09 Expiration Date: 06/07/16 Approval Date: 05/26/11 Page 1 of 6 ROOFING ASSEMBLY APPROVAL Category: Roofing Sub Category: Roofing Tiles sitars t ° " .. _ ... r ,.. Concrete - 1. SCOPE This revises a rooting system using Entegra Flat Concrete Roof Tile, as manufactured Entegra Roof Tile Corporation in Okeechobee, FL. as described in Section 2 of this Notice of Acceptance, designed to comply with the Florida Building Code for High Velocity Hurricane Zone. For the locations where the pressure requirements, as determined by applicable Building Code, does not exceed the design pressure values obtain by calculations in compliance with RAS 127 using the values listed in section 4 herein. The attachment calculations shall be done as a moment based system. 2. PRODUCT DESCRIPTION Manufactured by Test Applicant Dimensions Specifications Entegra Flat Tile Trim Pieces .1 =16" TAS112 w =10" 1= varies w = varies varying thickness 2.1 MANUFACTURING LOCATION 2.1.1. Okeechobee, FL. 2.2 EVIDENCE SUBMITTED Test Agency Test Identifier Redland Technologies The Center for Applied Engineering, lnc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. 7161 -03 Appendix III 94 -084 94 -060A 25- 7094 -2 TAS 112 Product Description Flat profile, interlocking, high pressure extruded concrete roof tile equipped with two nail holes. For mechanical, mortar 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 IO2 & PA 102(A) . Static Uplift Testing PA 101 (Mortar Set) Static Uplift Testing PA 101 (Adhesive Set) Static Uplift Testing PA 102 (4" Headlap, Nails, Direct Deck, New Construction) Date Dec. 1991 May 1994 March, 1994 Oct. 1994 NOA No. 11-0414.09 Expiration Date: 06/07/16 Approval Date: 05/26/11 Page 2 of 6 The Center for Applied Engineering, Inc. The Center for Applied En ineer'n Inc. 25- 7094 -8 25- 7094 -5 Static Uplift Testing PA 102 (4" Headlap, Nails, Battens) Static Uplift Testing PA 102 Oct. 1994 Oct. 1994 The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. 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. Professional Service Industries, 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 25- 7183 -6 25- 7183 -5 25- 7214 -1 25- 7214 -5 7161 -03 Appendix 11 Letter Dated Aug. 1, 1994 P0631 -01 P0402 Project No. 307025 Test #MDC -77 R1.894 R2.894 R3.894 395 - 40011 -1 520109 -1 520111 -4 520191 -1 Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Calculations 13343.1 (4" Headlap, Nails, Direct Deck, Recover/Reroof) Static Uplift Testing PA 102 (2 Quik -Drive Screws, Direct Deck) Static Uplift Testing PA 102 (2 Quik -Drive Screws, Battens) 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 Physical Properties PA 112 Static Uplift Testing PA 101 Static Uplift Testing PA 101 Aerodynamic Multiplier 25 -7094 25 -7496 25 -7584 25- 7804b -8 25- 7804 -4 & 5 25- 7848 -6 25 -7183 Restoring Moment, MR Two Patty Adhesive Set System TAS 112 Feb. 1995 Feb. 1995 March, 1995 March, 1995 Dec. 1991 Aug. 1994 July 1994 Sept. 1993 Oct. 1994 Aug. 1994 Feb 2004 Dec. 1998 March 1999 March 2004 Feb 1996 April 1996 December 1996 March 1995 March 2004 April 1999 05/06/08 NOA No. 11- 0414.09 Expiration Date: 06/07/16 Approval Date: 05/26/11 Page 3 of 6 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. 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 and Neighborhood Compliance Department — Product Control Section for review. 3.4 Minimum underlayrnent shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.5 30/90 hot mopped underlayrnent applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayrnent material manufacturers published 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 Entegra `Flat' Concrete Roof Tile and its components shall be installed in strict compliance with Miami Dade County 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) Width -w (ft) Ente • ra Flat Tile 9.7 1.33 .833 Table 3: Restorin Moments due to Gravi Table 2: Aerod namic Multi a liers - A. ft3 Tile Profile Tile 4 ":12" X (ft) 6 ":12" 2. (ft ) Profile Battens Batten Application Direct Deck Application Entegra Flat Tile Battens 0.189 Battens 0.205 Table 3: Restorin Moments due to Gravi - M ft-lb Tile Profile 3 ":12" 4 ":12" 6 ":12" 6 ":12" Greater than 7 " :12" Entegra Flat Tile Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck 6.53 6.97 6.43 6.86 6.29 6.71 6.14 6.54 5.97 6.35 MAM1•DADE COUNTY APPROVED NOA No. 11- 0414.09 Expiration Date: 06/07/16 Approval Date: 05/26/11 Page 4 of 6 Tile Profile Table 4: Attachment Resistance Expressed as a Moment - Mr (ft-lbf) for Nall -On Systems Fastener Type Direct Deck Direct Deck (min 15132" plywood) (min. 19132" plywood) Battens Entegra Flat Tile 2 -10d Ring Shank Nails 1 -10d Smooth or Screw Shank Nail 30.9 38.1 17.2 7.3 9.8 4.9 2 -10d Smooth or Screw Shank Nails • 14,0 18.8 7.4 1 #8 Screw 2 #8 Screw 1 -10d Smooth or Screw Shank Nail (Field Clip) 1 -10d Smooth or Screw Shank Nail (Eave Clip) 30.8 30.8 18.2 51.7 51.7 24.4 24.3 19.0 24.3 19.0 24.2 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 Nailsi_[- 50.3 65.5 48.3 Installation with a 4" tile headlap and fasterners are located a min. of 2W from head of tile. Table 5: Attachment Resistance Expressed as a Moment Mr (ft -Ibf) for Two Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Entegra Flat Tile Adhesive` 31.33 __ 2 See manufactures component approval for installation requirements. 4 Large paddy placement of 45 grams of PolyProTM. 3 Flexible Products Company TileBond Average weight per patty 13.9 grams. Polyfoam Product, Inc. Average weight per patty 8 grams. Table 6: Attachment Resistance Expressed as a Moment - MI (ft-Ibf) for Sin le Pa Adhesive Set S stems Tile Profile Tile Application Minimum Attachment Resistance Entegra Flat Tile • PolyProTM 118.9 PolyProTM 40.4' 4 Large paddy placement of 45 grams of PolyProTM. 5 Medium paddy placement of 24 grams of PolyProTM. MIAMI•DADE COUNTY APPROVED NOA No. 11- 0414.09 Expiration Date: 06/07/16 Approval Date: 05/26/11 Page 5 of 6 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 ". ENTEGRA FLAT TILE LABEL (LOCATED ON UNDERSIDE OF TILE) 6. BUILDING PERMIT REQUIREMENTS: 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Any other documents required by Building Official or Applicable building code in order to properly evaluate the installation of this system. PROFILE DRAWING ENTEGRA "FLAT" CONCRETE ROOF TILE 16' 10' 16' FIELD TILE 1 END OF THIS ACCEPTANCE MIAM I: ADE COUNTY APPROVED NOA No. 11- 0414.09 Expiration Date: 06/07/16 Approval Date: 05/26/11 Page 6 of 6 MIAMI•DADE COUNTY BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT (BNC) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Polyfoam Products, Inc. 11715 Boudreaux Road Tomball, TX 77375 MIAMI -DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 33175 -2474 T (786) 315 -2590 F (786) 315 -2599 www.miamidade.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 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 I lurricane Zone of the Florida Building Code. DESCRIPTION: PoIypro® AH160 LABELING: Each unit shall bear a pertnanent 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 I through 7. The submitted documentation was reviewed by Alex Tigera. MIAMFDADE OUNTY 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 Polyproo A11160 as manufactured by Polyfoam Products, Inc. as described in Section 2 of this Notice of Acceptance. For the locations where the design pressure requirements, as determined by applicable building code, does not exceed the design pressure values obtained by calculations in compliance with Roofing Application Standard RAS 127, for use with approved flat, low, and high profile roof tiles system using Polypro® AH 160. Where the attachment calculations are done as a moment based system for single patty placement, and as an uplift based system for double patty systems PRODUCTS MANUFACTURED BY APPLICANT: Product Dimensions Test Specifications Polypro® AH 160 N/A TAS 101 Foampro® RTF1000 ProPack® 30 & 100 N/A N/A Product Description Two component polyurethane foam adhesive Dispensing Equipment Dispensing Equipment PRODUCTS MANUFACTURED BY OTHERS: Any Miami -Dade County Product Control Accepted Roof Tile Assembly having a current NOA which list moment resistance values with the use of Polypro AH160 roof tile adhesive. PHYSICAL PROPERTIES: Property Density Compressive Strength Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability Closed Cell Content Test ASTM D 1622 ASTM D 1621 ASTM D 1623 ASTM D 2127 ASTM E 96 ASTM D 2126 ASTM D 2856 Results 1.6 Ibs. /ft.3 18 PSI Parallel to rise 12 PSI Perpendicular to rise 28 PSI Parallel to rise 0.08 Lbs./Ft2 3.1 Perm / Inch +0.07% Volume Change @ -40° F., 2 weeks +6.0% Volume Change @158 °F., 100% Humidity, 2 weeks 86% 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 No.: 11- 0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 2 of 7 EVIDENCE SUBMITTED: Test A e ncv Test Identifier Test Name/Reaort Date Center for Applied Engineering #94 -060 TAS 101 04/08/94 257818 -1 PA 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 I623 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 -I 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® 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 tile adhesive with their tile assemblies shall test in accordance with TAS 101 with section 10.4 as modified herein. (—F —) —W 2 F'= MS MIAMI DADE COUNTY APPROVED NOA No.: 11- 0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 3 of 7 INSTALLATION: 1. Polypro® AH 160 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of Polypro® AH160. 2. Polypro® A11160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof tile assembly's adhesive attachment with the use of Polypro® AH 160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed the uplift resistance determined in compliance with Miami -Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA 3. Polypro® 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 othcr settings shall be approved. 6. Polypro® AH160 shall be applied with Foampro RTF1000 or ProPack® 30 & 100 dispensing equipment only. 7. Polypro® AII160 shall not be exposed pennanently to sunlight. 8. Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after Polypro® AI-1160 has been dispensed. 9. Polypro® AH 160 placement and minimum patty weight shall be in accordance with the 'Placement Details' herein. Each generic tile profile requires the specific placement noted herein. Table 1: Adhesive Placement For Each Generic Tile Profile Tile Profile Placement Detail Single Paddy Weight Min. (grams) Two Paddy Weight per paddy Min. (grams) Flat, Low, High Profiles #1 35 N/A High Profile (2 Piece Barrel #1 17 /side on cap and 34 /pan 24 N/A N/A Flat, Low, High Profiles #2 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. MIAMI DARE OUNTY APPROVED NOA No.: 11- 0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 4 of 7 Nall through pleatic cement Underlayment ADHESIVE PLACEMENT DETAIL 1 SINGLE PATTY Paddy (Beneath Tile) 10 In. Ens Comae Ewe Closing Nail through plastic cement Underlayment Eva course only: Keep adhesive wrox. 4 In. up from weepholes Paddy (Raneath Tile) Nall through plastic cement Underlayment Paddy (Beneath TIte) 10 tn. Ewa Course Eave course only: Keep adhesive approx. 4 In. up from weepholes Fascia Mesh* Eave closure Drip edge 1) Place enough adhesive to achieve 17 to 23 Optional 2x4's for square Inches In contact with the pan Itle 2) Turn covers upskle down. Place adhaelve 11210\. To 1 hi. From *Melds edge of carnet Then WWI the Me. 4 steep pitch applications Nall through plastic cement Underlayment 10 In. Ewe Celan Ewe Closure Eave coon only: Keep adhesive appro. 4 In. vp from weepholes Fascia Berney top porllon of the gave course cow Ole. Abut to second course ot pan Mu. Emilie wive end of pan and cover OM are flush at save line. Eave closine (mortar shown) Weephole Fascia Sheathing Optional Poinbup Mortar on longitudinal edges of tile NOA No.: 11-0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 5 of 7 Nall through plastic cement Underlayment ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY Paddy (Beneath Tile) Fescla Eave Closure Nall through plastic cement Undertaymant 1 Paddy (Beneath Tile) 71n. i In. Eave Course Fascia Weophole Eave closure Drip edge Nall through plastic cement Paddy (Beneath Tlle) Underlayment MIAMFDADE COUNTY APPROVED Eave Course Fascia Eave 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) x3 in. Single paddy on under- layment Single paddy under tile Single paddy on top of tile Eave course in. X 7 in. medium size paddy eave Fascia course only Nail through plastic cement Nall through plastic cement Underlayment Single paddy under tile Single paddy between tile 2 in. x 7 in. medium site paddy eave course only OA' re- 3 in. x 3 in. 4 In. Single paddy on under- layment Single paddy on top of tile (%, Eave Course Fascia Weephole Eave closure Drip edge Single paddy between tile 191 -441n.x 3 In. 4 In Single paddy on underlayment Single paddy on top of tile Eave Course Eave Closure 21n. x 7 In, medium sirs paddy eave course only Fascia END OF THIS ACCEPTANCE MADE COUNTY APPROVED NOA No.: 11-0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 7 of 7 M I AMIDE bE COUNTY BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT (BNC) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Polyglass USA Inc. 150 Lyon Drive Fernley, NV 89408 MIANII -DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street. Room 208 • Miami, Florida 33175 -2474 T (786) 315 -2590 F (786) 315 -2599 ww•w.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 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 Tigera. MANMADE COUNTY APPROVED 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 Manz facturing 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 MIAMI•DADE COUNTY APPROVED Dimensions Roll: 65'8" x 3'3-3/8" 60 mils thick Roll: 65' x 3'3-3/8" Or 65' x 3' 80 mils thick Roll: 32' 10" x 3'3-3/8" 100 mils thick Roll: 65' x 3'32/8" 80 mils thick Roll: 32' 10" x 3.3 -3/8" 130 trails 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 polyolefinic 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 roofing 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: Product Polystick Dual Pro Manufacturing Location #2 Dimensions Roll: 61' x 3'3 -3 /8" 60 mils thick MANUFACTURING PLANTS: 1. Haze1ton, PA 2. Winter Haven, FL EVIDENCE SUBMITTED: Test Agency Exterior Research & Design, LLC Trinity' ERD PRI Asphalt Technologies Momentum Technologies, Inc. MIAMI-DADE COUNTY APPROVED 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 Description 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 & G155 TAS 103 /ASTM D4798 & G155 TAS 103 /ASTM D4798 & G155 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 11 or A$TM D 2626. Fastening: Per FBC 1518.2 & 1518.4 Nails and tin caps 12" grid. 6" o.c. at a minimum 4" head lap. (tier 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 3-1/4" 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. MIAMI•DADE COUNTY APPROVED NOA No.: 11- 0601.10 Expiration Date: 09/13/16 Approval Date: 09/15/1 1 Page 4 of 8 0 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 he 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 -Xe TU TU Plus TU P Tile 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 Bui ding 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 rooftile applications with the exception .of mortar set tile applications. 9. The maximum roof slope for use as rooftile 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. MIAMI•DADE COUNTY APPROVED 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 lot 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. Roofing Tiles (6 Max. Per Stack) 12 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. MIAMI•DADE COUNTY APPROVED 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. MIAMI•DADE COUNTY APPROVED 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 " /I2" or greater. It is suggested that on pitch/slopes in excess of 6'/4 "/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. MIAMI•DADE COUNTY APPROVED NOA No.: 11- 0601.10 Expiration Date: 09/13/16 Approval Date: 09/15/11 Page 7 of 8 V 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 ALEX $ NK STATE OF FLORI A .. MEP FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES .^ DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * CONSTRUCTION INDUSTRY EXEMPTION 03 -31 -2010 7- 35S -0212 - FELLA) 'J - 4Li5c - tao1- VrtG"lo2 This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 0313112010 EXPIRATION DATE 0313012012 PERSON: FEIN: VARGAS 580798424 BUSINES4 NAME AND ADDRESS: J S SERVICES ENTITY INC 18408 SW 67TH STREET MIAMI FL 33193 SCOPES OF BUSINESS OR TRADE 1- REPAIR SERVICE 3- INSTALLATION SERVICES MAURICIO 1 2- HANDYMAN 4- TILE IMPORTANT: Parietal to Chapter 440 .,981141, F.B., an officer at s corparotioe who elects exemption from Ms chapter by tiling a certificate of electioe under this woo may cot recover benefits ar ceMpeneellae under this chapter. Pursuant to Chapter 440.08112) F.8 ;Certificates of election to be exempt,.. apply only within the mope of the business or trade Wed on the notice of Weeder 10 be exempt. Pursuant to Chapter 440.0 18f, F.S., Notices of eletlen to be exempt end certif cotes of election to be exempt obeli be abject to revocation 16 at any tien alter the 1111ag of the notice or the Iseaasse el the sertEcete, the perms named on the notice or certificate as longer meets the requirements of this seethe for Issuance of a certificate. The department shall revoke a certificate et any time for failure of the parson named en tha certificate t0 meet the regairem.Mi of 011 sestina. O.uESTION57 (860) 413 -1808 OWC -252 CERTIFICATE OF ELECTION 10 BE EXEMPT REVISED 09 -06 11 03 -02 -2011 JEFF ATWATER STATE OF FLORIDA CHIEF 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 03/28/2011 EXPIRATION DATE: 03/24/20131 PERSON: VARGAS GABRIEL H FEIN: 880798424 BUSINESS NAME AND ADDRESS: J S SERVICES ENTITY INC 12831 SW 211ND TERRACE MIAMI FL 33177 SCOPES OF BUSINESS OR TRADE: 1- REPAIR SERVICE 3- INSTALLATION SERVICES' 2- HANDYMAN 4- TILE IMPORTANT: Pursuant to Chapter 440. 06414 F.S., en officer of s corporation who elects exemption from 110* chapter by tiling a certificate of election under this section say not recoverbenef Its or compensation under Ibis chapter. Pursuant t0 Chapter 440.061121, F.S., Certificates of election to be exempt... apply only within the scope of the business or trade listed on the aatice of election to be exempt. Pursuant to Chapter 440.05113), F.S., Notices of election to he exempt and certificeiu el election to be exempt shell be subject to revocation If, et any time after the Ming of the 0attce or the !dunce of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for !nuance of a eertNleste. The department shad revoke s certificate el eny time for failure of the person named on the certificate to meet the requirements of this section. QUESTIONS? (8601 413 -1609 OWC -262 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 a. 06-22-2011 JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OP WORKERS COMPENSATION * * CERTIFICATE OF ELECTION TO 1111 EXEMPT FROM FLORIDA WORiUNIr COMPENSATION LAW * * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to.be exempt from Florida Workers' Compensation law. 1 EFFECTIVE DATE 06/22/2011 EXPIRATION DATE: 0012112013 PERSON r FIGUEROA 4 RAFAEL • FEIM 2729111250 a BUSINESS NAME AND ADDRESS: MPG QARBAGE CORP Wen W 20TH AVE HIALEAI4 FL 22012 SCOPES OF BUSINESS OR TRADE 1- DEMO RENOVAL a 16111011TANTs Pursuant to Motor 440. 0504), F.L. el Wiser of $ corporation who elects omega from this *apt., by Mini $ cordlione of election mist tbls saga sop soi mow basalt s a umpaspilim vador his Wpm Persson to ampler 440.01012). F.5., Cortiffesies of eiscrion so be exempt.. apply oily Willie the scope of the' business or uses listed on the mace of GINO& to be esompl. Pursuant fo Cliseiu 440.00010, P.O., Notites.of election to be emend sad tertillostes of ' eletion e be exmpt skill be oiv raniOles 0, a say de alta do Min of the nato sr ie bunco of the certficets. be perste nixed au ts IitiO or 4 cettlflesie Its knit =els the requireissols *9 101* satin for Wes= of e sertillege. The department 411001 nuke 1 sertilisete si op tine 90, Wien *9 10* pence i wand es tbs corifflosis to meet the reqskomeals of this gedin. QUESTIONS1 0228 419-1801 OWC-262 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01-11 IfElq LICE CDL CLASS A S522- 556 -61 -023 -0 XU 1ES RAFAEL SANCHEZ f3 hp1415 AVE TN1IAMI, FL 33168.3816 01 2 -1961 sex: M HOT 5-09 ►-31- 2007 1313 -201' Tas 7T0 CT t B Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY 04BS00586 M R SANCHEZ CARPENTRY INC D.B.A.: "g NC Z MERXIADES Is certified under the provisions of Chapter 10 of Miami -Dade County VALID FOR CONTRACTING UNTIL 09/30/2012 NEOTHIMI AM1 [ 0 IR 0 City of North Miami 776 N.E.125 Street • North Miami, FL 33161 • 305-893-6511 Business Tax Receipts Waled Date: 10/1/2011 Expiration Date: 9/30/2012 Business Tax Receipt #: BT-000721 M.R. SANCHEZ CARPENTRY INC 13460 NW 5 AVE NORTH MIAMI, FL 33168 CARPENTRY/general contractor AT CUSTOMER LOCATIONS (OFFICE ONLY) SPECIAL RESIDENCE CITY CODE SEC 29-22 Business Name / Address: M.R. SANCHEZ CARPENTRY INC 13460 NW 5 AVE NORTH MIAMI, FL 33168 et, lerk NOTICE: BUSINESS TAX RECEIPT MUST BE TRANSFERED WHEN BUSINESS IS MOVED NON-TRANSFERABLE • POST IN A CONSPICUOUS PLACE • NON-TRANSFERABLE _ DATE BATCH NUMBER 4R » CERTIFICATE OF LIABILITY INSURANCE DATE ("`�°��'' PRODUCER Excellence Insurance Agency 3801 SW 107 Avenue Miami, FL 33165 Phone (305)226 -3900 Fax (305)226 -3997 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIL # INSURED M.R. Sanchez Carpentry, Inc. 13460 N.W. 5th Avenue North Mlanli, FL 33168 (305) 688 -7924 INSURER A: UNITED SPECIALTY INSURANCE CO. INSURER B: INSURER C: INSURER D: INSURER E: COVERAGES INSURER F: THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDn1ON 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN RR INSS D TYPE OF INSURANCE POLICY NUMBER DA DATE ( LIMITS DATE (( A • GENERAL LIABILITY ® COMMERCIAL GENERAL LIABILITY ❑ ■ CLAIMS MADE ® OCCUR o 1245 05/19/11 05/19/12 - EACH OCCURRENCE 1,000,000 DAMAGE S occurence) 100,000 MED EXP (Any one person) 5,000.00 PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE 1,000,000 • GENtAGGREGATE PRODUCTS - COMP /OPAGG 1,000,000 U(ITAPPLIESPER POUCY • PROJECT • LOC MI AUTOMOBILE • • • • ❑ • • LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) • GARAGE LIABILITY IN ANY AUTO • AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG • EXCESSIUMBRELLA UABIL1Y • OCCUR ❑ CLAIMS MADE • DEDUCTIBLE • RETENTION $ EACH OCCURRENCE AGGREGATE WORKERS COMPENSATION AND EMPLOYERS' LIABIUIY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below ❑ WC STATU- • OTH- TORY LIMITS ER EL EACH ACCIDENT EL DISEASE - EA EMPLOYEE EL DISEASE - POUCY LIMIT OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS Certificate holder is an additional insured CERTIFICATE HOLDER CANCELLATION Miami Shores Village Hall 10050 Northeast 2nd Avenue Miami, FL 33138 SHOULD ANY OF THEp6 DESCRIBED POLICIES B ELLED BEFORE THE EVIRATION DATE:HERE THE ISSUING INS ENDEAVOR TO MAIL 0 DAYS WRITTEN OTICE TO THE CERTIFICATE HOLDER NAMED TO THE - UT FAI.UR O DO SO NO OBUGATION OR LIABILITY OF ; KI;' D UPON T)3EE INSURER, ¢ENTS OR REPRESENTATIVES. v s ACORD 25 (2001108) OF STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PRonssictiwneurgaTxow CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487-1395 1940 NORTH INDIROE STREET TALLAHASSEE FL 32399-0783 SANCHEZ_ VICTOR APOLINAR N.R. BANC= -Z CARPENTRY, INC. 13460 NW 5 AVE • NORTH' MIANX FL 33168 Congratulations! With lids license you become one of ihe nearly one rniMon Floridians licensed by the Department ce Business and Professional Regulation. Our professionals and butimsses range *on architects to yrold Woken, from boxers to barbeque restaurants, and they keep Florida's economy strong. - Evers, day we work to Improve the way we do business in order to serve you better • For infonnation about our servkes. Please log onto www.owIlloridatioenee.00ni. There you can find more Intone:Mon about our diviskse and the regulations that : - impact you. subscrWe to departmert newsbatters and team more about the Department's Mayes. • Our mission at the nepotist/it kt License Efficlentli, Regulate Fairly. We • constantly strive to serve you better so that you can =rye your customer's. Thank you for doing business-1n Markle. and congratulations on Your neW &Wad AC# : • . '.BVSINESS 1D • 2REGUI.414701t-, '-02/07/11 -100234161 ROOFING • CONTRACTO_R CTOR APOLINAR • "- • - CARPENTRY DETACH HERE oadtir t#9 provisians of Ch.489y$ T.a3.0207.00428 : - - OF,„,_ . TE- FLO DA --- - -- - wr OF --,::-: -,,.--z1,.k., ip-i. •=7,,-,.,-1,.... ---..--s: ,.:_-_-... ,.„-,.-„,-.., „....„ , ...-,„: ss, itst. 1„.iitoi itg- stib. 47:LA.x.:_--_-7,... =i-40:1 .::-.1 '-''--CrisLltu LICENSE ••• NBR- -..,-. - ...._ - , .. . .. . .107-/2-011 02341 , ....__ , .,. - 61, .- Cab13297.E67 .4,VCCI1MtirlWq ormitti ci-•*- Chapter• 489 .FS. iration. date:. AUG 31, 2012 - - - • : • - , . L11027.00 OttlOAINg. ''':-.., • :: -. -_ . • . 4. . iV: A,RP" 1 14-fill RY;•:'•"P it;-•' - - " - ' -J1.--..-,. --- NORTH MAKE FL 34168 . - ... .•.; .7:3: STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 SANCHEZ VICTOR APOLINAR M R SANOHEZ CARPENTRY INC 13460 NW 5TH AVE NORTH MIAMI FL 33168 Congratulations! With this lice you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from archItects to yacht brokers, from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better For information about our services, please log onto www.myfloridalicense.com. There you can find more won about our divisions and the regulations that impact you, subscribe to department newsletters and team more about the Department's initiatives. Our mlssion at the Department is License Effidently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE STATE OF FLORIDA AC# DNRARtTMENT QF : BUSINESS AND -- PROFESSIONAL _REG0188.TION CGC1517240 07/13/10 108007203, CERTIFIED GENERAL CONTRACTOR SANCHEZ; 'VICTOR APOLINAR M _R SANCEZ ; CARPENTRY INC: IS.. CERTIFIED under the Provisions of Ch.489 FS Ess ration date. ?AUG 31, 2012 .1.10071300986 s AC# STATE.OF FLORIDA:. DEPARTMENT .OF BUSINESS AND PROFESSIONAL .REC,ULATI CONSTRUCTION INDUSTRY:" LICENSING BOARD -_ BATCH NUMBER LICENSE NBR 07/13/2010 1080 )7203: CGC 1517240 The GENERAL :CONTRACTOR Named below IS CERTIFIED. under the provisions of Chapter 489 FS.. Expiration date: AUG 31, 2012 SA dC HEZ;' VICTOR APOLINAR 2,4-12 -SANCBICZ• CARPENTRY INC 13460 NN` :5TR` -AVE NORTH MIAMI FL 33168 CHARLIE :GRIST .GOVERNOR DISPLAY: AS REQUIRED BY LAW JEFF ATWATER "w. OfficeIR DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * LATE OF ELECTION TO BE Exam FROM R.ORMA Wes' CIMIPBMATION LAW * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. 06 -06 -2011 EFFECTIVE DATE PERSOI% FEIPk 0610612011 SANCHEZ 571205691 BUSINESS NAME AND ADDRESS: NR SANS CARPENTRY INC 13480 NW B AVENUE NORTH MIAMI FL 33168 EXPIRATION DATE 06/05/2013 VICTOR SCOPES OF BUSINESS OR TRADE 1- CERTIFIED ROOFING CONTRACTOR 2- CERTIFIED GENERAL CONTRACTOR * IMPOHTA/T Pormant to Chapter 440 . 05141; F.B. an officer el a coopmatlea who elects exemonee tram the cbopter by Mug a certificate al election mater this section may eat recover benefits or compensation totter this chapter Format to Chapter 450.65t12L F.S., CertifiwMs of election to be exempt—. fly only Wilde the scope of the btu or trade listed an ate setice of election to he exempt Pmt to Chapter 440.05113 F.S., Notices of election to be exempt aid certificates of election to be exempt Mail be subject a resoceles if, et any time alter the filing of the make or the issuance of the certificate, Me person wined an the notice or emttiiaaee oo conger reacts the requirements at this section for issuance of a certificate. The department shall revoke a certificate et any time for faflore of the person named on the certificate to meat the reqntremeats of this settles. OWC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 01 -11 QUESTIONS? (850) 413-1609 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OP FLORIDA DEPARTMENT OF Fa Nc1AL SERVICES DIVISION 'TI� CERTIFICATE OF SECTION TO BH Ewan FROM FLORIDA WORKERS' CORWENSATKIN LAW EFFECTIVE OD/OS/2011 EXPIRATION DATE: 06/05/2013 PERSON: VICTOR SNNCHEZ mink 5712 81 BUSINESS NAME AND ADDRESS: MR SANCsr2 CARPENTRY u 13460 NW 5 AVENUE NORTH MIAMI. FL . 33168 SCOPE OF BLJSIltESS OR TRADE 1- CERin-t£O ROOFING CONTRACTOR 2- CERTIFIED GBIERAL CONTRACTOR IMPORTANT n Pursuant to Cif 44805(14). F.S., an officer of a corporation who elm exemption from this chapter by firing a certificate of election I- under this Section afay not recover benefits or won wider this D chapter. be H Pursuret to Chapter ( exempt.. apply only within the scope of of the business or trade listed on R the notice of election to to exempt E Pursuit to Chaffer 440.05(13) F.S. Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if, at any time after the filing of the notice or the issuance of the certificem, the peen named on the notice or certificate to longer meets the requirements of this section for issuance of a certificate The depirtmet shall revoke a certificate at any time for failure of the person named an the certificate to meet the remdrements of this section OUESTIDNS? (850) 413 -1609 CUT HERE * Carry bottom portion on the job, keep ter portion for your records. WC -252 CERTIRCATE OF ELECTION TO BE EXEMPT REVISED 01 -11 • .tom_ ATWATER STATE OF FLORIDA RNAN1u,OFFICEi DEPARTMENT OF FINAMLAL SERVICES DIVISION OF WD ' COWENSATIM * * EERTffIA1E OF III TO BE EXEMPT MOM A.IMUI TDN LAW CONSTRUCTION EXEM'TION This =W es that the individmil lisp below has elected to be exempt from Florida Workers won law. 06-06 -2011 EFFECTJVE DATE: PERSOM 07110/2011 EXPIRATION DATE 0710912013 SAPCHEZ 111651XIADES FEU* 571205691 BUSINESS NAME AND A N R SANCHEZ CAGY INC 13400 Nil STH AVENUE ND RTH SIIAKI FL 38188 SCIWES OF BUSINESS OR TRADE 1- CERTIFIED ROOFING COISTRACiOR 2- CERTIFIED ORAL CONTRACTOR mM'89TA4lF Pomona 10 amides 4 4 11 - a F.B., se officer of s ceroweetion oho elects exempthe fry eds draper by Meg is cenlibeele el denim star We sect q m1 nearer hafts compenstaine olds 8110 chaphr. Farms to Chapter 440.0511* F.S., Cernfiestes of antra to be e>s "r* apply only withfs the scoff of We amine or tole Mad eo foe eelte of election to be exert. Peseta to Chapter MAIM 1* F.S., lades of election to be exsapt end conficates of slethcn to he meow shit be ambled to taeog4Ra i, et any time after the Waq of Ike stake er tie inseam of tie ce ditai, the per eased ea the antics or =Mime es baser wee*s the reams a RNs sett for tssese[e at a catthta t . the depenmeat BMW r.exke a entificste ai any time for failsre of the petsaa earned ea the califirsde to of this sect. WES ICOU1 (850) 413 -1609 OWC -252 (WITWEATE OF TO BE EXIEWT WISED 01 -11 PLEASE CUT OUT THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE sTATEM FLORMA OMUiMUMMERS' CONITRIATION INDUSTRY CERrimuEOFELECINNITOBEBEIWTFROINFLORIDA WORKERS* COIDETWATION LAW EFFECTIVE 07/10/2011 B70►1RATI0N DATE: 07/09/2013 P1R;SON: FE01t 5711 Btu NAIVE AND AIXIESS M R mama etwownRY WC _ 19480 NW 5171 AYt Nom wait R 33189 SCOPE OF BUSINESS OR TRADE 1- CSUFED ROOFING C8911a11Pr0R 2- WOWED nEWERAL catamaran IMPORTANT Pomona to Chapter 449.05(14), F.S., at officer of a who O elate exemption from 41411 t by f a a of election Dsection may not recover benefits or i ender this H Formamt to Chapter 449.Ndi*. F.S., C01 dt des of aleakla to be E within t of the or Vale an the notice isf election � be eXeMPL E Pursuant to Master 440.050 FS, Notices of electian to be exempt and certificates of elm to be exempt sba8 be =blast to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person mated at the mace or certificate no longer meets the requirements of this section for issuance of a certificate. The department shaft remake a oeiftcr8e at say lints for failure of the person mated an the certificate to meet the requirements of this section. (8501 413 -1009 UT 11101£ • Carry bottom partial on the job, keep No' portion for your records. aWC -252 CE1lT01CATE OF 9.ECT= TO Sir EIPT REWIND 01 -11 1 I11III 11II11111111111II111I11111IIII IIII IIII NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. \ \ -32 o -19‘7- C5 7 o STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Legal description of property and street/address 2. Description of improvement: >Ze>aF CIF'iN 2012R>I 0_x9'99' 60 OR Bk 27995 P's 0626x• (1Ps ) RECORDED 02/13/2012 019:42:04 HARVEY R1JVII+ir CLERK OF COURT MIAMI-DADE COUNTY? FLORIDA LAST PAGE Space above reserved for use of recording office SQL 4 A4'Lb E'I -AT 1 6 (S —l'1- 3. Owner(s) name and address: Interest in property: Name and address of fee simple titleholder 4. Contractor's name, address and phone number: VV\.(L, 5. Surety: (Payment bond required by owner from contractov any) Name, address and phone number. ( I Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. A r� Name, address and phone number: 7 V 9. Expiration date of this Notice of Commencement: (the expiration date Is 1 year from the date of recording unless a different date Is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AN. POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENAER-p : • - j ' sP COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT a" f ' ? ..1 4°11,:i'144!::tc Raab! 11 it i ii r 311:Wal Signature(s) of Owne or Own s)' A horized Officer/Director/Partner /Ivlanag Prepared By a� -� Prepared By Print Name N g&iPrlso us sli-N Print Name Title /Office ®ud r Q ' Title /Office ''' STATE OF FLORIDA COUNTY OF MIAMI -DADE r The forre,�go,i,ng,,, ins rument was acknowledged_befor_e.me_this. (e� day of 1 ��r By —b►fi e r 5 p [ThSC1i n Individually, or ❑ as for ❑ Personally known, or 'produced the following type of identification: Signature of Notary Public: _ Print Name: U (',1 r C c 1 W (SEAL) VERIFICATION PURSUANT TO SECTION 92525. FLORIDA STATUTES Under penalties of perjury, 1 declare that I have read the foregoing and that the facts stated in it are true, to the best of my knowledge and belief. . /o12_ Signs s) of Owner(s) or Owner(sys Authorized Officer/Director /Partner/Manager who signed above: By By 4