RF-12-918Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 175458
Scheduled Inspection Date: July 10, 2012
Inspector: Rodriguez, Jorge
Owner: BAILEY, JAIMES
Job Address: 1080 NE 92 Street
Miami Shores, FL 33138-
Project <NONE>
Contractor: GS COLEMAN CONSTRUCTION & ROOFING INC
Permit Number: RF -5 -12 -918
Permit Type: Roof
Inspection Type: Final Roof
Work Classification: Tile
Phone Number (305)891 -5020
Parcel Number 1132050270400
Phone: (954)421 -7677
Building Department Comments
RE -ROOF TILE SECTION
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- 173877. Flat roof replaced
without permit. Tin cap at flat not per code. NB
July 09, 2012
For Inspections please call: (305)762 -4949
Page 18 of 27
RE: Permit # le 6 /2" "
1; l CO
(Print name and cirde License Type)
Miami Shores Village
Building Department
INSPECTION AFFIDAVIT
licensed as a
FS 468 Building Inspector
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
DATE:
_i3 i
Engineer / Architect,
License #: CC /9333
On or about �ric /3 2,0 , I did personally inspect the roof deck nailing and
(Date & time)
Secondary water barrier work at jb S-0 4C J Z
(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.
Sworn to and subscribed before me this // 13 day of � c 2c) i1
Notary Public, Sate of Florida at Laria;)
*General, Building, Residential, or Roofing Contractors or any in dual certified under468 F.S.
permit # and address # Beady shown marked on the deck for each inspection
Revised on 5/21/2009
a9ta •»:� JOCELYNE HERARD
* MY COMMISSION # EE 124835 h$ of each plane of the roof with
Bonded ihru Budget Nary Services
A . Tomassi Roof Testing, Inc.
5451 NW 24th Street, Suite # 3
Margate, Florida 33063
TAS — 106-95 TeL 954 — 979 —1180
Fax. 954 — 979 —1182
Roof Tile Static Uplift Test Report
Test Date:
June 29, 2012
Project:
1080 NE 92nd Street., Miami Shores, Florida
Contractor:
G.S. Coleman
Permit #:
RF -5 -1 -2 -918
Roof Pitch:
3 : 12
Tile Installation Date:
June 27, 2012
Attachment Method:
Polyprofoam
Tile Type:
Hanson Regal
All testing is in strict accordance with the 2010 Florida Building Code,
High Velocity Hurricane Zone Testing Application Standard (TAS) 106
Each Test location was pulled using a Imada Force Gauge to a minimum of 35 lbs.
1'EST SUMMARY:
Roof Area
Total # of Tests
# of Tests Passed
% Passed
Field
20
20
100%
Comer
18
18
100%
Perimeter
22
22
100%
Hip (Approx 108 Total)
10
10
100%
Ridge (Approx 34 Total)
4
4
100%
TEST RESULTS: PASSED
See Attached Sketch For Further Details.
Report Reviewed by:
Dominick Scarfo, "AR0010248
Dade County Certified Testing Agency # 07- 0720.04 Revises: # 03- 0317.03
31'
2'
16'
15'
10' 4' T T
T
4' T
2'
23'
T
T
T T
T
T
T T
T
T T
T
T
T T
T
28'
T
28'
TAS —106 Test Locations
T = Tested Location
All Dimensions are Approximate
N
27'
Project:
T = Tested Tile and Passed
F = Tested Tile and Failed
1080 NE 92nd Street
Miami Shores, Florida
• Certificate of Calibration
# KELC-152300
Kimball Electronic Laboratory, Inc.
Precis* Measurement Equipment Specialists
4. 01 •
KIMBALL ELECTRONIC LABORATORY, INC
8081 W 21 LANE
HIALEAH, FL. 33016
3144,WEM44..
Description: DietrAt FORCE GAUGE
Manufacturer: IMADA
Model -Number DPB14440
Part Number. DPSH-440
Range: 0-440 LBS
Serial Number 109171
Customer W.: N/A
Cue. Barcode: N/A
Cust. Dept.: N/A
Specifications: +/- .2 LBS
Purchase Order #
A. TOMASSI ROOF TESTING, INC.
5451 NW 24 STREET
*3
MARGATE
FL 33063
Cal Date: 16-Apr-12
Cal. Due Date: 16-./u1-12
Cal. Interval: 3 MONTHS
Received: IN TOLERANCE
Calibration Result PASS
Environmental Conditions: 74 DEG -f / 38 % R-H
Performed By: ELIU
LAGO
Procedure: SYN156
Cal Location: ON-SITE
Ibis Is to certify that the above-listed instrument meets or exceeds all spedfications as stated in the referenced procedure at the Points tested (unless otherwise Met)- It has
been calibrated' ustng measurement slandardatraceable tote National institubs of Standards and Technology (NIST), or to NIST accepted intrinsic standards of measurement, or
derived by the mdrii tivectselkalibration This calibration is in accordance with Kimball Electronic Laboratory, Inc Marty Assurance Manual. KELTs Quay system is
A21A-ParreditedttrablEC-17025.Z05 and - mpliant With MIL-STO.45662A and ANSUNCSL Z540 32008 TURS when applicable are greater than or equal to 41; with expanded
uncertainty usedlovalculatathe Test Repo, with a coverage factor of K=2 at a confidence level of appnadmately95%, unless otherwise noted.
Any number of factors may cause the-calibratton beta to drift out of calibration before the recommended interval has expired.
-tral
Ar*-Wit
wei-r-r"F -
1,411114.EILIZIk„
--
Tf#S-UNIT WAS FOUND TO BE IN TOLERANCE AT THE TIME OF CALIBRATION.
PERFORMED ROUTINE CAL. NO ADJUSTMENTS REQUIRED
Company
KIM001
KIM001
LD.
446
447
aP:21' A 4,
7.4,14IP. •
„oat
DesprIptiOn
AKO TSD 125-S DEAD WEIGHT SYSTEM
AKO TSD 2052-613 DEAD WEIGHT SYSTEM
Last Cal. CaL Due Date
29-Aug-11 31-Aug-12
29-Aug-11 31-Aug-12
Certtfied by: jj ApprovedBy:
ELIU Q G JAVIER
LAcio 16 -Apr -12 8:18:20 AM BALCEIRO 17-Apr-12 8:18:33 AM
This report may not be reproduced, except in full, unless permission for the publication of an approved abstract is obtained in writing from Kai Labs., Inc.
KinthalIE1e0tronic Laboratory, Inc. - 8081 W. 21st Lane - Hialeah, FL. 33016
Tel: 305422-5192 - Toll Free: 800-393-1094 - Fax: 305-362-3125 - Web: uwAv.kelilabs.com
E
lgi-VAV$Atigait
i••,.•••1••••••••r•e!:;„,•:•••
E
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO.
TAX FOLIO NO. 11, ✓ z S z7 0 r60
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.
111111111111111111111111111111111111111111111
CFN 2O12R0134 -5637
OR Bk 28111 Ps 4531; (1Ps)
RECORDED 05/15/2012 12:59:25
HARVEY RUVIH, CLERK OF COURT
MIAMI -DADE COUNTY' FLORIDA
LAST PAGE
�y Space above reserved for use of recording office
1. Legal description of property and street/address: /t, Ed 'k / ZSA /4 333 F
•
2. Description of improvement: AC/WA-
3. Owner(s) name and address: ////.4 -
Interest in property:
Name and address of fee simple titleholder:
4. Corptjactor's name, address and phone number:
d9/
5. Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone number:
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.
Name, address and phone number:
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 AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK
OR RECORDING YOUR NOTICE OF COMMENCEMENT.
$j�ature(s) o. • ner(s) er(sttki orized Officer /Director/Partner/Manager
Prepared By Prepared By
Print Name CO 2%eS no %A5?.0 Print Name
Title /Office 4, L— Title /Office
TATE OF FLORIDA
COUNTY OF MIAMI -DADE
The foregoitlq irzrent was apknowiedged before me this / day of /7/ 2-an
Individually, or as c� for �'4 d le/
1:i Personally (mown, or ❑ pro uced the following type of identifi ny
Signature of Notary Public:
Print Name: ,AOt ::.°4b„ JOCi1YNE HERARD
(SEAL) *t * MY COMMISSION # EE 124835
EXPIRES: November 4, 2015
0, 9jFORFl Baled Thru Budget Wary Services
Cia S'/f //o
VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES
Under penalties of perjury, I declare that 1 have read the foregoing and
that the facts stated in it are true, to the best of my knowledge and belief.
Signa =(s) of Own
By '
123.01- PAS.. 3 3/10
ner(s)'s Au orized Officer /Director/Partner /Manager who signed above:
By
DIl"
PERMIT APPLICATION
FBC 20
Permit Type: BUILDING ROOFING
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
fe `v 1
Permit No. oL'
Master Permit No.
OWNER: Name (Fee Simple Titleholder): 1114921 1-S46c/ 5141/0 Phone#: 4.47/- 437- 7 / )12-
Address: 6a 4 E 9 2$�L
City: // mu, State: ic? zip: 3 3 )3k
Tenant/Lessee Name: Phone#:
Email:
JOB ADDRESS: /t5 a A, # E q
City: Miami Shores County:
--- Folio/Parcel #: 1/— 3 26,j- 6 s-7— d ipso
Miami Dade
zip: 33 / 3 F
Is the Building HisAorically Designated: Yes NO )C Flood Zone:
CONTRACTOR: Company Name: 6. S. Co 4'w &4? .r,4/etiL, c Phone#: 9sy Y2/- 7677
Address: //Z/ S /h/b4941 "2—.$2,97/
City: Dec / 1' r /7' P/ State: a"vett- zip: 3 3 z/ y L
Qualifier Name: 6-14-17 , Co /c/vr4 J Phone#: %Shy laktSca c,»
Mate Certification or Registration #: C C 4 2 /3g2.- Certificate of Competency #:
Contact Phone#: qfy- V2 /- 0 0 e Email Address: A, I /Svc 9 y *y er tie //SdVJ ",,,e/
DESIGNER: Architect/Engineer. Phone#:
Value of Work for this Permit: $ / l2 c Square/Linear Footage of Work: /50
Type of Work: DAddition OAlteration ONew /O--Repair/Rep1lace ODemolition
Description of Work: deC't # - 06,40,,,_ —A/c. / /4 ri e /49 4/.ki✓ 'Jae
Submittal Fee $ Permit Fee $ CCF $ CO /CC $
Scanning Fee $ Radon Fee $ DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $62(0C1 0
Bonding Company's Name (if applicable) A1/4
Bonding Company's Address
City State Zip
Mortgage Lender's Name (if applicable) /t//4
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 AMR 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 $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued In the !f such posted notice, the
inspection will not be a roved anfil a reinspection fee will be charged.
Owner or A'_: nt Contractor
The foregoing instrument was acknowledged before me this 2 ° The foregoing instrument was acknowledged before me this
day of /7'4'1 , 20 /3 , by C /..1 00 454
who is
, day of
o me or who has produced who is
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
JO UNE BERARD
My Commission Expires:
20 j, by 64e'7
to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission E
ADRY 4 JO(ELVNE WARD
* MY COMMISSION #EE124
EXPIRES: �Nov„e�mber4, 2515
' %0F fl.° BOO swot % semen
** ***: k*:: k+ k, k****% k+ k***A' *, k$ ok: bnktk: k**+ k, 1: *N+ sb, k, Rak, k*, k,k,knAslaH:sk,k:Ksi:**$,R* k, k*, kNi**+k+k***okeksksk*ik*,k* Fed: 8q- 9k***** *, R*****As*:k*,k,k*+k*deds***
APPROVED BY �`�- 5;123-/Z Plans Examiner Zoning
Structural Review Clerk
(Revised 07 /10/07)(Revised 06/10/2009)(Revised 3/15/09)
NOTICE OF COMMENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO tI TAX FOUO NO. ` .- 32675-12-7 V60
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.
1111111 11111 1111111111111111111111111 11111111
CFN 20128034 563 r
OR Bk 28111 Ps 4531; (fps )
RECORDED 05/15/2012 12 :54 :25
HARVEY RUVIN► CLERK OF COURT
MIAMI —DADE COUNTY► FLORIDA
LAST PAGE
Space above reserved for use of recording office Ell �y M ve
1. Legal description of property and street/address: /a Ell / .15A rbig 7 tom/ 3 3 F
2. Description of improvement: J'Ceev/'
3. Owner(s) name and address: _ i f../41-
Interest in property:
Name and address of fee simple titleholder.
4. Coot�_a ctor's name, address and phone number:
/ /G/ S /Jii //47 2r / '21'3 / cc, « e
5. Surety: (Payment bond required by owner from contractor, if any)
Name, address and phone number
Amount of bond $
6. Lender's name and address:
7. Persons within the State of Florida designated by Owner upon w
Section 713.13(1)(a)7., Florida Statutes,
Name, address and phone number
STATE OF FLOR othe
TIFY that this is a true copy f.
t A
•
atirupe
74, vi.,AnyitaTOrIbill....,74
6
8. In addition to himself, Owners designates the following person(s)
713.13(1)(b), Florida Statutes. y
Name, address and phone number:
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 AND POSibu ON THE JOB SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK
OR RECORDING YOUR NOTICE OF COMMENCEMENT.
nature(s) o ner(s) er(syAat3prized Off icer /Director/Partner /Manager
Prepared By Prepared By
Print Name (7e-7 2AS no, /AsP. Print Name
Trtle/Office 4,1.17/-- Title /Office
TATE OF FLORIDA
COUNTY OF MIAMI -DADE
The forego; in ment w 2--j___ s a knowledged before me this _ day of 4 /7/ /
. 241/-7
dJ Individually, or ❑ as Aa,,/,_ for
❑- P- ersonaUy-leaowns- or —❑ -prc uced- the4ellewing- type- of- identifie
Print Name:
(SEAL)
VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES
Under penalties of perjury, I declare that I have read the foregoing and
that the facts stated in it are true, to the best of my knowledge and belief.
749/2,m, 1(e( C4 Sri //®
Signatt e(s) of Owne
By
��r: 's�•^ JOCELYNE HERARD
* MY COMMISSION # EE 124635
EXPIRES: November 4, 2015
�1 . Battled llvY Budget Nay Swims
r(s)'s Au oriz //ed��Officer/Director/Partner /Manager who signed above:
P LS BY
123A1 -62 PA 3 3/10
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OWNERS'S AFFIDAVIT OF EXEMPTION
ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE -
BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES
PERSUANT TO SECTION 553.844 F.S.
To: Miami Shores Village Building Department
10050 NE 2nd Ave
Miami Shores, Fl 33138
Re: Owner's Name: CI 4 6j 11 u l6s(o (4.54.-)
Property Address: / 'o 6- 9p. S.
Roofing Permit Number:
Dear Building Official:
("4 et vi // / /set) certify that I am not required to retrofit the roof to wall connections of my
building because:
he 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 building was constructed in compliance with the provisions of the Florida Building Code (FBC) or with the provisions
of 1994 edition o the South Flori 1a Building Code (1994 SFBC)
Date: 5J /�
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 2 ° day of On4.7 Z0)1., 4164444- A°�0,.• •`" MYCOi AlYNEtERARD
Notary Public, Sate of Florida at Large *XpjREg: November 4, eats
mr� 044 eamedNuB tte Services
• When the just valuation of the structure for purpose of ad valorem taxation is equal to or more than i,000.00, and the buncing was not constructed with FBC nor a 1994
SFBC. Then you must provide a bung application from a General Contractor for the Roof to Wall connection Hurricane rvrifigafion.
Revised on 5/21/2009
Bufete Paz Andino
Special Power of Attorney
I, Maria Isabel Castillo Avila, through this today April 30, 2012, I hereby grant to
Special Representative Carlos Nolasco, naming and designating his as my true
and lawful agent, so that my name can do and / or authorize a third, all tasks or
activities concerning the maintenance and / or repair of my property and around
the facility as a whole; as if I were present.
Property Address: 1080 NE 92 ST Miami, FL 33138
Legal Description: BAY SEIVUELO PB 44 -63 LOT 1 BLK 3 Taman° del lote 70,420
X 125 o 16.863 hasta 0.603 0.795 1 COC
26334 -2631 02 2008 6 0908 00 0 26.594 -0575
parcel identification number: 11 -3205- 027 -0400
In witness whereof, I sign this on the thirtieth day of April 2012
Marla Isabel Castillo
Mima Andino
Lawyer # 10616
Email: Mirna andino2005@yahoo.com
Tel: +504 - 99109374
Bufete Paz Andino
Poder Especial de Representacion
Yo, Maria Isabel Castillo Avila, por media de Ia presente hoy 30 de abril de 2012,
le confiero poder Especial de Representacion a Carlos Nolasco, nombrandolo y
designandolo como mi agente verdadero y legitimo, para que en mi nombre pueda
hacer y/o autorizar a un tercero, todas las tareas o actividades concernientes al
mantenimiento y/o reparaciOn de mi propiedad y alrededores de Ia instalaciones
en su totalidad; Tal como si estuviera yo presente.
Direccibn de la Propiedad: 1080 NE 92 ST Miami, FL 33138
Legal Descripci6n: BAY SENUELO PB 44 -63 LOTE 1 BLK 3 Taman() del lote
70,420 X 125 0 16.863 hasta 0.603 0.7951 COC
26334 -2631 02 2008 6 0908 00 0 26.594 -0575
N ° de identificacibn de parcelas 11- 3205 - 027 -0400
En fe de lo cual, suscribo Ia presente a los treinta dias del mes de Abril del of o 2012.
ti t4
Mima Andino
bogado # 10616
Email: Mirna andino2005Pyahoo.com
Tel: +504 - 99109374
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
CONTRACTORS' REGISTRATION FORM
ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS
SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR.
IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR:
A. COPY OF QUALIFIER'S STATE LIC CARD
B. COPY OF LOCAL BUSINESS TAX RECEIPT
C. � OPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT)
D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION)
IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY:
A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER
B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT
C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT)
D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION)
YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW:
MIAMI SHORES VILLAGE BLDG DEPT
10050 NE 2ND AVE
MIAMI SHORES, FL 33138
BUSINESS NAME:
COMPLETE CONTRACTOR'S INFORMATION
l' • s_ Co / ors ,,,✓ Co riv d 6(7‘c 7./ ce
BUSINESS ADDRESS: / 12/ S' /62/44"7"--7407, CITY /Deck%
STATE ir ZIP CODE 3 3 ` V1--
BUSINESS PHONE: ( 9S ' ) 92/ GCS i FAX NUMBER ( 7$ ) 7 S 3 3 7Sea.
,,,.,CELL PHONE ( 9.5"Y ) VL-/ -7677 QUALIFIER'S NAME: 0I �� C6 /e,
QUALIFIER'S LIC NUMBER: CCC 4 2 ) 3 s
E -MAIL ADDRESS (IF APPLICABLE):
Created on 3119109 BY MLDV 1 RV 3126109 MLDV
:Te-='"Wk :46.r..4Mraitztle ntr. XV: S'AF'.1M4:•,:rA 4P: 1:MAZ:=.:=1.:".
BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT
115 S. Andrews Ave., Rm. A-100. Ft. Lauderdale, FL 33301-1895 — 954-831-4000
VALID OCTOBER 1, 2011 THROUGH SEPTEMBER 30, 2012
DBA: Receipt a185-246349
Business Name: G. S . COLEMAN CONSTRUCTION & Business TvninliCOFING/sBEET METAL CONTRA
ROOFING, INC (ROOFING CONIEACTOR)
Owner Name: GARY S COLEMAN
Business Location; 1121 S MILITARY TRAIL #283
DEERFIELD BEACH
Business Phone: 954-481-1947
Rooms
Seats
Entia*Yees
1
Bushtess Opened:01/01/2°12
State/County1CertiFteg:CCC.A21382
Exemption Code:
Machines Professionals
FortfentangeusinessOnly
Number of machines:
Vendlna T
Tax Amount
Transfer Fee
NSF Fee
Pen*
Prior Years
Canadian Cost
Total Pali
27.00
0.00
0.00
0.00
0.00
0.00
27.00
THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS
THIS13ECOMES A TAX RECEIPT This tax is levied for the privilege &doing business within Broward County and is
non-regulatory in nature. You must meet an County andlor Municipality planning
WHEN VAUDATED and zoning requirements. This Business Tax Receipt must be transferred when
the business is sold, business name has changed or you have moved the
business location. This receipt dos not indicate that the business Is legal or that
it is in compliance with State or local laws and regtdatlons.
MalUng Address:
G.S. COLEMAN CONSTRUCTION & ROOFIN
1121 S MILITARY TRAIL #283
DEERFIELD BEACH, FL 33442
2011 - 201.2
Receipt 4101a-11-00004011
Paid 01/24/2012 27.00
-440 ' ThVI:
AC #59
8
�� g�SgT ATTEe3F FL
STRIICTIfI
TION
SEQ# L1112150097:
The SAL CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter
Expiration date: AUG 31, 2012
COLEMAN S
G.S.` �e }:
3956 NOT STS DRIVE
DEERFIELD BEACH
RICK SCOTT
tXNERNOR
AC #5942073
ww.
KEN LAWSON
SECRETARY
DISPLAY AS REQUIRED BY LAW
C.< (SRI
STATE CF FLORIDA
DEPARTMENT QF SINESS AND PROFESSIONAL. REGULATION
CONSTRUCTION INDUSTRY LICENSING BOARD
SEQ9L12011001350
6: 3 PAPS%
01/10/2012 117036766 CCCA21382
The ROOFING CONTRACTOR
Named below IS CERTIFIED
Under the provisions of Chapter 9 -..FS.
Expiration date: AUG 31, 2012
COLEMAN GARY STEPHEN
coLENA T CONSTRUCTION & ROOFING -
3956 NW sTS mri s
DEERFIELD BEACH FL 33442
RICK SCOTT
GOVERNOR
DISPLAY AS REQUIRED BY LAW
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERaces
DMS1ON OF WORKERS COM SAT1ON
LION INDUSTRY
CERTIFICATE OF ELECTION TO SE EXEMPT FROM FLORIDA
WORKERS COMPENSATION LAW
EFFECTIVE: 03/29/2012 EXPIRATION DATE: 03/29/2014
FERSOIt GARY S COLEMAN
FEW: 650747225
BUSINESS NAIVE AND ADDRESS:
G S COLEMAN CONSTRUCTION & ROOFING INC
3958 NW 5TH NNE
DEERFIELD OCH. FL 33442
SCOPE OF BUSINESS OR TRADE
KEN LAWSON
SECRETARY
05/10/2012 12:32 9544258614
PAGE 01/01
A CERTIFICATE OF LIABILITY INSURANCE
THIS CERTIFICATE 18 1SSUED 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 010 PRODUCER, AND THE CERTIFICATE HOLDER
IMPORTANT: If the certificate holder i an ADDITIONAL. INSURED, the p oIicy(sas) must be endorsed- I/ SUBROGATION 18 WAIVED, subject to
the terms and conditions of the policy, certain ponchos may require an endorsement A statement on this c Bate does not Guntur rights to the
certificate Molder In Lieu of such endorsomtne)-
PROOUCac
BB Insurance Marketing Inc P ** NE 3.�,4•�52 4900 ,11 954 -452 -0450_
11870 W. State Road 84. C-15 a,�.,_ btsimi- _
Ft. Lauderdale FL 33324 - MC •
rnNr COVERAGE
INSU GSCOI -1
G 3 Coleman Construction & Roofing, Inc
5283
1121 South Military Trail
Deerfield match FL 33442
mums • dale IDS Go
INNUNIQI
INSURER C:
INSURER() :
INSURER E :
1297
JIISURbR F
COVERAGES
CERTIFICATE NUMBER: 96937E94
REVISION NUMBER:
INSURE
PERIO
THIS IS TO CERTIFY THAT THE POLICIES DE INSURANCE USTt1I NeLuvr rinvlr, nttn t U(U , V 1,IC .--. -.- - - - - --
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 HEREIN IS SUBJECT TO ALL THE TERMS,
AND CONDITIONS OF SUCH POLICIES. oars SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ExcimaroNS
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TYPE OF DANCE
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-
DESCNIPRON OF a E A1t064S I LOCATIONSI MUCUS (A*Rt ACORN Vkl, AddInaecl Rw ea Senadnia, r mews apr h )
Remodeling contractor.
N
I
Miami Shores Village
10050 NE 2nd Avenue
Miami Shores FL 33138
SHOULD ANY OF THE Aim DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
AC NCE MTN THE POUCY PROVISIONS.
AUTRORMEDIREPRESENTATIVE
IV
ACORD 25 (2010185)
0 1888-2010 ACORD CORPORATION. AI rights reserved.
The ACORD name and logo are registered marks of ACORD
•
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
SECTION 4402.14
HIGH - VELOCITY HURRICANE ZONES UNIFORM PERMIT APPLICATION
Florida Building Code Edition 2007
High - Velocity Hurricane Zone Uniform Permit Application Form.
INSTRUCTION PAGE
COMPLETE THE NECESSARY SECTIONS OF
THE UNIFORM ROOFING PERMIT
APPLICATION FORM AND ATTACH THE
REQUIRED DOCUMENTS AS NOTED BELOW:
Roof System
Required Sections of the
Permit Application Form
Attachments Required
See List Below
Low Slope Application
A,B.0
1,2,3,4,5,6,7
Prescriptive BUR -RAS 150
A,B,C
4,5,6.7
Asphaltic Shingles
A,B.D
1,2,4,5,6,7
Concrete or Clay Tile
A,B,D,E
1,2,3,4,5,6,7
1,2,3,4,5,6,7
1,2,4,5,6,7
1,2,3,4,5,6,7
Metal Roofs
A,B,D
Wood Shingles and Shakes
A,B,D
Other
As Applicable
ATTACHMENTS REQUIRED:
1.
Fire Directory Listing Page
2.
From Product Approval:
Front Page
Specific System Description
Specific System Limitations
General Limitations
Applicable Detail Drawings
3.
Design Calculations per Chapter 16, or If Applicable, RAS 127 or RAS
128
4.
Other Component of Product Approval
5.
Municipal Permit Application
6.
Owners Notification for Roofing Considerations (Reroofing Only)
7.
Any Required Roof Testing /Calculation Documentation
FLORIDA BUILDING CODE — BUILDING
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
Florida Building Code Edition
High - Velocity Hurricane Zone Uniform Permit Appl
Miami Shores Village
APPROVED
BY
DATE
ZONING DEPT
1UOl
i,-. op�3�'iEPT
SUBJECT TO COMPLIANCE WITH ALL FEDERAL
Section .4 (General Information)
STATE AND COUNTY RULES AND REGULATIONS
Master Permit No. Process No.
Contractor's Name • f Lc hewn✓ An Siw-e/.+ d teitqc, -7.Ac
Job Address /011) 61F 9IS1
❑ Low Slope
❑ Asphaltic
Shingles
❑ Mechanically Fastened Tile
❑ Metal Panel /Shingles
❑ Prescriptive BUR -RAS 150
ROOF TYPE
❑ New Roof I teroofing ❑ Recovering
�� ll ROOF SYSTEM
INFORMATION
Low Slope Roof Area (SF)
Steep Sloped Roof Area (SF)
go
S ration R (Roof Plan)
Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains.
Include dimensions of sections and levels, clearly identify dimensions of elevated pressure zones and location of
parapets.
Mortar /Adhesive Set Ti
❑ Wood Shingles /Shakes
e � EcENED
�94Y2.1 Nit
❑ Repair ❑ Maintenance
Total (SF)
/8616
FLORIDA BUILDING CODE — BUILDING
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
Florida Building Code Edition 2007
High - Velocity Hurricane zone Uniform Permit Application Form.
Roof System Manufacturer:
Notice of Acceptance Number:
Minimum Design Wind Pressures, If Applicable (From RAS 127 or
Calculations):
P1: P2: P3:
Maximum Design Pressure
(From the Product Approval Specific System): '/5.5
Roof Slope:
31 /ti : 12
Deck Type:
s:-• :es
-it ell
sit
Type Underlayment:
Ridge Ventilation?
Ncg
Insulation:
/- 30#
Fire Barrier:
\\ Fastener Type & Spacing:
Mean Roof Height: ! 3
Adhesive Type:
6f®4 ia'J
fief
\\ Type Cap Sheet:
\ Roof Covering:
Type & Size Drip
Edge:
90 # 7 i mod, /�
ha.71 6/1,~ 71, 4'.4,Scs4er&
/40-4k0../
../ �51�
3,43 Gn /J. brp
FLORIDA BUILDING CODE — BUILDING
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
Florida Building Code Edition 2007
High - Velocity Hurricane Zone Uniform Permit Application Form.
Section F (Tile Calculations)
For Moment based tile systems, choose either Method 1 or 2. Compare the values for Mr with the values from Mf. If the Mf values are greater than or
equal to the Mr values, for each area of the roof, then the tile attachment method is acceptable.
Method 1 "Moment Based Tile Calculations Per RAS 127"
) - Mg: = Mrl Product Approval Mf
) - Mg. = Mi2 Product Approval Mf
) - Mg: = Mr3 Product Approval Mf
Method 2 "Simplified Tile Calculations Per Table Below"
Required Moment of Resistance (Mr) From Table Below Product Approval Mf r
Mr required Moment Resistance*
Mean Roof Height -+
Roof Slope
16'
20'
26'
30'
40'
3:12
4:12
5:12
30.4
34.4
36.0
37.4
39.8
32.2
33.8
35.1
37 -3
30.1
31.8
32.8
34.9
7:12
24.4
25.9
27.1
28.2
30.0
*Must be used in amjumction with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals.
For Uplift based tile systems use Method 3. Compared the values for F with the values for Fr. If the F values are greater than or equal to the Fr values,
for each area of the roof, then the tile attachment method is acceptable.
Method 3 "Moment Based Tile Calculations Per RAS 127"
(Pt: x = xw• =_) -W: x cos 0
(PZ
•
x L = x =_) -W:
xm•= i_w-
Fri
x cos0 =F
x cos8 =F,
Product Approval F'
Product Approval F'
Product Approval F
Where to Obtain Information
Description
Symbol
Where to find
Design Pressure
PI or P2 or P3
RAS 127 Table 1 or by an engineering analysis prepared by PE based on ASCE 7
Mean Roof Height
H
Job Site
Roof Slope
8
Job Site
Aerodynamic Multiplier
d
Product Approval
Restoring Moment due to
Gravity
Mg
Product Approval
Attachment Resistance
Mf
Product Approval
Required Moment Resistance
Mg
Calculated
Minimum Attachment
Resistance
F'
Product Approval
Required Uplift Resistance
Fr
Calculated
Average The Weight
W
Product Approval
The Dimensions
L = length
W = width
Product Approval
All calculations must be submitted to the building official at the time of permit application.
FLORIDA BUILDING CODE — BUILDING
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. °` Aesthetics - Workmanship: the workmanship provisions of Section R4402 are for the purpose of
providing 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
renailed 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
units (Le., townhouses, condominiums, etc.) In buildings with common roofs, the roofing contractor and/or
owner should notify the occupants of adjacent units of roofing to be performed.
4. Exposed Ceiling: Exposed, open beam ceilings are where the underside of the roof decking can
be viewed from below. The owner may wish to maintain the architectural appearance; therefore, roofing nail
penetration of the underside of the decking may not be acceptable. This provides the option of maintaining the
appearance.
5. ,, Ponding water. The current roof system and /or deck of the building may not drain well and may
cause ':ter to pond (accumulate) in low -lying areas of the roof. Pounding can be an indication of structural
distress and may require the review of a professional structural engineer. Pounding may shorten the life
expectancy and performance of the new roofing system. Pounding conditions may not be evident until the
original roofing system is removed. Pounding conditions should be corrected.
Overflow scuppers (wall outlets): It is required that rainwater flows off so that the roof is not
overloaded from a buildup of water. Perimeter /edge wall or other roof extension may block this discharge if
overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in
accordance with the requirements of Sections R4402, R4403 and R4413.
&. Ventilation: Most roof structures should have some ability to vent natural airflow through the
Interior
o e structure assembly (the building itself). The existing amount of attic lation shall not be
reduced. It may be beneficial to consider additional venting which can � ;� xtendi',g the service life of the
roof.
wmer /Agents Signature Date 04 _'3 z Contracto
Revised on 7/9/2009 LD
COUN Y
BUILDING CODE COMPLIANCE OFFICE (BC CO)
PRODUCT CONTROL DIVISION
NOTICE OF ACCEPTANCE (NOA)
Hanson Roof Tile
1340 SW 34a' Ave
Deerfield Beach, FL 33442
MIAMI -DADE COUNTY, FLORIDA
METRO -DADE FLAGLER BUILDING
140 WEST FLAGLER STREET, SUITE 1603
MiAMi, FLORIDA 33130 -1563
(305) 375-2901 FAX (305) 375 -2908
SCOPE:
This NOA is being issued under the applicable rules and regulations governing the use of construction
materials. The documentation submitted has been reviewed by Miami Dade County Product Control
Division and accepted by the Board of Rules and Appeals (BORA) to be used in Miami Dade County
and other areas where allowed by the Authority Having Jurisdiction (AHJ).
This NOA shall not be valid after the expiration date stated below. The Miami Dade County Product
Control Division (In Miami Dade County) andlor the AHJ (m 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 including the High Velocity Hurricane Zone of the Florida Building Code.
DESCRIPTION: Hanson Hacienda Double Roll Roof Tile
LABELING: Each unit shall bear a pennanent 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 perfornnance 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, andlor manufacture of the product or process. Misuse of this NOA as an
endorsement of any product, for sales, advertising or any other purposes shall automatically terminate
this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of
NOA.
ADVERTISEMENT: The NOA number preceded by the words Miami Dade County, Florida, and
followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is
displayed, then it shall be done in its entirety.
INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its
distributors and shall be available for inspection at the job site at the request of the Building Official.
This revises NOA No. 09- 0928.03 and consists of pages 1 through 6.
The submitted documentation was reviewed by Alex Tigers.
j A PPROVED
NOA No.: 10-0706.07
Expiration Date: 12/16/12
Approval Date: 09/15/10
Page 1 of 6
ROOFING ASSEMBLY APPROVAL
Category:
Sub Category:
Material:
Roofing
Roofing Tile
Concrete
1. SCOPE
This approves a roofing system using Hanson Hacienda Roof Tile, as manufactured by
Hanson Roof Tile in Hobe Sow4 Florida and as described in Section 2 of this Notice of
Acceptance. For the locations where the pressure requirements, do not exceed the values
listed in section 4 herein. The attachment calculations shall be done as a moment based
system.
2. PRODUCT DESCRIPTION
Manufactured by
Applicant Dimensions
Length: 171/4"
Hanson "Hacienda" Width: 13"
V2" thick
Trim Pieces
Length: varies
Width: varies
Varying thickness
2.1 EVIDENCE SUBMITTED
Test Aaencv
Redland Technologies
Professional Service
Industries, Inc.
The Center for Applied
Engineering, Inc.
Test
Specifications
TAS 112
TAS 112
Test Identifier
7161 -03
7161 -03
7161 -03
P0402
P0631 -01
Letter Dated Aug. 1, 1994
224 -47099
94-060B
94-084
25- 7094 -1
25- 7094 -7
25- 7094 -4
Product
Description
Low profile, interlocking, extruded concrete
roof the equipped with two nail hole and
double roll ribs. For direct deck or battened
nail -on, mortar or adhesive set applications.
Accessory trim, concrete roof pieces for use
at hips, rakes, ridges and valley terminations.
Mangy for each tile profile.
Test Name/Report
PA 102
PA 102(A)
PA 108
Withdrawal Resistance Testing of
screw vs. smooth shank nails
PA 108
PA 108
PA 112
PA 101
PA 141
PA 102
PA 102
PA 102
ate
Dec. 1991
Dec. 1991
Dec. 1991
Sept 1993
July 1994
Aug. 1994
Sept. 1994
March, 1994
May 1994
Oct. 1994
Oct. 1994
Oct. 1994
NOA No.: 10-0706.07
Expiration Date: 12/16/12
Approval Date: 09/15/10
Page 2 of 6
Test Agency Test Identifier Test Name/Report Date
Project No. 307025 PA 100 Oct. 1994
Test #MDC -76
25- 7183 -1 PA 102 Feb. 1995
25-7183-2 PA 102 Feb. 1995
25- 7214 -2 PA 102 March, 1995
25- 7214 -6 PA 102 March, 1995
Celotex Corporation
Testing Services
528454 -2 -1
520109 -2
PA 101
Sep. 1998
Dec. 1998
Wacker Engineering, Inc. Calculations Aerodynamic Multiplier March 1999
IBA Consultants, Inc. 2381-249 TAS 112 09/20/07
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 be required, refer to applicable building code.
33 Applicant shall retain the services of a Miami -Dade County Certified Laboratory to
perform quarterly test in accordance with TAS 112, appendix `A'. Such testing shall be
submitted to the Building Code Compliance Office for review.
3.4 Minimum underlayment shall be in compliance with the applicable Roofing Applications
Standards listed section 4.1 herein.
3.5 30/90 hot mopped underlayment applications may be installed perpendicular to the roof
slope unless stated otherwise by the underlayment material manufacturers published
literature.
3.6 This acceptance is for wood deck applications. Minimum deck requirements shall be in
compliance with applicable building code.
4. INSTALLATION
4.1 Hanson `Hacienda' Roof Tile and its components shall be installed in strict compliancewith
Roofing Application Standard RAS 118,119, & 120.
4.2 Data For Attachment Calculations
Table 1: Average Weight (W) and Dimensions (1 x w )
Tile Profile
Weight -W (lbf)
Length-1 (ft)
Width -w (ft)
Hanson Hacienda
10.0
1.4375
1.08
APPROVED
NOA No.: 10-0706.07
Expiration Date: 12/16/12
Approval Date: 09/15/10
Page 3 of 6
Table 3: Restoring Moments due to Gravity - MA (ft -ibf)
Tile
Profile
Table 2: Aerodynamic Multipliers - A (ft3)
4 ":12"
Tile
6":12"
A O
A (ft3)
Battens
Profile
Battens
Batten Application
Direct Deck Application
Hacienda Tile
Battens
Direct
Deck
0.267
0.289
Table 3: Restoring Moments due to Gravity - MA (ft -ibf)
Tile
Profile
3":12"
4 ":12"
5";12"
6":12"
7":12" or
greater
Hanson
Hacienda
Tile
Battens
Direct
Deck
Battens
Direct
Deck
Battens
Direct
Deck
Battens
Direct
Deck
Battens
Direct
Deck
5.92
6.80
5.82
6.69
5.70
6.55
5.56
6.39
5.41
6.22
Table 4: Attachment Resistance Expressed as a Moment - M, (ft- lbf)
For Nall -On Systems
Tile
Profile
Fastener Type
Direct Deck
(Min 15132"
plywood)
Direct Deck
(Min. 19132"
plywood)
Battens
Hanson
Hacienda
Tile
2 -10d Ring Shank
Nails
27.8
37.4
28.8
1 -10d Smooth or
Screw Shank Nail
8.8
11.8
4.1
2- 10d Smooth or
Screw Shank Nails
16.4
21.9
7.1
. 1 #8 Screw
25.8
25.8
22.9
2 #8 Screw
47.1
47.1
49.1
1 -10d Smooth or
Screw Shank Nail
(Field Clip)
24.3
24.3
24.2
1 -10d Smooth or
Screw Shank Nail
(Eave Clip)
19.0
19.0
22.1
2 -10d Smooth or
Screw Shank Nails
(Field Clip)
35.5
35.5
34.8
2 -10d Smooth or
Screw Shank Nails
(Eave Clip)
31.9
31.9
32.2
2 -10d Ring Shank
Nails'
43.0
67.5
50.9
1 Installation with a 4" tile headlap and fasteners are located a min. of 2'h° from head of tile.
NOA No.: 10-0706.07
Expiration Date; 12/16/12
Approval Date: 09/15/10
Page 4 of 6
Table S: Attachment Resistance Expressed as a Moment Mf (ft -4bf)
For Two Patty Adhesive Set Systems
Tile
Profile
Tile Application
Minimum Attachment
Resistance
Hanson Hacienda Tile
Adhesive
26 .13
2 See manufactures component approval for installation requirements.
3 Flexible Products Company T leBond Average weight per patty 11.4 grams.
Polyfoam Product, Inc. Average weight per patty 8 grams.
Table 6: Attachment Resistance Expressed as a Moment - Mt (ft -Ibf)
For Single Patty Adhesive Set Systems
Tile
Profile
Tile Application
Minimum Attachment
Resistance
Hanson Hacienda Tile
Polyfoam PoIyProTra
. 1
Polyfoam PolyProTh'
45.5'
4 Large paddy placement of 54grams of PolyPro TM.
5 Medium paddy placement of 24grams of PolyPro TM.
Table 7: Attachment Resistance Expressed as a Moment - Mr (ft lbf)
For Mortar Set Systems
Tile
Profile
Tile
Application
Attachment
Resistance
Hanson Hacienda Tile
Mortar Set'
20.60
5. LABELING
All tiles shall bear the imprint or identifiable marking of the manufactuec"s name or logo
(See Detail Below), or following statement "Miami Dade County Product Control Approved ".
Hanson
HANSON HACIENDA ROOF TUX
TILE IDENTIFICATION MARK (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 the Building Official or applicable
building code in order to properly evaluate the installation of this
system.
APPROVED
NOA No.: 10-0706.07
Expiration Date: 12/16/12
Approval Date: 09/15/10
Page 5 of 6
FASTENER HOLES
PROFILE DRAWINGS
OVERLOCK
J
UNDERLOCK
HANSON HACIENDA CONCRETE ROOF TILE
END OF THIS ACCEPTANCE
NOA No.: 10- 0706.07
Expiration Date: 12/16/12
Approval Date: 09/15/16
Page 6 of 6
MIAMI
C(Al N rr
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.miamidaticgovfimikliaa/
a/
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 pure. 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 in comply with the Florida Budding Code
including the High Velocity Hurricane Zone of the Florida Building Code.
DESCRIPTION: Polypro® A}1160
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 afterthe 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.
AD : The NOA number preceded by the words Miami Dade County, Florida, and followed by
the expiration date may be displayed in advertising ligature Limy portion of the NOA is displayed, then it shall
be done in its c tireiy.
INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors
and shall be available for inspection at the job site at the request of the Building Official.
This renews NOA# 06- 0201.02 and consists of pages 1 through 7.
The submitted documentation was reviewed by Alex Tigera.
"foto"-
I AP ROVED
NOA No.: 11-0124.04
Expiration Date: 05/10/12
Approval Date: 04/14/11
Pagel of 7
ROOFING COMPONENT APPROVAL:
Category Roofing
Sub Category: Roof tile adhesive
Materials: Polyurethane
SCOPE:
This approves Polypro® AH160 as man by Polyfoam Products, Inc. as described in Section 2
of this Notice of Acceptance. For the locations wee the design pressure a 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 appoved flat, low, and high
profile roof tiles system using Polypro® AH 160.1 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 TeT
Specifications
Polypro® AH160 N/A TAS 101
Foampro® RTF1000 N/A
ProPack® 30 & 100 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:
Prouerty
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
ASTMD2127
ASTM E 96
ASTM D 2126
ASTM D 2856
Results
1.6 lbsfft.3
18 PSI Parallel to rise
12 PSI Perpendicular to rise
28 PSI Parallel to rise
0.08 LbsJFt2
3.1 Perm / Inch
+0.07% Volume Change a} -40° F., 2 weeks
+6.0% Volume Change Q158°F., 100%
Humidity, 2 weeks -
860
Note: The physical properties listed above are presented as typical average valves 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 2of1
EVIDENCE SUBMITTED:
Test Agency Test Identifier Test Name/Revart Date
Center for Applied Engineering #94 -060 TAS 101 04/08/94
257818 -IPA 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 1193 12/12/95
Miles Laboratories NB- 589 -631 ASTM D 1623 02/01/94
Polymers Division
Ranitech Laboratories, Inc. 9637 -92 ASTM E 108 04/30/93
Southwest Research Institut/a 01- 6743 -011 ASTM E 108 11/16/94
0I -6739- 0626[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 (Willis 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 nnderlayment 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 assonblies shall test in accordance with TAS 101.
5. Roof Tile manufactures acquiring acceptance for the use of HANi3I -STICK roof tile adhesive with
their tile assemblies shall test in accordance with TAS 101 with section 10.4 as modified herein.
_W
2
I kPPROYED
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 tale assembly having a current NOA that lists uplift
resistance values with the use of Polypro® AH160.
2. Polypro® AH160 shall be applied in compliance with the Component Application section and the
corresponding Placement Details noted herein. The roof file mbly'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 Pmducts, 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 Foarnpro® 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 disperse timer shall be set to deliver 0.0175 to 0.15 pounds per tile as
determined at calibration. No other settings shall be approved.
6. Polypro® AH160 shall be applied with. Foampro RTF1000 or ProPack® 30 & 100 dispensing
equipment only.
7. Polypro® AH160 shall not be exposed permanently to sunlight.
8. Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after
Polypro® 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
Pleement
Detail
Single Paddy
Weight Min.
1.1 -" II,
Two Paddy Weight
per paddy Min.
!4 If ri)
Flat, Low, High Profiles
#1
35
N/A
High Profile (2 Piece
Barrel)
#1
17 /side on cap and
34/pan
N/A
Flat, Low, High Profiles
#2
24
NIA
Flag Low, High Profiles
#3
8
LABELING:
All Polypro® AH160 containers shall comply with the Standard Conditions listed herein.
BUILDING PERMIT REQUIREMENTS:
As required by the Building Official or applicable building code in order to properly evaluate the
installation of this system.
NOA No.: 114124.04
Expiration Date: 05/10112
Approval Date: 04/14111
Page 4 of 7
ADHESIVE PLACEMENT DETAIL 1
SINGLE PATTY
NOA No.: 11-0124.04
Expiration Date: 05110/12
Approval Date: 04/14/11
Page 5 of 7
ADHESIVE PLACEMENT DETAIL 2
SINGLE PAT'T'Y
nPPP.O'r'ED
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
END OF THIS ACCEPTANCE
NOA No.: 11-0124.04
Expiration Date: 05/10/12
Approval Date: 94/14111
Page 7 of 7