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RF-12-749Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 172831 Permit Number: RF -4 -12 -749 Scheduled Inspection Date: August 14, 2012 Inspector: Bruhn, Norman Owner: GIUSTI, ADELMO AND MARTA Job Address: 9801 NE 1 Avenue Miami Shores, FL Project: <NONE> Contractor: MOONLIGHT ROOFING INC Permit Type: Roof Inspection Type: Final Roof Work Classification: Tile Phone Number Parcel Number 1132060132290 Phone: (786)317 -2178 Building Department Comments RE -ROOF TILES USING CLAY TILES Inspector Comments Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. August 13, 2012 For Inspections please call: (305)762 -4949 Page 4 of 28 A -1 Engineering Inspection Services, Inc 7066 SW 44th Street Miami, FI 33155 Tel: 786- 326 -9877 Fax: 305 -485 -9011 a1roofinspection@gmail.com LAB CERTIFICATION # 10- 0512 -01 SITE SPECIFIC INFORMATION UPLIFT TEST - TAS #106 Roofing Contractor MOONLIGHTROOFING Job Address Owner's Name ADELMO & MARTA GIUSTI Type of Tile 9801 NE 1 AVE Permit # RF -4-12 -749 SANTA FE Date Installed Approximate Roof Height 12 feet Roof Pitch 3/12 Type of access to Roof OK Approximate Square Footage of Roof 33 ft 2 Date Tested 8/13/2012 Contact Name FRANK LOCATIO Corner Perimete Field Ridge Total Required Testing Force 35/bs Number of Tests 70 Testing Equipment: FEE. 100 Phone # (786) 380 -0156 N iI # OF TEST PASS # OF TEST FAIL L 9 Tests U Pass 0 Tests L i Fail r 14 Tests L Pass 0 Tests ❑ Fail 33 Tests 1/ Pass 0 Tests Fail 14 Tests Pass 0 Tests ❑ Fail 70 Tests '11l Pass 0 Tests li_ ❑ Fail IN ACCORDANCE WITH THE CRITERIA OF PROTOCO PA 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST. THIS TAS 106 TEST HAS BEEN PERFORMED IN FULL ACC ANCE TO THE REQUIREMENTS OF DADE COUNTY, WITH NO DEVIATIONS. THIS REPORT IS NOT GUARANTEED IN CASE OF NATURAL DISASTERS. Cordially REMBEI TC'9�CONTRERAS P.E P.E # 21522 A -1 ENGINEERING INSPECTION SERVICES INC CERTIFICATION NO 10- 0512.01 7066 SW 44th Street Miami, FI 33155 — Telephone (786)326 -9877 « Fax (305)485 -9011 A -1 Engineering Inspection Services, Inc 7066 SW 44th Street Miami, FI 33155 Tel: 786- 326 -9877 Fax: 305 -485 -9011 a1roofinspection@gmail.com LAB CERTIFICATION # 10- 0512 -01 SITE SPECIFIC INFORMATION UPLIFT TEST - TAS #106 Roofing Contractor MOONLIGHT ROOFING Job Address Owner's Name ADELMO & MARTA GIUSTI Type of Tile SANTA FE 9801 NE 1 AVE Permit # RF -4 -12 -749 Approximate Roof Height 12 feet Roof Pitch Approximate Square Footage of Roof 33 ft 2 Date Tested 8/13/2012 Contact Name FRANK Date Installed 3/12 Type of access to Roof OK Required Testing Force 351bs Number of Tests 70 Testing Equipment: F.G.E. 100 Phone # 786 380 -0156 SKETCH OF ROOF Revised by 7066 SW 44th Street Miami, FI 33155 — Telephone (786) 326 -9877 — Fax (305) 485 -9011 RE: Permit # RS- 14,-k 2, a quick (Print name and *de License Type) License #: CC . t32 F9"cil Miami Shores Viiiage Building Department INSPECTION AFFIDAVIT On or about 5- (c, - t �. licensed as a (n FS 468 Building Inspector 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 DATE: / Engineer / Architect, , I did personally inspect the roof deck nailing and (Date & time) Secondary water barrier work at 95 71 14e (°= 1r-C o-ui v 4c-e.s , �. (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 tlis • 2® t''' -- HErit414: -OM a �. coct4%, WQN t'' >: Notary Public, Sate of Florida at Large " � � = r r z FObramli Aft , `oo (9) - `General, Building, Residential, or Roofing Contractors or any individual certified under 468 F.S. to make such an inspection. include photographs of each plane of the roof with permit it and address it dearly shown marked on the deck for each inspection Revised on 5/21/2009 Miami Shores Village Building D epartment 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 B L h" PERMIT APPLICATION Permit Type: BUILDING JOB ADDRESS: CI gO ( City: I\ E ( ASE ECITVE JUL 1 t ,tom FBC 20 L� Permit No. 12F-4-4 2 741 Master Permit No. ROOFING Miami Shores County: Miami Dade Zip: 33 t3 ?? Folio/Parcel #: I (- 3100 - D i 3" 229 o Is the Building Historically Designated: Yes NO 4" Flood Zone: OWNER: Name (Fee Simple Titleholder): ttdtA t40 G:UsTi Phone #: Address: gO\ i pzoe City: StA-o e,.S, State: .av ti (7 t1 Zip: 3 331 Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name: novr.11,i Nr Rom Phone #: 786 `3t7 Address: (j 0(oc» NSW L SCe City: •• State: oar+ 04- Zip: 35C t 5— Qualifier Name: &LAI./aci N 2 Phone #: State Certification or Registration #: CCC. t32 89 97 Certificate of Competency #: Contact Phone #: 79c. sr-j— ?A 22 Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Square/Linear Footage of Work: _ Type of of Work: ❑Addition UAlteration UNew VRepair/Rep Description of Work: Color thru tile: •I.1L' 911 IMES= ay -rile 6— ,,a-A) -A) * * * * ** *. * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 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 $ 44 Bonding_Company'siame(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commen' ment and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certe# spy of the recorded notice of commencement must be posted at the job site for the first inspection , h occurs < - - ° (7) d' '. a the building permit is issued. In the absence of such posted notice, the inspection will not be approv -d and ' reins %ectio , ee be charged. Owner or Agent The foregoing instrument was acknowledged before me this (0 day of , 20 ja,_, by ,642.-Q.�..0 C�us�,r: who is persona ly known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commissio OR DO NUNEZ or My Comm. Expires Apr 5, 2014 qW� • O• Z Commission # DD 978896 Signature Contractor The foregoing instrument was acknowledged before me this CO day of Hd , 2012. , by 4Ih•6000 cT who is personally known to me or who has produced as identification and who did take an oath. NO Sign: Print: My C PUBLIC: f31U Gt. 407)ng=01 ERNANR�x taIMISSION # D0860062 EXPFRES February 10, 2013 F lortosN W ary servbe.co m ** ******9:9*******> Foe: Y** **kkoYoY9:***k***YY9:9***kk &*** * **kY ***** ****** * ** ** **k***k*****k** ** **YYYY:Y * * * ** APPROVED BY \7? �/'iz a Plans Examiner Structural Review (Revised 5/2 /2012XRevised 3 /12 /2012XRevised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk w 3 w w J w Cr `-R® System Manufacturer: 54 ii ce 1 i le Ci?orm-Pon P rOduct Approval Number: 12- 0210. 01 5\eitirilum Design Wind Pressures, If Applicable (From RAS 127 or Calculations): o 3 L P1: -39.1 P2: -(08.1 P3: - (00. Aa9imum Design Pressure product Approval Specific System: 2S. Method of tile attachment -('Iuo p,-ppv � s i'eNl / potef Qin> AO_« ffl c g ECEVVED JUL 1 1 202 Florida Building Code Edition 2010 High Vebcity Hurricane Zone Uniform Permit Application Form. Section D (Steep Sloped Roof System) HIGH- VELOCrIY HURRICANE ZONES teep Sloped Roof System Description ?0 ypet I I4- I V4000 / tqj_ Roof Slope: 3 :12 ype Underlayment: Insulation: 14%lb 4STH P224 N/A Fire Barrier: Ridge Ventilation? /`d — r1 /A Fastener Type & Spacing: 044154 tails, ( Cf 12rac 1 tt4 1 dhesive Type :I e.) I VA Pro 40140 ype Cap Sheet: Mean Roof Height: it G " 2010 FLORIDA BUILDING CODE — RESIDENTIAI IcO Ib. 14 rr Row) Roof Covering: ISlam -r des . I Type & Size Drip dge: HIGH - VELOCITY HURRICANE ZONES 44.24 Florida Building Code Edition 2010 High Velocity Hurricane Zone Uniform Permit Application Form. Section E (Tile Calculations) For Moment based tile systems, choose either Method 1 or 2. Compared the values for Mr with the values from Mt 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" (1),:-31.? x - Zen = 11461 l ) - Me 5.22. = Mr1 5.71 Product Approval M, 25%5 (P2: b S. [ x 1. = Zo.2.3 )- Me = M.2 1 Product Approval �% (Ys: (OD. x A _ ) - `.. pproval Mr = Mrs i Product Approval M, 1.0 p( 1 p Method 2 "Simplified Tile Calculation Per Table Below" Required Moment of Resistance (Mr) From Tabie Below Product Approval Mr Mean Roof Height -p► Roof Slope 4 2:12 3:12 4:12 5:12 6:12 7:12 Mr Required Moment Resistance* 15' 34.4 32.2 30.4 28.4 20' 25' 30' 36.5 38.2 39.7 34.4 38.0 37.4 32.2 33.8 35.1 42.2 39.8 37.3 30.1 31.6 32.8 28.4 24.4 28.0 29. 25.9 27.1 30.6 28.2 34.9 32.4 30.0 *%lust be used in conjunction with a List of moment based tile systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based tile systems use Method 3. Compared the values for F' with the values for F. If the F' values are greater than or equal to the F, values, for each area of the roof, then the tile attachment method is acceptable. Method 3 "Uplift Based Tile Calculations Per RAS 127" (Ps: xL•- x w:= )- W : x cos 0: = (P2 :.__ x h _ x W: = rt: (P3: x I: - = ) - Vi•': x cos B.• - = Fn, x ►►: = )- W: s cos 9.• = Fr3: Description Where to Obtain Information F Design Pressure Mean Roof Height Roof Slope Aerodynamic Multiplier Restoring Moment due to Gravity Attachment Resistance Required Moment Resistanee • Minimum Attachment Resistance Required Uplift Resistance Symbol PI or P2 or P3 Where to find RAS 127 Table 1 or by an engineering analysis prepared by PE based on ASCE 7 11 Job Site 9 Job Site hiR Mr M, ProductAwroval PmduetApproval Product Approval Calculated Average Tile Weight Tile Dimensions F, Product Approval Calculated W Product Approval I= length wa width All calculations must be submitted to the Building Official at the time of permit application. PmductApproval DEPARTMENT OF PERMITTING, ENVIRONMENT, AND REGULATORY AFFAIRS (PERA) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Santafe Tile Corporation 8825 NW 95th Street Medley, FL 33178 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.eov /sera 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 PERA - 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. PERA 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: Santafe Spanish `5' Clay 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 replaces NOA# 10- 1005.15 and consists of pages 1 through 5. The submitted documentation was reviewed by Alex Tigera. NOA No.: 12- 0210.01 Expiration Date: 02/01/16 Approval Date: 05/31/12 Page 1 of 5 ROOFING ASSEMBLY APPROVAL Category: Sub - Category: Material: Deck Type: Roofing Roofing Tiles Clay Wood 1. SCOPE This approves a roofing system using Santa Fe "Santafe `S" Clay Roof Tile, as manufactured by Ladrillera Santafe S.A. in Bogota, Colombia and distributed by Santafe Tile Corporation as described in Section 2 of this Notice of Acceptance. For locations where the pressure requirements, as determined by applicable Building Code does not exceed the design pressure values obtained by calculations in compliance with RAS 127 using the values listed in section 4 herein. The attachment calculations shall be done as a moment based system. 2. PRODUCT DESCRIPTION Manufactured by Applicant Dimensions Santafe `S' Clay Roof L = 18" Tile W = 11.1" Trim Pieces 1= varies w = varies varying thickness 2.1 MANUFACTURING LOCATION 1. Bogota, Colombia 2.2 SUBMITTED EVIDENCE Test Agency The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. Redland Technologies Redland Technologies Redland Technologies Test Specifications TAS 112 TAS 112 Product Description One piece high profile clay roof tile equipped with two nail holes. For nail -on, mortar set and adhesive set applications. Accessory trim, clay roof pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tile profile. Test Identifier 94 -156 -8 94 -156 -9 25- 7205 -1 Project: 07- 07 -00 -91 (307023) 7161 -03 Appendix II 7161 -03 Appendix III P 0402 Test Name/Report TAS 101 TAS 102 TAS 101 TAS 100 TAS 108 (Nail -On) Static Uplift Testing TAS 102 & TAS 102(A) Withdrawal Resistance Testing of Screw vs smooth shank nails Date Aug. 1994 March 1995 Sept. 1994 Dec. 1991 Dec. 1991 Sept. 1993 NOA No.: 12- 0210.01 Expiration Date: 02/01/16 Approval Date: 05/31/12 Page 2 of 5 2.2 SUBMITTED EVIDENCE Test Agency Test Identifier Test Name/Report Date Redland Technologies P 0647 -01 TAS 108 Aug. 1994 (Mortar Set) Redland Technologies P 0631 -01 PA 108 July. 1994 (Mortar Set) Celotex Corporation Testing Services 520305 -01 thru 05 PA 102 June 1999 IBA Consultants, Inc. 2353 -4 Restoring Moment Aug. 1999 PRI Asphalt Technologies, Inc. SFTC- 003 -02 -01 TAS 101 12/06/02 IBA Consultants, Inc. 2353 -70 TAS 101 09/22/03 IBA Consultants, Inc. 2353 -71 TAS 101 09/22/03 IBA Consultants, Inc. 2353 -93 ASTM C 1167 07/18/05 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 shall be performed in accordance with TAS 106. 3.3 Applicant shall retain the services of a Miami -Dade County Certified Laboratory to perform quarterly test in accordance with TAS 112, appendix `A'. Such testing shall be submitted to the Building Code Compliance Office for review. 3.4 Minimum underlayment shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.5 30/90 hot mopped underlayment applications may be installed perpendicular to the roof slope unless 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. 3.7 May be installed on slopes 7:12 and greater. 4. INSTALLATION 4.1 Santafe 'S' and its components shall be installed in strict compliance with Roofing Application Standard RAS 118, RAS 119 and RAS 120. 4.2 Data For Attachment Calculations Table 1: Average Weight (W) and Dimensions (I x w ) Tile Profile Weight -W (Ibf) Length -I (ft) Width -w (ft) Santafe 'S' 6.7 1.5 0.958 MIAMI•DADE COUNTY APPROVED NOA No.: 12- 0210.01 Expiration Date: 02/01/16 Approval Date: 05/31/12 Page 3 of 5 Table 3: Restoring Moments due to Gravity - Mg (ft-Ibf) Tile Profile Table 2: Aerodynamic Multiplyers— X(ft3) p3 ":12" Tile 5 ":12" X (ft3) X (ft3) Battens Profile Battens Batten Application Direct Deck Santafe 'S' Direct Deck Battens 0.274 0.297 Table 3: Restoring Moments due to Gravity - Mg (ft-Ibf) Tile Profile 2 ":12" p3 ":12" 4 ":12" 5 ":12" 6 ":12" 7 ":12" or greater Battens Direct Deck Battens Direct Battens Deck Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Santafe 'S' 5.93 5.90 5.85 5.82 4/ 5.73 5.69 5.56 5.53 5.32 5.29 5.03 5.00 Table 4: Attachment Resistance Expressed as a Moment - Mf (ft -Ibf) for Nail -On Systems Tile Profile Fastener Type Direct Deck Battens Santafe 'S' 2 -10d Ring Shank Nails 21.8 N/A One #8 Screw 29.161'1 N/A Two #8 Screws 38.28' N/A One #8 Screw w/ Clip 57.311'2 N/A Two #8 Screws w/ Clip 57.60' 61.77' 1. Approved screws as noted 'Product manufactured by others'. 2. When using one screw it must be installed in the inside hole located nearest to the hump of the tile. Table 5: Attachment Resistance Expressed as a Moment Mf (ft-lbf) for Two Patty Adhesive Set Systems Tile Profile Tile Profile Tile Application Minimum Attachment Resistance Santafe 'S' Tile Bond Polyfoam Polypro AH 160TM p.94 4olyfoam Polypro AH 160TM 6 Paddy placement of 24 grams of Polypro AH 160T"". .54 2 See manufactures component approval for installation requirements. 3 Flexible Product, Inc. Average weight per patty 10.4 grams. 4 Polyfoam Product, Inc. Average weight per patty 9.4 grams. Table 5A: Attachment Resistance Expressed as a Moment - Mf (ft -Ibf) for Single Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Santafe 'S' Polyfoam Polypro AH 16OTM 63.8° Polyfoam Polypro AH 160TM 61.96 5 Paddy placement of 63 grams of Polypro AH 160Tm. 6 Paddy placement of 24 grams of Polypro AH 160T"". NOA No.: 12- 0210.01 Expiration Date: 02/01/16 Approval Date: 05/31/12 Page 4 of 5 Table 6: Attachment Resistance Expressed as a Moment - Mf (ft-lbf) for Mortar or Adhesive Set Systems Tile Profile Tile Application Attachment Resistance Santafe 'S' Mortar Set 23.6 NOA No.: 12- 0210.01 Expiration Date: 02/01/16 Approval Date: 05/31/12 Page 4 of 5 5. LABELING 5.1 All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo as shown below, or following statement: "Miami -Dade County Product Control Approved ". SANTA FE TM MADE IN COLOMBIA LABEL FOR SANTA FE SPANISH "S" CLAY ROOF 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. 18" PROFILE DRAWING When using one screw use this hole. "SANTAFE S" CLAY ROOF TILE END OF THIS ACCEPTANCE MANMADE COUNTY APPROVED NOA No.: 12- 0210.01 Expiration Date: 02/01/16 Approval Date: 05/31/12 Page 5 of 5 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. TAX FOLIO NO. STATE OF FLORIDA: COUNTY OF MIAMI -DADS 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: 11111 11111 1110 11111 11111 11111 11111 11111111 CFN 2012R0306':'39 OR Bt. 28092 N 1972; (1RS) RECORDED 04/30/21 112 16:03:47 HARVEY RUVIN, CLERK OF COURT MIAMI -DADE COUNTY, FLORIDA LAST PAGE Space above reserved for use of recording office c 801 t Ave F e 61 Ft. . 3. Owner(s) name and address: c s CS l t�l �. \ Q �{ i` Aole.4tv.o Interest in property �:��t,e �.�.: -e�..0 54.s„re.S, Ft, Name and address of fee simple titleholder. 4. Contractor's name, address and phone number. K oo cJ I tG rt r TZo (QO 140.) (8CQ - mtr. Kt (&. •3Ot 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. S TIJE OF FLORID", COUNTY OF DAME FFRJSY C,OP.TiFY tire id:: AR Copy o/J1v 8. In addition to himself, Owners designates the following person(s) tom, 713.13(1)(b), Florida Statutes. Name, address and phone number. 9. Expiration date of this Notice of Commencement: rav 'ran p ,dry Ivo (the expiration date 1 year from the date of recording unless a different date is specified) `tge as A. 1.2„— LER .y d c ticuFy -y i'i e roiir Costs `cg', D.C. 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 F1GING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR N s.:.. E OF C• , NCEME Signature(s) of Own' •r O -r cer/Director/Partner/Manager Prepared By Prepared By Print Name I Print Name Title /Office 4f))/ Mb C7 Ile S7-! Title/Office STATE OF FLORIDA COUNTY OF MIAMI -DADE The foregoing instrument was acknowledged before me this By dc..o G°rcI ❑ Individually, or ❑ as for ❑ Personally known, or ❑ produced the following type of identification: 23 day of_bp i:( Signature of Notary Public: Print Name: (SEAL) VERIFICATION PURSUANT TO SECTION 92.525. FLORIDA STATUTES Under penalties of perjury, I declare that I :v read the foregoing and that the facts in It e, to the +est •f my knowledge and belief. Signatu „ "v PT: !� LB • OR •1111 04" i. Notary-1'01M - - 'ii Qe" My Comm. Expires Apr 5, 2014 'Aar p°'- Commission # DD 978896 orized Officer/Director/Partner/Manager who signed above: By 123.01 --i PAGE3 3/10 By 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 BUILDING PERMIT APPLICATION FBC 20 Permit Type: BUILDING ROOFING OWNER: Name (Fee Simple Titleholder): 1\ cl e\ Q Address: c3 Vg ©\. fi1 \ E, RECEIVED APR 272012 BY. C)6 Permit No. (zeI-- I —14 Master Permit No. Phone #: City: 86.47.0a$ �1[ ((a je. s- State: R1 +rte ora Tenant/Lessee Name: Zip: 33V Phone #: Email: JOB ADDRESS: cl 8 c \ ,K F. A ?NE. City: Miami Shores Folio/Parcel #: i l- 32 ©(0. O 13 - 2ZRO County: Is the Building Historically Designated: Yes Miami Dade Zip: 33135 0 NO Flood Zone: Company Name: Hocle,A i *- 12.4 et' t4a. Phone #: 786 -SO- 24 T9 Address: (1 4 Ca -'� City: State: _ (.„o-v- .o4 -Q-- Zip: "-A,301-.S- Qualifier Name: (4 Phone #: 286, - 3 t7 - 2) 72 State Certification or Registration #: CCC- ('3 2. S? q R 7 Certificate of Competency #: Email Address: ((,�) S(: T �aoQ r f4�e Kt Contact Phone #: 7 C, 3 (7 - 24.7 g DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 1 9. OOc, Square/Linear Footage of Work: 3o S 6 + Type of Work: Addition ❑Alteration UNew 'SdRepair/Replace ❑Demolition Description of Work: r 11 �to - 12c 4- te-5 os i oJc . yd(-k - a.+ "T'EY't(a- Q1 Acif —1-i te.5 (c.ot.pr -t-4 rw ) W /Ir.cora- + -5er..f- ******** * * * * * * * * ** * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * *** * * * * * * * * * * * * * * * * * * * * ** D4N Submittal Fee $'- .J Permit Fee $ . l .1 CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ o24 Bonding Company's Name (if applicable) `. Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of smynencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a rtified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) «ays after the building permit is issued. In the absence of such posted notice, the inspection will not ' ap roved a insp; cti d n i e will be charged. Signature Signature Owner or Agent Con ctor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 23 day of 20 (a. , by 142( CAij A; day of AP24 -- , 20 a-, by Otfitk -2. who is personally known to me or who has produced who is personally known to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBL Sign: Print: My Commission Expires: ORLANDO NUNEZ Notary Public - State of Florida p omm. Expires Apr 5, 2014 ._�..a /LA) a u• .. .. .. . Print: My Comm 's �t esERESITA H _ = 41Y COMMISSION # DD860062 EXPW S February 10, 2013 ia77®,, FbridePfolB�Y!�e.COm 407)398-01` 4ek9ekir�koY**** �Y�Y4c9e9rdeoY�Yk�YoY�YnYAr�YoY4 :9�FY�Y:Bk Y9:9:9:4: �Y k�:9: oY9:9: Y9F4r4cdeoY :F:F9:9:kk9e4r4:****k�keY4c4e ..- ** 4c*9:* 4:*: Y: F :O***9::F*xk****9:9e9* ** APPROVED BY / -'C,� 7r•& Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07XRevised 06 /10/2009)(Revised 3/15/09) State Farm Florida Insurance Company 7401 Cypress Gardens Blvd. WinterHaven, FL 33888 -0007 B-19- 2799 -F606 H W F 001641 GIUSTI, ADELMO & MARTA M 9801 NE 1ST AVE MIAMI SHORES FL 33138-2306 Location: Same as Mailing Address SFPP No: 0349353719 Loss Settlement Provisions (See Policy) Al Replacement Cost - Similar Construction B2 Depreciated Loss Settlement - Coverage B Forms, Options, and Endorsements Homeowners Policy Ordinance /Law 50 %/ $103,150 Increase Dwlg up to $41,260 Wind Hail Tornado Hurr Exclu Motor Vehicle Endorsement Fungus (Including Mold) Excl Amendatory Collapse Special Limits - Money /Jf Amendatory Debris Removal Sinkhole Cat Gmd Cvr Coll Coy Mandatory Reportng Endorsement *Effective: NOV 17 2011 ** FL EMPA ASSESSMENT FP- 7955.FL OPT OL OPT ID FE -5423 FE -5396 FE -5453 FE -5714 FE -5258 FE -5480 * FE- 5445.1 * FE -5801 RENEWAL CERTIFICATE Homeowners Policy NOV 17 2011 to NOV 17 2012 BILLED THROUGH SFPP Coverages and Limits Section 1 A Dwelling Dwelling Extension Up To B Personal Property C Loss of Use Deductibles - Section I All Losses 1.00% $206,300 20,630 113,465 Actual Loss Sustained 2,063 Section 11 L Personal Liability $300,000 Damage to Property of Others 500 M Medical Payments to Others 1,000 (Each Person) Annual Premium 2005 FL GUARANTY -REG FHCF ASSESSMENT 2007 FL GUARANTY -REG 2005 CITIZENS -REG 2005 FL GUARANTY -EM * *Addl Asmts(See Below) Total Amount Premium Reductions Claim Free Discount Inflation Coverage Index: 244.2 $1,044.00 .52 13.57 1.88 1.25 1.25 12.44 $1,074.91 175.00 2.00 2005 CITIZENS -EM 10.44 + For the full name of each assessment entity and the dollar amount, please see the Florida Assessment Page. N NOTICE: Information concerning changes in your policy language is included. Please call your agent if you have any questions. Coverage Change Premium Increase 2 $0.00 Rate Change Premium Decrease $200.00 Hurricane Deductibles may be per calendar year. There is also a possibility that the deductible applied %%u7/1�C6 AZ" uscf'L'evera. far ?�iA f i fGUS' X112 11372 401B i A t BOB MILLI A NS AGCY INC N * DR J1,K3,K4,NP,2E,K2 Telephone (305) 899 -9424 14 REP Moving? See your State Farm agent. See reverse for important information. Prepared SEP 19 2011 11 63ZIIIIII I11i1ltlt1I1fl111 III III IIul III( f1I!IlI11I11 S10££ 13 IWVIW SS31 99I MN 0908 S321d Z3NfN 21 OUNv180 3NI 9NI30021 1H9I1NOOW OHVMHO4 ION OO' 301S 1:13H10 was • •':aoz33-t1oo'. iCtlY•.1:tFtf10:30V 6-R4C/51 :pax1303a 1N3WAVd: • iaoi, • VJt3i7vnb.S2f3'U'foH� 3H]•,: " :.NOI1V01 ssao• ..st•SW1': N11f?:AB:'03FAFlO3a :: 3514300': :..:1i0•;'•: • 114Va3d' •: U3Ht : :A10:170V1: OiOF1 :• :3H1:;;.t2N�lt3- •:1t::.: 5300: 'HON::' S3ftI.T•Hb; :A N110a 3111:::30:• :.SMV 7:::ONW1oz: HO. tI}OtV !O`J3N:�JN,iSiX3 '.: 3H1> 1119l13d:' :1ON'::SSIOa • :U'-2di3031b'X*J 5SSNISIIH: ::::.;1VDOl: V.•: X"INO:::S1.:2SIHJ: • tads.::. pts„9:10:e • .N ie c Busin : itti..as3 ONLY:: Ac LOOAL {i BUSIN•'1'AX• RECEIPT. ti: OES ••:NOt. =: PERMIT: THE.:: }HiOO��pp�g R=. TOE •:NOLATB: EX$S71NR AEBUL A.TO'Y -• OR : : 201101tr :.: YAWS:•: • OF. ': •THE:: COUNTr. 08v NOR. OOES.:i::17: : :.EXEMP?:: :'THE;: .HOLpER..FgOM.ANY OTHER: ': PER /.AI'i•::r::O &:;:'L'iC):NSf;: REOLIR %EO.UY. tAW-:THI.S IS: • .NO1: A :. OERTIFFOATION • OF.. : PAYMENT. RECEIVE1:0 ' MIAMG4A0ECOUNTYTAX.: CQLLkCTAR;:: 2'i=::: f :r : - • :....-.... . . • OQ;3;aQ_OQfl4:3 :> OQ.07:5Oa SEE OTHER SIDE DO NOT FORWARD MOONLIGHT ROOFING INC ORLANDO R NUNEZ PRES 8060 NW 186 TERR MIAMI FL 33015 11111111111111111111 1111111,1► II I II 111111111, 111111 II, 121^ On STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 NUNEZ, ORLANDO R MOONLIGHT 6 NW 86THHFTERRACE MIAMI FL 33015 Congratulations! With this license 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 information about our divisions and the regulations that • impact you, subscribe to department newsletters and team more about the Department's initiatives. Our mission at the Department is: License Efficiently, 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 A'�' °REA CERTIFICATE OF LIABILITY INSURANCE 410..►0- °ATE`MM'° °"Y"r' 4/23/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Alliance Insurance Solutions LLC ID: (Convergence) Go Convergence Employee leasing, Inc. 3951 Baymeadows Road Jacksonville, FL 32217 CONTACT NAME: PHONE (A/C. No. Earn: 904-731 -9014 FAX (A/C, No): 904 -731 -0059 EMAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC # INSURER A: SUNZ Insurance Company 34762 INSURED Convergence Employee Leasing, Inc. Convergence Emplo yee Leasing II, Inc. 3951 Baymeadows Road Jacksonville FL 32217 INSURER B : Aspen Re - London - Best Rating "A" INSURER c : Catlin Syndicate - Lloyds - Best Rating "A" 0: Brit Syndicate - Lloyds -Best Rating "A" $ INSURERE: $ INSURER F : COVERAGES CERTIFICATE NUMBER: 12904055 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POUCY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYYi OMITS GENERAL UABIUTY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ PREMISES (EaE�rrrence) $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE 7 POLICY LIMIT APPUES JECOT PER: LOC PRODUCTS - COMP /OP AGG $ $ AUTOMOBILE — LIABILITY ANY AUTO ALLOWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON-OWNED AUTOS AUTOS (Ea COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PRRPEY DAMAGE (Per acaRTdent $ $ $ UMBRELLA UAB, EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ $ $ A WORKERS COMPENSATION AND EMPLOYERS' UABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A WCPE0000004202 WCPE0000004201 7/1/2011 7/1/2010 7/1/2012 7/1/2011 ✓ WC STATU- TORY OMITS °R- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POUCY UMIT $ 1,000,000 B C D Workers Compensation Excess Coverage This is for informational purposes and nothing shall create any right under such reinsurance. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Coverage provided for all leased employees but not subcontractors of: Moonlight Roofing Inc Location coverage effective: 12/13/2011 CERTIFICATE HOLDER CANCELLATION 1410 Miami Shores Village 10050 NE 2 Avenue Miami Shores FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE „r ijj//J, ��7� _ w e.. Glen J Distefano ACORD 25 (2010105) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERT NO.: 12904055 Sandra Solis 4/23/2012 8:35:51 AM Page 1 of 1 AR � CERTIFICATE OF LIABILITY INSURANCE /G THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES- NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PROD10Elt 239-415 -2821 239 - 415 -2851 Associates Insurance Group, Inc. 16387 S. Tamiami Trail Ste. G Fort Myers, FL 33908 CONrnrAA• `T Jeff Grube Paw, N,. : 239- 415 -2821 Nrc. N ,: 239 -415 -2851 :jgrube©apradvantage.com INSURERS) AFFORDING COVERAGE NAIL $ RWURER A : American Safety Indemnity Group INSURERS : LIABILITY COMMERCIAL GENERAL LIABILITY INSURED Moonlight Roofing Inc. 8060 NW 186 Terrace Hialeah, FL 33015 INSURER C: 156AU1- 85282 -O0 INSURER D : 08/03/2012 ARE: $ 1000000 INSURER P : $ 100000 GES CERTIFICATE N ---- - - - - -- ----- - - - - -- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDrI1ON 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 POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDM. I SUER yyyD pnucy N� POLICY EFF MI POLICY EXP LIMITS A GENERAL ✓ LIABILITY COMMERCIAL GENERAL LIABILITY 156AU1- 85282 -O0 08/03/2011 08/03/2012 EACH OCCURRENCE $ 1000000 PPREMISEST (Ea aarufefee) $ 100000 CLAIMS -MADE I ✓ I OCCUR MED EXP. (Any acre pin) $ 5000 PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $2000000 GENT. AGGREGATE LINIIT —1 POLICY n IS APpi LOC PRO - PRODUCTS • COMPOP AGG 2000000 $ AUTOMOBILE __ _ l- IABS.ITY ANY AUTO HIREDAUTOS ^ i SSLC)THEDOSULED AUTOS NCO )ED SINGLE LIMIT BODILY INJURY (Per perm) $ BODILY INJURY (Per acddenf) $ (PROS 0DAAMAGE $ $ UMBRELLA LIAR EXCESS LUIS OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED 1 RETENTION$ $ WORKERS COMPENSATDN AND EMPLOYERS' UAINLITY ANY PROPRIETOR/PARTNER/EXECUTIVE YI N OFFICER/MEMBEREXCWDED? I 1 ( Mayaenad�ator' hi NN) If yes, OF OPERATIONS below N 1 A f csr T - 1 1 FR EL EACH ACCIDENT $ E DISEASE - EA EMPLOYEE $ EL. DISEASE - POLICY OMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101. AOdWanal Remarks Sahwhde, E male space Is required) TE HOLDER CANCELLATION Miami Shores Village 10050 NE 2 Avenue Miami Shores, FL 33138 ACORD 25 (2010105) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTNORQFD ALIVE �C 28 ACORD CORPORATION. All rights reserved. The ACORD name and logo are reg marks of A ORD IVI iami Shores 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: 4i -23 -IA 10050 NE 2nd Ave Miami Shores, Fl 33138 Re: Owner's Name: A-12ailo C't�l5ri• Property Address: 9So/ NE / A Roofing Permit Number: Dear Building Official: 1 1444e-Q-1"44-0 Ca iL'44i certify that I am not required to retrofit the roof to wall connections of my building because: �I a 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 ed' '• of the South Florida Building Code (1994 SFBC) S' nature ,4-ot ek wv o 1.0 5.1i Print Name State of Florida County of Dade The undersigned, being the first duly sworn, deposes and says that he /she is the owner for the above property mentioned. Swom to and subscribed before me this � day Notary Public, Sate of Florida at Large ORLANDO NUNEZ tary Public - State of Florida Comm. Expires Apr 5, 2014 Commission # DD 978896 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 5/21/2009 Miami -Dade My Home My Home e. go Show Me: Property Information .........._...... Search By: Select Item v 61 Text only Property Appraiser Tax Estimator 5 Property Appraiser Tax Comparison 5 Portability S.O.H. Calculator Summary Details: Folio No.: 11- 3206 -013 -2290 Property: 9801 NE 1 AVE Mailing ADELMO GIUSTI &W Address: MARTA Living Units: 9801 NE 1 AVE MIAMI FL Adj Sq Footage: 33138 -2306 Property Information: Primary Zone: 1000 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds /Baths: 3/2 Floors: 1 Living Units: 1 Adj Sq Footage: 2,108 Lot Size: 9,309.25 SQ FT Year Built: 1950 $50,000/ $78,310 MIAMI SHORES SEC 1 City: AMD PB 10 -70 LOT 15 & Legal W1/2 LOT 16 BLK 17 Description: LOT SIZE 80.950 X 115 OR 11628 -384 1182 1 OR 11628 -0384 1182 00 Assessment Information: Year: \ 2011 2010 Land Value: $80,153 $83,969 Building Value: $160,980 5160,980 Market Value: $241,133 $244,949 Assessed Value: $128,310 $126,414 Exemption Information: Year: 2011 2010 Homestead: $25,000 $25,000 2nd Homestead: YES YES Taxable Value Information: Year: 2011 2010 Applied Applied Taxing Authority: Exemption/ Taxable Exemption/ Taxable Value: Value: Regional: $50,000/ $78,310 $50,000/ $76,414 County: $50,000/ $78,310 $50,000/ $76,414 City: $50,000/ 578,310 $50,000/ $76,414 School Board: 525,000/ $103,310 $25,000/ $101,414 Sale Information: Sale Date: 11/1982 Page 1 of 2 Aerial Photography - 2009 My Home I Property Information I Property Taxes I My Neighborhood! Property Appraiser 0 112 ft Home] Using Our Site I Phone Directory 1 Privacy I Disclaimer If you experience technical difficulties with the Property Information application, or wish to send us your comments, questions or suggestions please email us at Webmaster. Web Site © 2002 Miami -Dade County. All rights reserved. Legend ▪ Property • Boundary Selected Property Street Highway Miami -Dade County Water http: / /gisims2 miamidade .gov /MyHome /propmap.asp 4/27/2012 RECEIVED APR 2 2012 BY: Miami Shores Village APPROVED ZONING DEPT BLDG DEPT BY DPIIIg- VELOCITY HURRICANE ZONES SUBJECT TO COMPLIANCE WITH ALL FEDERAL Florida BuliditirglWattiikiii ND rnrrul \TIONS High Velocity Hurricane Zone Uniform Permit Application Form. Section A (General Information) Master Permit No. Process No. Contractor's Name H e t l Li G tr RC .e kta , tr�� Job Address -{ 91 NE (me. ROOF CATEGORY ❑ Low Slope ❑ Mechanically Fastened Tile PI' Mortar /Adhesive Set Tile ❑ Asphaltic ❑ Metal Panel /Shingles ❑ Wood Shingles /Shakes Shingles ❑ Prescriptive BUR -RAS 150 ROOF TYPE ❑ New Roof Dlt' Reroofing ❑ Recovering ❑ Repair ❑ Maintenance ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF) -3o 5`' 3025# Section B (Roof Plan) Sketch Roof Plan: Illustrate all levels and sections, roof .drains, scuppers, overflow scuppers and overflow drains. Include dimensions of sections and levels, clearly identify dimensions of elevated pressure zones and location of parapets. 2010 FLORIDA BUILDING CODE — RESIDENTIAL 44,21 SECTION 1524 HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with the required roofing pemvt, and to explain to the owner the content of this section.. The provisions of Chapter 15 of the Florida Building Code, Building govern the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner and the contractor. The owner's initial in the adjacent box indicates that the item has been explained. _1. Aesthetics - Workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane Zone) are for the purpose of providing that the roofing system meets the wind resistance and water intrusion performance standards. Aesthetics (appearance) issues 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. ri /7 2. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Building Code. (The roof deck is usually concealed prior to removing the existing roof system). 04 & 3. Common Roofs: Common roofs are those which have no visible delineation between neighboring units (i.e. townhouses, condominiums, etc.). In buildings with common roofs, the roofing contractor and /or owner should notify the occupants of adjacent units of roofing work to be performed. 4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof decking can be viewed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail penetrations of the underside of the decking may not be acceptable. The Florida Building Code provides the option of maintaining this appearance. 6 5. Ponding Water: The current roof system and /or deck of the building may not drain well and may cause water to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural distress and may require the review of a professional structural engineer. Ponding may shorten the life expectancy and performance of the new roofing system. Ponding conditions may not be evident until the original roofing system is removed. Ponding conditions should be corrected. 6. Overflow scuppers (wall outlets): It is required that rainwater flow off so that the roof is not overloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance the Florida Building Code, Plumbing. 7. Ventilation: Most roof structur; Should have some ability to vent natural airflow through the interior of the structural assembly • - = ilding ` se ' . The existing amount of attic ventilation shall not be reduced. It may be benefic; nsider - edition. ve 'n•'which can result in extending the service life of the roof. er's /Agent's Signature YO/ AlE ./ , Property Address 4// /20 - Date Permit Number Rev:112012005,Computer Services, Building Department 1// 4atit Con ctor's Signature HIGH - VELOCITY HURRICANE ZONES Florida Building Code Edition 2010 High Velocity Hurricane Zone Uniform Permit Application Form. Section D (Steep Sloped Roof System) Roof System Manufacturer: dOrgbrece.r Product Approval Number: ft- 01 D7 • 03 Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations): P1: '.-4( P2: --7g.(0 P3: s- Ji(..Z. Maximum Design Pressure Product Approval Specific System: 38.1 Method of tile attachment AV/l ey :0Q. cek 6421 i7a6:1 ) Steep Sloped Roof System Description Deck Type: Roof Slope: '4- :12 000 Ail wool 5� ,''. Type Underlayment: Insulation: 430117 A-siti 22u Ala Fire Barrier: Ridge Ventilation? f4 A Fastener Type & Spacing: Adhesive Type: Mean Roof Height: I l l. 411 I W i g s eetAtf -t2'oc P eS4 Qo�4pro AN.- Ibc1 (Ked Pall i) ype Cap Sheet: - Q©Ko• t4PT Karl( • Roof Covering: Aait -ca, 0.641 41e .C. Type &Size Drip dge: 2010 FLORIDA BUILDING CODE -- RESIDENTIAL 44.23 ROOF ASSEMBUES AND ROOFTOP STRUCTURES Florida Building Code Edition 2004 High - Velocity Hurricane Zone Uniform Permit Application Form. Section E (Tile Calculations) For Moment based tile systems, choose either Method I or 2. Compare the values for his with the values from M f. If the Mt values are greater than or equal to the Ms values, for each area of the roof, then the the attadrment method is acceptable. Method I "Moment Based Tile Calculations Per RAS 127" p 12. (Pr: 4S.1x k 274 = i 2 .14 ) - Mg: 5.27' rt .1•ct Q Product Approval Mf 38.70 0�- .4 C (P274 x X _ =21.14 ) - Mg: x M,2 Ito. 22. Product Approval Mf �� ppylyi (P3:` t f .2 u X ljr -Mi .) - Mg: = K. Z.57 Product Approval Mf �� ',ivy ' Method 2 "Simplified Tile Calculati -as Per Table Below" Required Moment of Resistance (Mr) From Table Below Product Approval Mf Mr required Moment Resistance* Mean Roof Height - Roof Slope 1 15' 20' • 25' 30' 4 t' 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 Average Tile Weight 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 anth a list of moment based tile systems endorsed by the B . • County Board of Rules and Appeals. For Uplift based tile systems use Method 3. Compared the values for F' with the values f. . 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 TtIe C errs Per RAS 127" (P1' (P2: (P3: x L x w: = ) - W: x cos : = Frr Product Approval F' x L = x w: = ) - W: x 9 = Fi2 Product Approval F' x L x w = ) - W: x cos @ = Fri Product Approval F' Wh - e to Obtain Information Description Symbol Where to find Design Presstue P1 or P2 or ' RAS 127 Table 1 or by an engineering analysis prepared by PE based on ASCE 7 Mean Roof Height t Job Site Roof Slope . 6 lob Site Aerodynamic Multiplier .2 Product Approval Restoring Moment du. to C : vity Mg Product Approval Attachment ' esistance M f Product Approval Required.Mom tit Resistance Ma F Calculated Product Approval Mi • um Attachment Resistance Re uired Uplift Resistance Fr Calculated Average Tile Weight W Product Approval _ Tile Dimensions L = length W = width Product Approval All calculations must to cuhmit ed to the 6,uilding uriti &.iI .0 the time of r■etmit Application. FLORIDA BUILDING CODE - BUILDING 15.35 4 M IAMI. BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT (BNC) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) MIAMI -DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 33175 -2474 T (786) 315 -2590 F (786) 315 -2599 www.miamidade.gov /building/ Clay Forever 6801 NW 77 Avenue, Suite 301 Miami, FL 33166 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: Altusa "S" Clay 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 NOA consists of pages 1 through 9. The submitted documentation was reviewed by Alex Tigera. MIAMI•DADE COUNTY APPROVED NOA No.: 11- 0707.03 Expiration Date: 08/26/14 Approval Date: 10/13/11 Page 1 of 9 ROOFING ASSEMBLY APPROVAL Category: Sub - Category: Material: Deck Type: Roofing Roofing Tiles Clay Wood 1. SCOPE This new roofing system using Altusa "S" Clay Roof Tile as manufactured by Sulacer, S.A. de C.U. in Pimienta, Honduras and distributed by Clay Forever LLC as described in Section 2 of this Notice of Acceptance. For locations where the pressure requirements, as determined by applicable Building Code does not exceed the design pressure values obtained by calculations in compliance with RAS 127 using the values listed in section 4 herein. The attachment calculations shall be done as a moment based system. 2. PRODUCT DESCRIPTION Manufactured by Applicant Altusa "S" Clay Roof Tile Trim Pieces Dimensions Length: 18 -3/4" Width: 10 -3/4" varying thickness Length: varies Width: varies varying thickness 2.1 SUBMITTED EVIDENCE: Test Agency American Test Lab of South Florida American Test Lab of South Florida IBA Consultants, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. Celotex Corporation Testing MIAMI DADE COUNTY APPROVED Test Product Specifications Description High profile, one - piece, `S' shaped single roll ASTM C 1167 clay tile with a nominal 2 -%2 inch headlap. For adhesive set applications. Accessory trim, clay roof pieces for use at TAS 112 hips, rakes, ridges and valley terminations. Manufactured for each tile profile. Test Identifier RT0426.01 -11 RT0706.01 -11 2397 -116 94 -083 94 -084 25- 7200 -1 Project No. 307025 Test #MDC -78 MTS 520649 Test Name/Report ASTM C 1167 Static Uplift Testing TAS 101 ASTM C 1167 Static Uplift Testing TAS 101 (Adhesive Set) Static Uplift Testing TAS 101 (Mortar Set) Static Uplift Testing TAS 102 (Quick -Drive Screws, Battens) Wind Driven Rain TAS 100 TAS 102(A) Date 05/07/11 07 /11/11 06/28/07 April 1994 May 1994 Feb. 1995 Oct. 1994 May 2000 NOA No.: 11- 0707.03 Expiration Date: 08/26/14 Approval Date: 10/13/11 Page 2 of 9 PRI Asphalt Technology, Inc. Redland Technologies Redland Technologies Redland Technologies Redland Technologies Redland Technologies Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. Walker Engineering, Inc. CLF- 003 -02 -01 7161 -03; Appendix III 7161 -03 Appendix II Letter Dated Aug. 1, 1994 P0631 -01 P0402 Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations Evaluation Calculations TAS 102 TAS 102 Wind Tunnel Testing TAS 108 (Nail -On) Wind Tunnel Testing TAS 108 (Nail -On) Wind Tunnel Testing TAS 108 (Mortar Set) Withdrawal Resistance Testing of screw vs. smooth shank nails Aerodynamic Multiplier 25 -7183 25 -7094 25 -7496 25 -7584 25- 7804b -8 25- 7804 -4 & 5 25- 7848 -6 October 2001 Dec. 1991 Dec. 1991 Aug. 1994 July 1994 Sept. 1993 March 1999 March 1995 February 1996 April 1996 December 1996 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 shall be performed in accordance with TAS 106. 3.3 Applicant shall retain the services of a Miami -Dade County Certified Laboratory to perform quarterly test in accordance with TAS 112, appendix `A'. Such testing shall be submitted to the Building Code Compliance Office for review. 3.4 Minimum underlayments 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 the applicable Building Code. 3.7 May be installed on slopes 7:12 and greater. MIAMI -DADE COUNTY APPROVED NOA No.: 11- 0707.03 Expiration Date: 08/26/14 Approval Date: 10/13/11 Page 3 of 9 4. INSTALLATION 4.1 Altusa "S" Clay Roof Tile and its components shall be installed in strict compliance with Roofing Application Standard 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) Altusa "S" Clay Roof Tile 6.5 1.56 0.9 Table 3: Restoring Moments due to Gravity - Mq (ft -Ibf Table 2: Aerodynamic Multipliers - X (ft3) 3 ": 12" or less Tile 5 ": 12" k (ft3) 7 ": 12" greater Battens X (ft3) Profile Battens Batten Application Direct Deck Application Altusa "S" Clay Roof Tile Battens 0.253 0.28 Table 3: Restoring Moments due to Gravity - Mq (ft -Ibf Tile Profile 3 ": 12" or less 4 ": 12" 5 ": 12" 6 ": 12" 7 ": 12" greater Battens or Direct Deck Altusa "S" Clay Roof Tile Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck 4.47 5.35 4.40 5.27 4.31 5.16 4.20 5.03 4.08 4.89 MIAMI•DADE COUNTY APPROVED NOA No.: 11- 0707.03 Expiration Date: 08/26/14 Approval Date: 10/13/11 Page 4 of 9 Table 4: Attachment Resistance Expressed as a Moment - Mr (ft -Ibf) for Nail -On Systems Tile Profile Fastener Type Direct Deck (Min 15/32" plywood) Direct Deck (Min. 19/32" plywood) Battens Altusa "S" Clay Roof Tile 2 -10d Ring Shank Nails 28.6 41.2 19.4 1 -10d Smooth or Screw Shank Nail 5.1 6.8 2.8 2 -10d Smooth or Screw Shank Nails 6.9 9.2 7.3 1 . #8 Screw 28.7 28.7 18.1 2 . #8 Screws 58.2 58.2 26.8 1 -10d Smooth or Screw Shank Nail (Field Clip) 23.1 23.1 19.0 1 -10d Smooth or Screw Shank Nail (Eave Clip) 29.3 29.3 24.0 2 -10d Smooth or Screw Shank Nails (Field Clip) 27.6 27.6 38.6 2 -10d Smooth or Screw Shank Nails (Eave Clip) 38.1 38.1 41.8 1 Screw with Altusa Clip (See c ip details) Altusa "S" Clay Roof Tile' 1 Screw with clip (at the head of tile) 187.1 187.1 N/A Altusa "S" Clay Roof Tile' 1 Screw with clip (at the water course of tile) 35.2 35.2 N/A 1. Screw must be installed in the inside nail hole located nearest to the hump of the tile. Table 5: Attachment Resistance Expressed as a Moment Mf (ft-Ibf) for Two Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Altusa "S" Clay Roof Tile Adhesive 29.33 2 See manufactures component approval for installation requirements. 3 Flexible Products Company TileBond Average weight per patty 10.7 grams. Polyfoam Product, Inc. Average weight per patty 8 grams. MIAMI•DADE COUNTY APPROVED NOA No.: 11- 0707.03 Expiration Date: 08/26/14 Approval Date: 10/13/11 Page 5 of 9 Table 6: Attachment Resistance Expressed as a Moment - Mf (ft-Ibf) for Single Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Altusa "S" Clay Roof Tile Polyfoam PolyProTM 66.54 Polyfoam PolyProTM 38.75 Polyfoam PolyProTM 52.056 4 Large paddy placement of 63grams of PolyPro TM. 5 Medium paddy placement of 24grams of PolyPro TM. 6 Large paddy placement of 54grams of PolyProT'". Table 7: Attachment Resistance Expressed as a Moment - Mf(ft -Ibf) for Mortar Set Systems Tile Profile Tile Application Attachment Resistance Altusa "S" Clay Roof Tile Mortar Set' 24.50 5. LABELING 5.1 All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo as detailed below, or following statement: "Miami -Dade County Product Control Approved ". ALTUSA MADE IN HONDURAS LABEL FOR ALTUSA "S" CLAY ROOF TILE. (LOCATED ON THE 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. MIAMI•DADE COUNTY APPROVED NOA No.: 11- 0707.03 Expiration Date: 08/26/14 Approval Date: 10/13/11 Page 6 of 9 PROFILE DRAWINGS ALTUSA `S' CLAY ROOF TILE MIAMI•DADE COUNTY APPROVED NOA No.: 11- 0707.03 Expiration Date: 08/26/14 Approval Date: 10/13/11 Page 7 of 9 TILE BY ALTUSA (TYP.) CLIP DETAILS 2 -1/2" OVERLAP (COVERS PIN HOLE) SCREW IN THE INSIDE HOLE NEAREST TO THE HUMP OF THE TILE DECK CLIP WITH ONE (1) SCREW ATTACHED TO DECK CUP PLACEMENT DETAIL MIAMI•DADE COUNTY APPROVED CLIP NOA No.: 11- 0707.03 Expiration Date: 08/26/14 Approval Date: 10/13/11 Page 8 of 9 SCREW (HOLDS CLIP ONTO DECK) TILE BY ALTUSA (TYP.) CLIP DETAILS (CON'T) 2 112" OVERLAP (COVERS PIN HOLE) SCREW IN THE INSIDE NAIL HOLE NEAREST TO THE HUMP OF THE TILE DECK 1 1/4" 1 3/4" 3/4" CLIP PLACEMENT DETAIL 5/ 5/8" 5/8' 3.00" GALVANIZED METAL CLIP DECK END OF THIS ACCEPTANCE MIAMI -DADE COUNTY APPROVED 2 1/2" SCREW NOA No.: 11- 0707.03 Expiration Date: 08/26/14 Approval Date: 10/13/11 Page 9 of 9 MIAMI•DWDE 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 -DADS COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 33175 -2474 T (786) 315 -2590 F (786) 315 -2599 www.aniamidade.aov/buildinuf SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed and accepted by Miami -Dade County BNC - Product Control Section to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Section (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. BNC reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Polypro ? AH160 LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved ", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This renews NOA# 06- 0201.02 and consists of pages 1 through 7. The submitted documentation was reviewed by Alex Tigera. MIAM1• • ADECOUNTY 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 Polypro® AH160 as manufactured by Polyfoam Products, Inc. as described in Section 2 of this Notice of Acceptance. For the locations where the design pressure requirements, as determined by applicable building code, does not exceed the design pressure values obtained by calculations in compliance with Roofing Application Standard RAS 127, for use with approved flat, low, and high profile roof tiles system using Polypro'? Ali 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 Polypro AH160 Dimensions Ted Specifications 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: 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 lbs.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. MiA•1.DADE CO APPROVED NOA No.: 11- 0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 2 of 7 EVIDENCE SUBMITTED: Test Agency Test Identifier Test Name/Report Date Center for Applied Engineering #94 -060 TAS 101 04/08/94 257818 -1PA TAS 101 12/16/96 25- 7438 -3 SSTD 11 -93 10/25/95 25- 7438 -4 25- 7438 -7 SSTD 11 -93 11/02/95 25 -7492 SSTD 11 -93 12/12/95 Miles Laboratories NB- 589 -631 ASTM D 1623 02/01/94 Polymers Division Ramtech Laboratories, Inc. 9637 -92 ASTM E 108 04/30/93 Southwest Research Institute 01- 6743 -011 ASTM E 108 11/16/94 01- 6739- 062b[1] ASTM E 84 01/16/95 Trinity Engineering 7050.02.96 -1 TAS 114 03/14/96 Celotex Corp. Testing Services 528454 -2 -1 TAS 101 10/23/98 528454 -9 -1 528454 -10 -1 520109 -1 • TAS 101 12/28/98 520109 -2 520109 -3 520109 -6 520109 -7 520191 -1 TAS 101 03/02/99 520109-2-1 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. W 2 F- MS MIAMFOADE COUNTY \PPROVED NOA No.: 11-0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 3 of 7 INSTALLATION: 1. Polypro® AH160 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of Polypro 17 AH160. 2. Polypro® AH160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof tile assembly's adhesive attachment with the use of Polypro® AH160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed the uplift resistance determined in compliance with Miami -Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA 3. Polypro® AH160 roof tile adhesive and its components shall be installed in accordance with Roofing Application Standard RAS 120, and Polyfoam Products, Inc. Polypro® AH160 Operating Instruction and Maintenance Booklet. 4. Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by Polyfoam Products, Inc. Polyfoam Products Inc. shall supply a list of approved applicators to the authority having jurisdiction. 5. Calibration of the Foampro® dispensing equipment is required before application of any adhesive. The mix ratio between the "A" component and the 'B" component shall be maintained between 1.0- 1.15 (A): 1.0 (B). The dispense timer shall be set to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No other settings shall be approved. 6. Polypro® AH160 shall be applied with Foampro RTF1000 or ProPack® 30 & 100 dispensing equipment only. 7. Polypro® AH 160 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 4') AH160 placement and minimum patty weight shall be in accordance with the 'Placement Details' herein. Each generic tile profile requires the specific placement noted herein. Table 1: Adhesive Placement For Each Generic Tile Profile Tile Profile Placement Detail Single Paddy Weight Min. {grams) Two Paddy Weight per paddy Min. (grams) Flat, Low, High Profiles #1 35 N/A High Profile (2 Piece Barrel) #1 17 /side on cap and 34 /pan N/A Flat, Low, High Profiles #2 24 N/A Flat, Low, High Profiles #3 8 LABELING: All Polyproo 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. MIAMPDADE COUNTY APPROVED NOA No.: 11- 0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 4 of 7 ADHESIVE PLACEMENT DETAIL 1 SINGLE PATTY MIAMIOADE COUNTY APPROVED 1) Plass enough adhesive to achieve 17 to 23 OpUoriaI2X4'$for square Inches tm swum with the pan the Mel* Pitch anlicabni 1n. Fm outside age of coysr a th. Then Install the Ma to„ Turn covers upskla down. Phu adhtslys ti2 In To 1 ro . Nal bough plastk swot Re top pardon otihe says counts cover aka Abuttosecond course of pan flu Ensure asyt end of pensndcoeerWeiere flush at toys Una Ern closure Meth* Fascia (molar shown) Optional Polak* Mortar on langUMA caps Mk NOA No.: 11-0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 5 of 7 ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY MADE COUNTY APPROVED 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) Pa (under tile) 0 . . Single paddy 3 1ft under the ( x3 In. Single paddy on under- layment Single paddy on top of file • COMO In. X7 tn. medium size paddy eave Paula course** 14 MADE COU APPROVED Nall through plastic cement Underlayment Single paddy under tHe Single paddy between tile 21n. x In. medium size pad* eave course only 10.441n.x 3 In. 4 in. Single paddy on under- layment Single paddy an top of tile Ewe Course Fascia Weephole Eave closure Drip edge Nall through plastic cement Single paddy under tile Single paddy between tile Peekln.x 3 in. Single paddy on underiayment Single paddy on top of tile Eave Course Eave Closure 21n. x 7 in, medium size paddy eave course only Fes* END OF THIS ACCEPTANCE NOA No.: 11-0124.04 Expiration Date: 05/10/12 Approval Date: 04/14/11 Page 7 of 7