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RF-12-2171
Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 186319 Permit Number: RF -11 -12 -2171 Scheduled Inspection Date: February 25, 2013 Inspector: Bruhn, Norman Owner: JONES, EVELYN Job Address: 1351 NE 101 Street Miami Shores, FL Project: <NONE> Contractor: ADDERLY DEVELOPMENT INC Permit Type: Roof Inspection Type: Final Roof Work Classification: Tile/Flat Phone Number Parcel Number 1132050230080 Building Department Comments RE ROOF TILE AND FLAT Infractio Passed Comments INSPECTOR COMMENTS False Failed .t9c)c) Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 181636. Provide plans and permit, uplift test and renail aff. NB February 22, 2013 For Inspections please call: (305)762 -4949 Page 22 of 25 Lab Report No. 121117 FLORIDA' Providing Solutions to the Roofing Industry C.A. #: 26095 Lab Certificate: 09- 0715.02 CONCENTRATED UPLIFT LOAD TESTING ON ROOF TILE TO COMPLY WITH METRO -DADE COUNTY PROTOCOL TAS -106 PROPERTY ADDRESS.: 1351 NE 101st St., Miami Shores OWWNNER. Jose Izquierdo PERMIT No: ROOFING SQUARES: 30 CONTRACTOR: Adderly Development Inc. ROOF PITCH :: 3:12 TILE TYPE: Flat ATTACHMENT.: Polyfoam Testing Equipment: Digital Chatillon DFIS 200 Test Tabulation INSPECTOR INITIALS: AB TEST DATE: 02/20/2013 Required Testing Force: 35 Ibs No. RESULT No. RESULT No. RESULT No. RESULT No. RESULT 1 -9 Passed 40-49 Passed 10 -19 Passed 20 -29 Passed 30 -39 Passed THIS ROOF HAS: PASSED IX] FAILED I1 THE STATIC UPLIFT IN ACCORDANCE WITH MIAMI -DADE COUNTY TAS 106. wed by: Alberto Cart bn Y.E. -Lic #17138 10735 SW 216th St. Unit 416 Miami, FL 33170 Front www.floridatec.net Tel: (305) 256 -4550 Fax (305) 256 -6833 RE: Permit # /0L - Z 17( 1 CrPt- Miami Shores Viiiage Building Department INSPECTION AFFIDAVIT (Print name and circle License Type) License #: C( 071 %c 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 DATE: licensed as a (n) FS 468 Building Inspector / Engineer / Architect, On or about , I did personally inspect the roof deck nailing and (Date & time) Secondary water barrier work at r5 3- 1 c- 10 [ " >-1- (Complete Job Site Address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S) Signature State of Florida County of Dade: The undersigned, being the first duly sworn, deposes and says that he /she is the contractor for the above property mentioned. Swom to and subscribed before me this NOTARY PUBLIC -STATE OF FLORIDA Notary Public, Sate of Florida 20-cg � � � .0 Steven A. Copeland Commission # DD 950706 ''•.'.�,...,� Expires: JAN. 10, 2014 BONDED THRU ATLANTIC BONDING co.,INC. `General, Building, Residential, or Roofing Contractors or any individual certified under 468 F.S. to make such an inspection. Include photographs of each plane of the roof with permit # and address # clearly shown marked on the deck for each Inspection Revised on 5/21/2009 CERTIFICATE OF LIABILITY INSURANCE PRODUCER The Solution Insurance SVCS INC 10868 SW 72 Street, Suite 7 Miami, FL 33173 INSURED DATE (eM np)yyyyt 11/29/12 THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COVERAGES Adderly Development, Inc 8255 W. Sunrise Blvd, Suite 119 Plantation, FL. 33322 INSURERS AFFORDING COVERAGE INSURER A: MID Continent Insurance Co, INSURER B= Florida CIGTROS Business Ins. CO. NAIC # INSURER C: INSURER D: INSURER E: THE POLICIES OF INSURANCE LISTED S INSR ANY .,n � n ,w newrve rut< 1 Mt r-'ULILY PERIOD INDICATED. NOTWITHSTANDING 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, EXCLUSION$ AND CONDITION$ OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADtrL t, INSRD TYPE OF INSURANCE POYCYNUMBER DAB" DTIVE POLICY EXPOtAT10N LIMITS A GENERAL LIABILITY GL 082012 08/18/2012 08/18/2012 COMMERCIAL GENERAL. EACH OCOURRENCE $ 1,000,000 CLAIMS MADE LIABILITY Ell OCCUR REM(Eao ► s 50400 MED E)P (Any one pers $ 50,000 PERSONAL $' ADV INJURY $ 1,000.000 GENERAL AGGREGATE 5 2,000,000 GEN.!. AGRE(A7E LIMIT APPLIES PER ^I POLICY IX IJECT X LOC PRODUCTS - COMP/OP AGO $ 1,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCNEOuLEb AUTOS HIRED AUTOS NON OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) (( paw) RY BODILY INJURY (Per modest) (PROPERTY Par dent) DAMAGE Sc GARAGE LIABILITY 1 ANY AUTO AUTO ONLY- EA ACCIDENT $ OTHER THAN E'er $ AUTO ONLY AGO $ EYCESSNMBRELLA" LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ � '" DEDUCTIBLE RETENTION $ 5 5 R WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR7PARTNFr2/D�CUTNE eyes, describe 0EFICER/MEMBER EXCLUDED? SPECIAL PROVISIONS bet w 106 -50339 08/18/2012 08/18/2012 X (T ORY LIMITS I I OER E.L EACH ACCIDENT $ 100,000 E.L DISEASE - EA EMPLOYEE, $ 100,000 E.L DISEASE. POLICY LIMIT $ 600,000 OTHER DESCRIPTION OP OPERATIONS 1 I.DcATIONS I VEHICLES I I&OLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Roofing, Carpentry, Masonry, Painting niervi ICIw L TLS 1JAI was City of Miami Shores 10050 NE 2 Avenue Miami Shores, FL. 33138 SHOULD ANY OF THE ABOVE DESCRIBED DATE THEREOF, THE ISSUING INSURER NOTICE Yo THE CERTIFICATE HOLDER IMPOSE NO OBLIGATION OR LIABI POLICIES BE CANCELLED BEFORE THE EXPIRATION WILL ENDEAVOR TO MAD. 30 DAYS . - RTEN NAMED TO THE LEFT BUT FAILURE T • . • 80 SHALL DP ANY KIND U ' . INSU - _- ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE 1/1 : aSDd 22.689SLSOET : 01 CORD CORPORATION 1988 :W0,ad ES :80 8002 -22 -180 1hZr_11 2 `(dD � srt.DING PERMIT APPLICATION 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 Permit Type: JOB ADDRESS: BUILDING X351 lO . City: Miami Shores County: Folio/Parcel #: AQ " C 2 3 -0080 NOV 152012 B Ye Permit No. —40-1.11 Master Permit No. ROOFING Miami Dade Is the Building Historically Designated: Yes NO OWNER: Name (Fee Simple Titleholder): C��� 1� � Phone#: 4-c5.2 ?WSJ Zip: Flood Zone: Address: City: A.A. State: 'I-- 33 Tenant/Lessee Name: ) �, f Phone#: Email: ll i.lf�'vrC�i I/IJlf� u l5�' q (,� F1 L% �' f�� CONTRACTOR: Company Name: Address: City: tk -' \ A . IA,119 '\il/kuA' O.( ■ 9 ,State: .Aet/ Qualifier Name: • AZ177 State Certificatio or Re stration #: Qr C /AS7s 1 i$ b Contact Phone#: 0 40 4 - 'lam DESIGNER Architect/Engineer: Phone#: I\ 4 101$ Email Address: Zip: 913 L - Phone#: Certificate of Competency #: Phone#: Value of Work for this Permit: $ L , t`° Square/Linear Footage of Work: Type of Work: OAddition C]Alteration ONew OfRRepair/Replace (TV Description of Work: e. 17,s9o, ODemolition Color th u tile: t i ***************************************F ***** ***** ******s *tea ******** * *** *****r **aye ** Submittal Fee $ Permit Fee $ 325 a) CCF $ Scanning Fee $ Radon Fee $ DBPR $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ .' CO /CC $ Bond $ F r Bonding Company's Name (if applicable) Bonding Company's Address City State Tap Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Tap Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the pe son whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the jo »site for the first inspection which occurs seven (7) days after the building permit is issued In the absence of such posted notic the inspection will not be approved a reinspection fee will be charged Signature t%∎ Signature gent The foregoing ' i trumen as acknowledged before me this S11 The fore _oing ins t i t was acknowledged before me this day o 20 by 15r Z L(L7! . , who is personally known to me or who produced Pe Y pr As identification and who did take an oath. day of 20 (%, by -Ow 1 '' who is Pe rsonally known to me or who has produ as identification and who did take an oath. C: My Commission Expires: a*"'H. Steven. A. Copeland Commission #DD950706 .� Expires: JAN. 10, 2014 TRRU AT[.ANnc BONDING CO.,RIC. .pliteven A. Copeland Commission #DD950706 �H..•= Expires: JAN. 10, 2014 scam TBRU ATLANTIC BONDING CO, INC. *** ******** #RA # #**WN * **** * *** ***** ** ******** ***** ************* ******#8988**** ************** *** ******i* APPROVED BY Plans Examiner Structural Review (Revised 3 /12/2012)(Revised 07 /10/07)(Revised 06/10/2009)(Revised 3/15/09) Zoning Clerk OCT -14 -2008 09:15 From: To:13057568972 Pase:4'4 CERTIFICATE OF LIABILITY INSURANCE i OATE(81/1YYYY) oa/0ro,na 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 I REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, • IMPORTANT: If the certificates holder is an ADDI-10NAL INSURED, the poiicy(i &S) i the terms and conditions 0 tae policy. certain pslicies may require an endorseme certificate holder In Lieu of such endoraement(1:) I PRODUCER Maples Insurance Agency 1051 East Sample Road Pompano Beach, FL 33084 Phone (954)946 -8940 Fax (954)946.8942 `INSURED Adderly Development 5255 West Sunnse Blvd Suite 119 Plantation, FL 33322- COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ANNE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDI'f ION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED DY 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. an TYPE OF IN SIJBR. INSR INSURANCE 'ADDL IN GENERAL LIABILITY I © COMMERCIAL GENERAL, LIA$iLITY ❑ CLAIMS-MADE ❑ OCCUR GEN'L AGGREGATE LIMIT APPLIES PER C POLICY ❑ ,PjE . ❑ LOC AUTOMOBILE { AAGILITY �N POLICY NUMBER (MM/DCDm MmboolYYYY)_, 12- 48568 108/01/2012 08/01/2013 ❑ ANY AUTO i AUTOS EO SCHEDULED I O NON -OWNED j 7 HIRED AUTOS _I AUTOS ■ ❑ ❑ • UMBRELLA LIAR ❑ a cuR • E%++E59 LU18 L-CI,AIMS -MADE 1 __—_ ❑ DEC, _❑ RETENTION $ _ /- WORKERS COMPENSATION AND EMPLOYERS' LIABIUTY Y1 N 1 ANY PROWRIETOR/PARTNER/FXC-CUrIYE OFFICER/MEMBER EXCLUDED" /---1 N / A (Mandatory in NN) DESCRIPTION OF PERATIONS below DS5CRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES CERTIFICATE HOLDER LIMITS EACH OCCURRENCE DAMAGE TOAENTED PREMISES (Ea occurrence) MEO EXP (Any and person} PERSONAL & ADV INJURY GENERAL, AGGREGATE 1,000,000.00 s 100,000.00 s 5,000.00 s 1,000,000.00 1,000,000.00 PRODUCTS COMP/OP AGO $ 1,000,000.00 S GOMBENED SINGLE LIMIT _Iva accident) 5 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE /Par accident) $ S EAOI-$OCCURRENCE $ AGGREGATE g f�I VVC STATU- OTR. TORY L1MITC ❑ ER EL EACH ACCIDENT 5 E L. DISEASE • EA EMPLOYE $ 6,L DISEASE . POLICY LIMIT 5 Attach ACORD 101, Additlanal Remarks 5ehedulg, if =NV space Is required) CANCELLATION City of Miami Shores, Building Dept 10050 NE 2 Ave Miami Shores, FL. 33138 J ACORD 25 (2010/05) QF SHOULD ANY OF THE ABOVE DESCRIBED POUCIE$ se CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1 AUTHORIZED REPRESENTATIVE iJohn Derma ®1888.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD rust be endomed. If SUBROGATION 1$ WAIVED, subject to M. A Statement on this certificate does not confer rights to the JAoltirgoi 1 Eirfe. ism (984)948-804 tc. f12.: (854)946.8942 A R s,. maplesinsd0i.com ,_ _ INSURER(S) AFFORDING COVERAGE NAIC ingsuNERA • Atlantic Casualty INSURER e: INSURER C ; INSURER D : INSURER E : INSURER F REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ANNE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDI'f ION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED DY 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. an TYPE OF IN SIJBR. INSR INSURANCE 'ADDL IN GENERAL LIABILITY I © COMMERCIAL GENERAL, LIA$iLITY ❑ CLAIMS-MADE ❑ OCCUR GEN'L AGGREGATE LIMIT APPLIES PER C POLICY ❑ ,PjE . ❑ LOC AUTOMOBILE { AAGILITY �N POLICY NUMBER (MM/DCDm MmboolYYYY)_, 12- 48568 108/01/2012 08/01/2013 ❑ ANY AUTO i AUTOS EO SCHEDULED I O NON -OWNED j 7 HIRED AUTOS _I AUTOS ■ ❑ ❑ • UMBRELLA LIAR ❑ a cuR • E%++E59 LU18 L-CI,AIMS -MADE 1 __—_ ❑ DEC, _❑ RETENTION $ _ /- WORKERS COMPENSATION AND EMPLOYERS' LIABIUTY Y1 N 1 ANY PROWRIETOR/PARTNER/FXC-CUrIYE OFFICER/MEMBER EXCLUDED" /---1 N / A (Mandatory in NN) DESCRIPTION OF PERATIONS below DS5CRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES CERTIFICATE HOLDER LIMITS EACH OCCURRENCE DAMAGE TOAENTED PREMISES (Ea occurrence) MEO EXP (Any and person} PERSONAL & ADV INJURY GENERAL, AGGREGATE 1,000,000.00 s 100,000.00 s 5,000.00 s 1,000,000.00 1,000,000.00 PRODUCTS COMP/OP AGO $ 1,000,000.00 S GOMBENED SINGLE LIMIT _Iva accident) 5 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE /Par accident) $ S EAOI-$OCCURRENCE $ AGGREGATE g f�I VVC STATU- OTR. TORY L1MITC ❑ ER EL EACH ACCIDENT 5 E L. DISEASE • EA EMPLOYE $ 6,L DISEASE . POLICY LIMIT 5 Attach ACORD 101, Additlanal Remarks 5ehedulg, if =NV space Is required) CANCELLATION City of Miami Shores, Building Dept 10050 NE 2 Ave Miami Shores, FL. 33138 J ACORD 25 (2010/05) QF SHOULD ANY OF THE ABOVE DESCRIBED POUCIE$ se CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL SE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 1 AUTHORIZED REPRESENTATIVE iJohn Derma ®1888.2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD FROWARD COUNTY LOCAL BUSINESS TAX RECEIPT i 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301 -1895 — 954- 831 -4000 VALID OCTOBER 4, 2 012 THROUGH SEPTEMBER 30, 20 #ROOFI1G 9 S ST METAL Cover Recei Business Type: (ROOFING CONTRACTOR) Business Opened:lo /25/2007 State/CountylCert1ReB:CCC1327 88 6 Exemption Code: DBA: ADDERLY DEVELOPMENT INC Business Name: Owner Name: TODD R ACOSRLY Business Location: �� pNRISB BLVD #119 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT is be This tax is Levied for the privilege of doing business within Broward County and non - regulatory in nature. You must meet all County and /or Municipality planning and zoning requirements. l usin business Business ame has changed or you have moved the WH>`Pl VALIDATED the business is , business location. This receipt a rdtocal lames and regulations. Receipt is legal or that it is in compliance Mailing Address: TODD R ADDERLY 8255 W.SUNRISE BLVD #119 PLANATION, FL 33322 Receipt #033-11-00002103 paid o7/31/2012 29.70 :w0JA OT:60 8002 -K -190 2L689SLSO2ti:O1 rn ru OCT -14 -2008 09:13 From: JEFF ATWATER CHIEF FINANCIAL OFFICER * * CERTIFICATE OF ELECT To:13057568972 STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION if CONSTRUCTION INDUSTRY EXE This certifies that the individual its EFFECTIVE DATE: PERSON: FEIN: 07/27/20 ADDERL 14195461 BUSINESS NAME AND ADORE ADDERLY DEVELOPMENT INC 1454 SW TENTH STREET FT LAUDERDALE FL 33312 SCOPES OF BUSINESS OR TRA 1- GENERAL CONTRACTOR IMPORTANT: Persaaai to Chapter 440. 05(14i, section may not recover bepefits or compensation and scope of the basinete or trade listed on the notice election to be exempt shall be Deblois to revocstfen certificate no Isngot weets the requirements of this named OD the certificate to meet the requirements of OWC-252 CERTIFICATE OF ELECTION TO SE EX PLEASE CUT OU 07 -27 -2011 Pase:1 /4 N TO OE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * PTION below has elected to be exempt from Florida Workers` Compensation law. 1 E: EXPIRATION DATE: 07/26/2013 TODD R 2- Roar ING en ofifcer of e corporation who elects exemption from this chapter r this chapter. Poreneet m Cbapter 440.05t12i, F.5., certificates of 1E by filing a certificate of election aeeer this eteetioe to be exempt... apPtY only wnbit the s of election to be exempt and certificates of certificate, tae person named on the notice or certificate at any time for Mare of the parson QUESTIONS? (8501 413 -1608 f election to be exempt. Pennant to Chapter 4411.05(131. F.S., Notice If, at nay time fifer the filing of the notice ar the issuance of tae Olga fir issuance al a rertificate. The department shall revoke e Min section, REVISED 01 -11 THE CARD BELOW AND RETAIN FOR FUTURE REFERENCE STATE OF FLORIDA DEPARTMENT OF FLNA►NCtAL SERVICES DIVISION OF WORKERS' COMPENSATION CONSTRUCTION INDUSTRY CERTIFICATE OF ELECTION TO BE EXEMPT FROM WORKERS" COMPENSATION LAW EFFECTIVE: 07/27/2011 EXPIRIiTI PERSON: TODD R ADDERLY FEIN 141954819 BUSINESS NAME AND ADDRESS: ADDERLY DEVEtomear INC 1454 SW TENTH StREEr Fr LAUD5 GALE, FL 33312 SCOPE OF BUSINESS OR TRADE 1- GENERAL CONTRACTOR Z- ROO1'I LORIDA G DATE: 07/28/2013 0 D H E R E IMPORTANT Pursuant to Chapter 440.05(14), F.S, an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 440.05(12), F.S.. Certificates of election to be exempt.. apply only within the scope of the business or trade listed on the notice of election to be exempt Pursuant to Chapter 440.05(13), F.S,, Notices of election to be exempt and certificates of election to be exempt shall be Subject to revocation if, at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate. The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section, QUESTIONS? {350) 413 -1609 * Carry bottom OWC -252 CERTIFICATE OF ELECTION TD 8E EXEM CUT HERE ortion on the job, keep upper portion for your records, T REVISED 01 -11 NOTICE OF COMMENCEMENT 1 111111 11111 11111 11111 1111111111111111111 1111 CFN 201280329208 OR Bk 28363 Ps 0405i' dips) RECORDED 11/19/2012 09055 :02 A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION HARVEY RUVIN, CLERK OF COURT I1IAIII -DADE COUNTY, FLORIDA AST PAGE PERMIT NO. TAX FOLIO NO.11- s-02 ~ OO.d) STATE OF FLORIDA: COUNTY OF MIAMI -DADE: I HEREBY CERTIF original filed in this THE UNDERSIGNED hereby gives notice that improvements will be made i'.�laitie'u rd property, and in accordance with Chapter 713, Florida Statutes, the followilitiftliiiinffil, C is provided in this Notice of Commencement. By A, COUNT OF DADE that this is a true copy of the friceon day of , A D 20 and Official S ERK, ofCir'• County Courts D.C. TANASH1A ARNOLD 1144 1. Legal description of property an street.�tl+ address: -, f i 1 t7 ( ,t N(t awl �e 1P°' co w wf nua 2. Descripiton of impnwement: 3. Owner(s) name and address: ke �',3 t & &-- t.O Interest in property: Name and address of fee simple titleholder: 4. C. - ctor's name and •ar IIP e, 5. Surety: (Payment bond required by owner from co or, any) Name and Address: 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 and Address: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and Address: 9. Expiration date of this Notice of Commencement (the expiration date is 1 year from the date of record ing unless a different date is specified) Print r'sNam= Sworn to and subscribed before me this Prepared by day of(1)01-04 a 20 / 2 . = o "% Stevens PG Notary >> ��cr.c��r Print Notary's . e: c �r :z; :Conine on #01 SO7° r mss: JAN , My canmission expires: aoiT wm,a. HIGH- VELOCITY HURRICANE ZONES Gr P 13'f. I ml Florida Building Coda Edition 2010 High Velocity Hurricane Zone Uniform Permit Application Form. Section A (General Information) Master Permit No. Process No. Contractor's Name A b Dm L( ->e, 19? tm Job Address (� 5 b t It ( ROOF CATEGORY Low it Slope ❑ Mechanically Fastened Tile E Mortar /Adhesiv ❑ Asphaltic ❑ Metal PaneUShingles ❑ Wood Shingles Shingles Prescriptive BUR -RAS 150 ROOF TYPE ❑ New Roof Reroofing ❑ Recovering ❑ Repair ❑ Mair ROOF SYSTEM INFORMATION pe Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF) s-6 Set'!I Shako co E w 0 Section B (Roof Plan) Plan: Illustrate all levels and sections, roof drains, scuppe oV °rn 4 overflow drains. include dimensions of sections and levels, clearly dim alone of elevated pressure zones and location • parapets. ZONING DEPT BLDG DEPT a; z • c ® < J 1 ° N Q U -J J • z o c c c: F- 0 UZ < LIJ w (/) • Cr; 2010 FLORIDA BUILDING CODE — RESIDENTIAL AA 01 HIGH- VELOCITY HURRICANE ZONES Florida Building Code Edition 2010 High Velocity Hurricane Zone Uniform Permit Application Form. Section C (Low Slope Application) Fastener Spacing for Anchor/Base Sheet Attachment FM in Specific Roof Assembly Components and Identify Manufacturer (if a component is not used, identify as 'NA") System Manufacturer. 4 t`7i ` i Vc NOA No.: 0°7 - la ? fl Design Wind Pressures, From RAS 128 or Calculations: P1: gct°2: z_ P3: 2-a Max. Design Pressure, From the Specific NOA System: Deck: Type: Put W Gaugelmic kness: � e Slope: Anchor/Base Sheet & No. of Ply(s): Anchor/Base Sheet Fastener/Bonding Material: Insulation Base Layer. Base Insulation Size and Thickness: Base Insulation FastenerBonding Material: Top Insulation Layer: <� Top Insulation Size and Thickness: Top Insulation Fastener/Bonding Material: Base Sheet(s) & No. of Ply(s): s ! `k 64x.. V Base Sheet Fastener/Bonding Maters Ply Sheet(s) & No. of Ply(s): 1 AS,4 c U' PIy Sheet Faste r/Bonding Material: Top PIy: 1 iAgt F Top PIy Fastener/ Bonding Material: Surfacing: / { /lit- 44.22 Field: oc @ Lap, # Rows @ oc Perimeter: ( " oc @ Lap, # Rows 1, @ " oc Comer.,' oc ( Lap,* Rows @ g' oc Number of Fasteners Per Insulation Board Field Perimeter Comer ----- Illustrate Components Noted and Details as Applicable: Woodblocking, Gutter, Edge Termination, Stripping, Flashing, Continuous Cleat, Cant Strip, Base Flashing, Counter- Flashing, Coping, Etc. indicate: Mean .Roof Height, Parapet Height, Height of Base Flashing, Component Material, Material Thickness, Fastener Type, Fastener Spacing or Submit Manufacturers Details that Comply with RAS 111 and Chapter 16. ite- Parapet Height Mean Roof Height x'13 D GY- d 2010 FLORIDA BUILDING CODE RESIDENTIAL 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: E -C4 1 o' ,r` 5 10 -, c1 Product Approval Number: /2 - 0 r.?-0 0 Y Minimum Design Wind Pressures, if Applicable (From RAS 127 or Calculations): P1: 176 P2: 8149 P3: /2 °D Maximum Design Pressure Product Approval Specific System: Method of tile attachment 1-1)--x) 1 -4- y s Roof Slope: : 12 Steep Sloped Roof System Description Deck Type: ype Underlayment, Insulation: Fire Barrier: Ridge Ventilation? Fastener Type & Spacing: Adhesive Type: ype Cap Sheet: Mean Roof Height: /1 '/(1 is A 17o(y 4 c(C s Roof Covering: 13e1 4;0— II 4- 4; Type & Size Drip dge: 3 iia v vim; 4".. 2010 FLORIDA BUILDING CODE — RESIDENTIAL 44.23 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 M. 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" (P,: 7 40 x R Z 3. D(,)� - Mt 7:7! =Mr, > �: Product Approval M r 5I (P2: S;r- Y ( x A. e. 2 % 6 _ 2 2 ' ! `E) - Ms: 7i . {' h = Mr2 @ ' O S-Product Approval M r (P3: 2 • t. x 0 e a3b = 3 j) - M . = Mr3 32Prodnct Approval Mr 3 p Method 2 "Simplified Tile Calculation Per Table Below" Required Moment of Resistance (Mr) From Table Below Product Approval Mr Mr Required Moment Resistance* Mean Roof Height -0* Roof Slope ,r 15' 20' 25' 30' 40' 2:12 34.4 36.5 38.2 39.7 42.2 3:12 32.2 34.4 36.0 37.4 39.8 4:12 30.4 32.2 33.8 35.1 37.3 5:12 28.4 30.1 31.6 32.8 34.9 • 6:12 26.4 28.0 29.4 30.5 32.4 7:12 24.4 25.9 27.1 28.2 30.0 *Must be used in conjunction with a list of moment based the systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based the systems use Method 3. Compared the values for F' with the values for Fr. If the F' values are greater than or equal to the Fr values, for each area of the roof, then the tile attachment method is acceptable. Method 3 "Uplift Based Tile Calculations Per RAS 127" (Pt : x 1: - x w: = ) - W: _ x cos 0: _ = Fr,: (P2 :xl := w:= )- W:xcost9 : :. = Fn: (P3 : x I: _ = x w: = ) - W: __- a cos 0: i = Ft3: Where to Obtain Information Description Symbol Where to find Design Pressure P1 or P2 or P3 RAS 127 Table I or by an engineering analysis prepared by PE based on ASCE 7 Mean Roof Height 11 Job Site Roof Slope 8 Job Site Aerodynamic Multiplier . Product Approval Restoring Moment due to Gravity M, Product Approval AttachnlcntResistance Mr Product Approval Required Moment Resistance M, Calculated Minimum Attachment Resistance F' ProductAppmvai Required Uplift Resistance F, Calculated Average Tile Weight. W Product Approval Tile Dimensions I= length tv= width Product Approval All calculations must be submitted to he Building Official at the time ofpermit application. 2010 FLORIDA BUILDING CODE - RESIDENTIAL 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 govem 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 providi 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 renal 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 (L e., 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. `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. 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. 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. 6. = Overflow scuppers (wall outlets): It is required that rainwater flows off so that the roof is not overlo ded 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. 7. / Ventilation: Most roof structures should have some ability to vent natural airflow through the interio j of the structure assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting which can result in extending the service life of the roof Signature Fate Revised on 7/9/2009 LD Contractor Signature Date TGFU.R14571 - Roofmg Systems rug; -r vi VT Membrane: — " DUFLEX G FR ", "POLYFRESKO TORCH FR ", " Xtraflex APP G FR" or " POLYFLEX G FR" (modified bitumen) F heat fused. 6. Deck: C -15/32 ! incline: 1/2 Base Sheet: — One or more layers " DUFLEX" or " POLYFLEX" or " Xtraflex APP S" or "POLYGLASS Base' (heat fused or m,cchanically fastened), "ELASTOBASE", "ELASTOFLEX V", "EtAST' *LEX V- C" or Type G2 base sheet (hot mopped, heat fused or mechanIcr,ilk fastened).. Ply Sheet: — One or More layers "DUFLEX" or "POLYFLEX" or "Xtra °ex \PP " or "rOLYCLR.SS Base" (heat fused) or "'OLYGLASS Base ", "ELASTOBASE ", "ELASTOFLEX V", "ELASTOFLEX V-C" or Type G2 base sheet (hOt� mopped) or mechanically attached. Membrane: — " DUFLEX G FR ", "POLYFRESKO TORCH FR ", " Xtraflex APP G FR" or "POLYFLEX G FR" (modified bitumen), heat fused. 7. Deck: C- 15/32 Incline: 1/2 Insulation: — Poiyisodyanurate (2 in. min), periite (3/4 in. min), glass fiber (7/16 in. min), periite /poiyisocyanurate composite, periite /urethane composite (2 In. min) or (2 in. min) potyisocyanurate covered with 1/2 in. periite or wood fiberboard. Base Sheet: — One or more layers "DUFLEX" or "POLYFLEX" or "Xtraflex APP S" (heat fused or mechanically fastened )1, "ELASTOBASE ", "ELASTOFLEX V", "ELASTOFLEX V -C" (heat fused, mechanically fastened Or hot mopped) or Type G2 base sheet (hot mopped or mechanically fastened). (heat fused) Ply Sheet: — One or More layers "ELASTOFLEX V-C" r Type G2 base sheet (hot mopped) or "ELASTOBASE", "ELASTOFLEX , mechanically fastened., Membrane: — "DUFLIf.X G FR ", "POLYFRESKO TORCH FR ", " Xtraflex APP G FR" or " POLYFLEX G FR" (modified bitumen), heat fused. 8. Deck: NC Incline: 1/2 Insulation (Optional): — Polyisocyanurate, urethane, perlite /poiyisocyanurate composite, periite /urethane com site, glass fiber or wood fiberboard, phenolic or periite, any thickness. Base Sheet: — One o more layers "DUFLEX" or "POLYFLEX" or "Xtraflex APP S" (heat fused or mechanically fastened , "ELASTOBASE ", "ELASTOFLEX V ", "ELASTOFLEX V -C" (hot mopped, mechanically fastened or heat fused) or Type G2 base sheet (hot mopped or mechanically 9. Deck: C-15/32 Incline: 1/2 if)ih faste Membrane: — "ELAS OFLEX VG FR , ELASTOSHIELD TS G FR ", "ELASTOFLEX S6 G "POLYFRESKO MOP FIr (modified bitumen), hot mopped or heat fused. 9. Deck: C -15/32 Incline: 1/2 / • — more layers " DUFLEX" or "POLYFLEX" or "Xtraflex APP S" (heat fu - ' or Base Sheet: One r Y mechanically fastened , "ELASTOBASE ", "ELASTOFLEX V" or Type G2 base sheet (hot mopped or mechanically fastened Ply Sheet: — One or more layers " DUFLEX" or "POLYFLEX" or " Xtraflex APP 5" (heat fused), "ELASTOBASE ", "ELASTOFLEX V", "ELASTOFLEX V-C" or Type G2 base sheet (hot mopped or mechanically attached). Membrane: — "ELASITOFLEX VG FR ", "ELASTOFLEX S6 G FR', "POLYFRESKO MOP FR" or "ELASTOSHIELD TS G FR" (modified bitumen), hot mopped or heat fused. 10. Deck: C -15/32 Incline: 1/2 http: // database. ul. com /cgi- bin/XYV/ template /LISEXT /1FRAME /showpage.html ?name =... 10/31/2012 DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Polyglass USA, Inc. 150 Lyon Drive Fernley, NV 89408 MIAMI-DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 33175 -2474 T (786) 315 -2590 F (786) 315 -2599 ymiamidade.gov /ecoaomy 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 RER - 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. RER reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Polyglass Self - Adhered Roof System over Wood Decks LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved ", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This renews NOA# 11-0425.07 and consists of pages 1 through 26. The submitted documentation was reviewed by Alex Tigera. NOA No.: 12-0815.07 Expiration Date: 10/11/13 Approval Date: 09/27/12 Page 1 of 26 ROOFING ASSEMBLY APPROVAL Category: Sub - Category: Materials Deck Type: Maximum Design Pressure Roofing Modified Bitumen SBS /APP/TPO Wood -112.5 psf TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT: TABLE 1 Test Product Dimensions Specification Description, Pt _Amt, Elastobase Elastobase P Elastoflex SA V FR (1 5-mm) Elastoflex SA V PLUS FR Elastoflex SA V (1.5- mm) Elastoflex SA V PLUS Elastoflex SA P FR Elastoflex SA P Polyflex SA P Polyflex SA P FR Polyfresko SBS SAP 65' 2" x 3' 3 -3/8" 5' 2" x 3' 3 -3/8" 32' 6" x 3' 3 -3/8" ASTM D 6163, Type I ASTM D 6164, Type I ASTM D 6163, Type I 32' 6" x 3' 3 -3/8" ASTM D 6163, Type I 32' 6" x 3' 33/8" ASTM D 6163, Type I 32' 6" x 3' 33/8" ASTM D 6163, Type I 32' 6" x 3' 3 -3/8" ASTM D 6164, Type I 32' 6" x 3' 3 -3/8" ASTM D 6164, Type I 32' 6" x 3' 33/8" ASTM D 6222, Type I 32' 6" x 3' 3-3/8" ASTM D 6222, Type I 32' 6" x 3' 33/8" ASTM D 6164, Type I SBS modified asphalt coated fiberglass reinforced base sheet. SBS modified asphalt coated polyester reinforced base sheet. Self- adhered, fiberglass reinforced, SBS modified bitumen membrane with a self- adhering back face and a smooth top surface. Self - adhered, fiberglass reinforced, SBS modified bitumen membrane with a self - adhering back face and a smooth top surface. Self - adhered, fiberglass reinforced, SBS modified bitumen membrane with a self-adhering back face and a smooth top surface. Self-adhered, fiberglass reinforced, SBS modified bitumen membrane with a self - adhering back face and a smooth top surface. Self- adhered, polyester reinforced, SBS modified bitumen membrane with a self-adhering back face and a granule top surface. Self - adhered, fiberglass reinforced, SBS modified bitumen membrane with a self-adhering back face and a granule top surface. Self - adhered, polyester reinforced, APP modified bitumen membrane with a self - adhering back face and a granule top surface. Self- adhered, polyester reinforced, APP modified bitumen membrane with a self - adhering back face and a granule top surface. Self - adhered, fiberglass reinforced, SBS modified bitumen membrane with a self - adhering back face and a granule top surface. NOA No.: 12- 0815.07 Expiration Date: 10/11/13 Approval Date: 09/27/12 Page 2 of 26 Polyfresko SBS SAP FR Polyfresko APP SAP Polyfresko APP SAP FR PolyKool PG325 Cold Process Adhesive PG100 Asphalt Primer PG350 Mod Bit Adhesive PG400 Plastic Roof Cement PG425 Wet/Dry Roof Cement PG450 Flashing Cement PG500 MB Flashing Cement Polyplus 35 Premium Mod Bit Adhesive Polyplus 45 Premium Flashing Cement Polyplus 50 Premium MB Flashing Cement Polyplus 55 Premium Modified Flashing Cement 32' 6" x 3' 33/8" 32' 6" x 3' 3 -3/8" 32' 6" x 3' 3 -3/8" 32' 10" x 3' 33/8" 1, 3, 5, 50, 55 gal. or tube 1, 3, 5, 50, 55 gal, tube or 17 oz. spray can 1, 3, 5, 50, 55 gal. or tube 1, 3, 5, 50, 55 gal. or tube 1, 3, 5, 50, 55ga1.or tube 1, 3, 5, 50, 55 gal. or tube 1, 3, 5, 50, 55 gal. or tube 1, 3, 5, 50, 55 gal. or tube 1, 3, 5, 50, 55 gal. or tube 1, 3, 5, 50, 55 gal. or tube 1, 3, 5, 50, 55 gal. or tube ASTM D 6164, Type I ASTM D 6222, Type I ASTM D 6222, Type I ASTM D6222 Type 1 ASTM D3019 Type III ASTM D41 ASTM D3019 Type f ASTM D4586 ASTM D3409 ASTM D4586 ASTM D3409 ASTM D4586 ASTM D4586 ASTM D3019 Type ASTM D4586 ASTM D4586 ASTM D4586 Self- adhered, fiberglass reinforced, SBS modified bitumen membrane with a self-adhering back face and a granule top surface. Self- adhered, polyester reinforced, APP modified bitumen membrane with a self - adhering back face and a granule top surface. Self - adhered, polyester reinforced, APP modified bitumen membrane with a self-adhering back face and a granule top surface Self - adhered, polyester reinforced, APP modified bitumen membrane with a self - adhering back face and a white film laminate on the top surface. A fibered cold process adhesive for use with roll or BUR roofing. A penetrating solution of solvent and a blend of selected asphalts used to promote adhesion. A fibered rubberized adhesive designed for use with modified bitumen membranes. A thick, fibered, rubberized flashing cement for use in dry or damp conditions. A thick, fibered, rubberized flashing cement for use in dry or damp conditions. A thick, fibered, rubberized flashing cement. A thick, fibered, rubberized flashing cement for use with modified bitumen membranes. A fibered rubberized adhesive designed for use with modified bitumen membranes. A thick, fibered, rubberized flashing cement. A thick, fibered, rubberized flashing cement for use with modified bitumen membranes. A mastic compound for use as a roof flashing adhesive. NOA No.: 12- 0815,07 Expiration Date: 10/11/13 Approval Date: 09/27/12 Page 3 of 26 APPROVED INSULATIONS: Product Name Polytherm H Polytherm Polytherm Composite ACFoam II ACFoam III High Density Wood Fiberboard Perlite Insulation Type X Gypsum DensDeck, DensDeck Prime II-Shield H- Shield CG ENRGY -3, JM ISO 3 Fesco Board Multi -Max FA -3 SECUROCK Gypsum-Fiber Roof Board TABLE 2 Product Description Polyisocyanurate foam insulation Polyisocyanurate foam insulation Polyisocyanurate /perlite composite insulation. Polyisocyanurate foam insulation Polyisocyanurate foam insulation Wood fiber insulation board Perlite insulation board Fire resistant rated gypsum. Gypsum insulation board Polyisocyanurate foam insulation Polyisocyanurate/perlite composite insulation Polyisocyanurate foam insulation Expanded mineral fiber Polyisocyanurate foam insulation Fiber reinforced coverboard Manufacturer (With Current NOA) Polyglass USA, Inc. Polyglass USA, Inc. Polyglass USA, Inc. Atlas Energy Products Atlas Energy Products Generic Generic Generic Georgia - Pacific Hunter Panels, LLC Hunter Panels, LLC Johns Manville Corp. Johns Manville Corp. RMax, Inc. USG NOA No.: 124815.07 Expiration Date: 10/11/13 Approval Date: 09/27/12 Page 4 of 26 APPROVED FASTENERS: Fastener Number Product Name 1. Dekfast Fasteners #12, #14 & #15 2. Dekfast Galvalume Steel Hex Plate 3. Dekfast Dekflat Round Plastic Lock Plate 4. #12 & #14 Roofgrip 5. Flat Bottom Metal Plate TABLE 3 Product Description Insulation fastener for wood, steel and concrete decks Galvalume hex stress plate. Polypropylene locking plate. Insulation and membrane fastener A2 -SS aluminized steel plate 6. Polyethylene stress plate 7. Insulation fastener for steel and wood decks 8. Tru Fast 3" Metal Insulation Round Galvalume AZ50 steel Plate plate 9. Tru -Fast TP Carbon steel fastener 10. Polygrip Fasteners #12, #14 Insulation fastener for wood, & #15 steel and concrete decks Plastic Plate Tru -Fast HD ( #14) 11. Polygrip Hex Plates 12. Dekfast Galvalume Steel 3 in. Round 13. Millennium One- Step'm Foamable Adhesive IAPPROVEDI Galvalume hex stress plate. 3" round galvalume AZ50 steel plate Insulation Adhesive Manufacturer Dimensions (With Current NOA). SFS Intec, Inc. 2'/g" x SFS Intec, Inc. 31/" 3" x 3 '/" SFS Intec, Inc. Various OMG, Inc. 3" square OMG, Inc. 3.2" round OMG, Inc. The Tru-Fast Corp. The Tra Fast Corp. 3.23 round 3" round Various Various 2 Tag" x 3 ' /a" 3" round Various The Tru -Fast Corp. Polyglass USA, Inc Polyglass USA, Inc SFS Intec, Inc. Adco Products NOA No.: 12-0815.07 Expiration Date: 10/11/13 Approval Date: 09/27/12 Page 5 of 26 APPROVED SURFACING: TABLE 4 Product Product Name Description PG200 Non - Fibered Roof Coating A non fibered asphaltic coating used to add life and rejuvenate existing BUR roofing substrates. PG300 Fibered Roof Coating An asphalt cutback fibered roof coating. May be applied by brush or spray equipment to rejuvenate aged BUR PG600 Non - Fibered Aluminum Roof Coating PG650 Fibered Aluminum Roof Coating PG700 White Elastomeric Roof Coating PG800 Non Fibered Asphalt Emulsion Roof Coating PG850 Fibered Asphalt Emulsion Roof Coating Polyplus 65 Premium Fibered Aluminum Roof Coating Polyplus 60 Premium Non - Fibered Aluminum Roof Coating Polybrite 70 White Elastomeric Roof Coating Gravel Slag Non - fibered aluminum roof coating. Fibered aluminum roof coating. A premium white elastomeric acrylic based roof coating (water based). A polyester fabric may be used for reinforcement with this coating. An asphalt base, un- fibered clay emulsion An asphalt base, fibered clay emulsion Fibered aluminum roof coating. Non - fibered aluminum roof coating. A premium white eastomeric acrylic based roof coating (water-based). A polyester fabric may be used for reinforcement with this coating. To be installed in a flood coat of approved asphalt at 60 lbs/sq To be installed in a flood coat of approved asphalt at 60 lbs/sq Application 1'/2 -2 gal/sq TAS 140 1%-2 gal/sq ASTM D4479 Specification, V2-1 gal/sq 1'/2 -2 gal/sq 1 -1' /2 gal/sq ASTM D2824 Type I ASTM D2824 Type III ASTM D6083 3 gal/sq in ASTM D1227 two coats 3 gal/sq in ASTM D1227 two coats 1'/z -2 gal/sq ASTM D2824 Type III 1/2-1 gal/sq ASTM D2824 Type I 1 -1'/2 gal/sq ASTM D6083 400 lbs/sq N/A 300lbs/sq N/A Manufactur er Polyglass USA, Inc. Polyglass USA, Inc. Polyglass USA, Inc. Polyglass USA, Inc. Polyglass USA, Inc. Polyglass USA, Inc. Polyglass USA, Inc. Polyglass USA, Inc. Polyglass USA, Inc. Polyglass USA, Inc. Generic Generic NOA No.: 12- 0815.07 Expiration Date: 10/11/13 Approval Date: 09/27/12 Page 6 of 26 EVIDENCE SUBMITTED: Test Agency Factory Mutual Research Corporation Underwriters Laboratory Trinity ERD PRI Asphalt Technologies Test Name/Report Revert No, ate 4470 J.I. 3001334 02.15.00 4470 J.I.3000857 01.12.00 4470 J.I.3004091 01.12.00 TAS 114 TAS 114 TAS 114 TAS 114 TAS 117(3) -ASTM D903 TAS 114 TAS 114 TAS 1144 TAS 1144 TAS 117(B) -ASTM D6862 ASTM D6164 / ASTM D6222 ASTM D6164 / ASTM D6222 ASTM D6222 TAS 114(D) — ASTM D1876 ASTM D6222 FM 4470 & TAS 114 ASTM D6163 / ASTM D 4601 ASTM D6222 ASTM D6222 ASTM D6163 00NK20869 06.08.00 11751.05.03 05.30.03 11758.08.03 08.11.03 P1738.02.07 02.05.07 020841.06.04 06.02.04 11757.12.00 -1 12.01.00 11757.04.01 -1 04.27.01 P9260.03.08 03.21.08 P7860S C.11.08 11.30.07 C8500SC.11.07 11.30.07 P10490.08.08 08.13.08 P10490.10.08-R1 10.03.08 P7400.03.08 -R2 10/09/08 P10070.10.08 10/09/08 P10490.10.08-2 10/30/08 P33970.03.11 03/15/11 P33960.03.11 03/15/11 PUSA - 061 -02 -02 01.28.08 PUSA -062 -02 -02 12.04.08 PUSA -064 -02 -02 02.27.08 NOA No.: 12- 0815.07 Expiration Date: 10 /11/13 Approval Date: 09/27/12 Page 7 of 26 Membrane Type: SBS /APP Deck Type 1: Wood, Non - Insulated Deck Description: 19/32n or greater plywood or wood plank. System Type E(1): Base sheet is mechanically attached to roof deck. All General and System Limitations apply. Base Sheet: One ply of Elastobase or Elastobase P fastened to the deck as described below: Fastening #1: Attach base sheet using 11 ga. annular ring shank and 1 -5/8" diameter tin caps spaced 8" o.c. in a 4" lap and 8" o.c. in three equally spaced staggered rows in the center of the sheet. Fastening #2: Attach base sheet using OMG Roofgrip Fasteners and Flat Bottom Plates, Dekfast #14 with Galvalume Steel Hex Plates, Polygrip Fasteners ( #14) with Polygrip Hex Plates or Tru-Fast HD ( #14) Fasteners with 3" Metal Insulation Plates spaced 12" o.c. in a 4" lap and 12" o.c. in two equally spaced staggered rows in the center of the sheet. Ply Sheet: One or more plies of Elastoflex SA V, Elastoflex SA V PLUS, Elastoflex SA V FR, or Elastoflex SA V PLUS FR self-adhered. Membrane: One ply of Polyfresko SBS SAP, Polyfresko SBS SAP FR, Polyfresko APP SAP, Polyfresko APP SAP FR, Elastoflex SA P, Elastoflex SA P FR, Polyflex SA P, PolyKool or Polyflex SA P FR self adhered. Surfacing (Optional) Install one of the approved surfacing products listed in Table 4 to obtain desired coating or required fire classification. Maximum Design Pressure: -52.5 psf, (See General limitation #7.). NOA No.: 12- 0815.07 Expiration Date: 10/11/13 Approval Date: 09/27/12 Page 20 of 26 WOOD DECK SYSTEM LIMITATIONS: 1. A slip sheet is required with Ply 4 and Ply 6 when used as a mechanically fastened base or anchor sheet. GENERAL LIMITATIONS: 1. Fire classification is not part of this acceptance; refer to a current Approved Roofing Materials Directory for fire ratings of this product. 2. Insulation may be installed in multiple layers. The first layer shall be attached in compliance with Product Control Approval guidelines. All other layers shall be adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbsJsq., or mechanically attached using the fastening pattern of the top layer 3. All standard panel sizes are acceptable for mechanical attachment. When applied in approved asphalt, panel size shall be 4' x 4' maximum. 4. An overlay and/or recovery board insulation panel is required on all applications over closed cell foam insulations when the base sheet is fully mopped. If no recovery board is used the base sheet shall be applied using spot mopping with approved asphalt, 12" diameter circles, 24" o.c.; or strip mopped 8" ribbons in three rows, one at each side lap and one down the center of the sheet allowing a continuous area of ventilation. Encircling of the strips is not acceptable. A 6" break shall be placed every 12' in each ribbon to allow cross ventilation. Asphalt application of either system shall be at a minimum rate of 12 lbsJsq. Note: Spot attached systems shall be limited to a maximum design pressure of -45 psf. 5. Fastener spacing for insulation attachment is based on a Minimum Characteristic Force (F') value of 275 lbf., as tested in compliance with Testing Application Standard TAS 105. If the fastener value, as field - tested, are below 275 lbf. insulation attachment shall not be acceptable. 6. Fastener spacing for mechanical attachment of anchor/base sheet or membrane attachment is based on a minimum fastener resistance value in conjunction with the maximum design value listed within a specific system. Should the fastener resistance be less than that required, as determined by the Building Official, a revised fastener spacing, prepared, signed and sealed by a Florida registered Professional Engineer, Registered Architect, or Registered Roof Consultant may be submitted Said revised fastener spacing shall utilize the withdrawal resistance value taken from Testing Application Standards TAS 105 and calculations in compliance with Roofing Application Standard RAS 117. 7. Perimeter and corner areas shall comply with the enhanced uplift pressure requirements of these areas. Fastener densities shall be increased for both insulation and base sheet as calculated in compliance with Roofing Application Standard RAS 117. Calculations prepared, signed and sealed by a Florida registered Professional Engineer, Registered Architect, or Registered Roof Consultant (When this limitation is specifically referred within this NOA, General Limitation #9 will not be applicable.) 8. All attachment and sizing of perimeter nailers, metal profile, and/or flashing termination designs shall conform to Roofing Application Standard RAS 111 and applicable wind load requirements. 9. The maximum designed pressure limitation listed shall be applicable to all roof pressure zones (i.e. field, perimeters, and corners). Neither rational analysis, nor extrapolation shall be permitted for enhanced fastening at enhanced pressure zones (i.e. perimeters, extended corners and corners). (When this limitation is specifically referred within this NOA, General Limitation #7 will not be applicable.) END OF THIS ACCEPTANCE NOA No.: 12-0815.07 Expiration Date: 10/11/13 Approval Date: 09/27/12 Page 26 of 26 i DEPARTMENT OF PERMITTING, ENVIRONMENT, AND REGULATORY AFFAIRS (PERA) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Eagle Roofing Products LLC 1575 East C.R. 470 Sumterville, FL 33585 MIAMI -DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 33175 -2474 T (786) 315 -2590 F (786) 315 -2599 www.miamidade.eov/nera 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: Bel Mr, Bel Mr Double Eagle, Ponderosa, Ponderosa Double Eagle, Golden Eagle Low Profile Concrete Tiles LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved ", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. 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# 11 -0321.02 and consists of pages 1 through 10. The submitted documentation was reviewed by Alex Tigers. NOA No.:12- 0430.04 Expiration Date: 10 /05/16 Approval Date: 08 /02/12 Page 1 of 10 ROOFING ASSEMBLY APPROVAL Category: Roofing Sub Category: Roofing Tiles Material: Concrete 1. SCOPE: This approves a new roofing system using "Low Profile Concrete Tile" as manufactured by Eagle Roofing Products LLC in Sumterville, FL and described in Section 2 of this Notice of Acceptance. For locations where the pressure requirements, as determined by applicable Building Code does not exceed the design pressure values obtained by calculations in compliance with RAS 127 using the values listed in section 4 herein. The attachment calculations shall be done as a moment based system. 2. PRODUCT DESCRIPTION: Manufactured by Applicant Dinlensions Bel Air Concrete Tile Bel Air Double Eagle Concrete Tile Ponderosa Concrete Tile Ponderosa Double Eagle Concrete Tile Golden Eagle Concrete Tile Trim Pieces L= 17" W= 12'/4" Thickness =' /z" L = 17" W =12%" Thickness =' /2" L =17" W = 12'/4" Thickness = 17" W =12'/4" Thickness =' /2" L= 17" W= 12'/4" Thickness ='/2" 1= varies w= varies varying thickness Test Specifications TAS 112 Product Description Flat profile concrete roof tile equipped with two nail holes. For adhesive set, direct deck or battened nail -on applications. TAS 112 Flat profile concrete roof the equipped with two nail holes. For adhesive set, direct deck or battened nail -on applications. TAS 112 Flat profile concrete roof tile with slate finish equipped with two nail holes. For adhesive set, direct deck or battened nail -on applications. TAS 112 Flat profile concrete roof tile with shake finish equipped with two nail holes. For adhesive set, direct deck or battened nail -on applications. TAS 112 Flat profile concrete roof tile brushed finish equipped with two nail holes. For adhesive set, direct deck or battened nail -on applications. TAS 112 Accessory trim, clay roof pieces for use at hips, rakes, ridges and valley terminations. Manufactured for each tile profile. NOA No.:12-0430.04 Expiration Date: 10/05/16 Approval Date: 08 /02/12 Page 2 of 10 2.1 EVIDENCE SUBMITTED: Test Aaencv Test Identifier PRI Asphalt Technologies ERPF- 001 -02 -01 Redland Technologies 7161 -03 Appendix lII Redland Technologies Redland Technologies Redland Technologies Redland Technologies Redland Technologies The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. Celotex Corporation Testing Service Celotex Corporation Testing Service Walker Engineering, Inc. Walker Engineering, Inc. 7161 -03 Appendix III 7161 -03 Appendix II F0402 Letter Dated Aug. 1, 1994 P09647 -01 94-084 25- 7094 42, 5, & 8) 25- 7183 -(5 thru 6) 25- 7214-(1, 5 , & 8) 25- 7487 -2 25- 7496 -(1 & 4) 25- 7804 -6 520109 -1 520111 -4 520191 -1 Calculations Calculations Test Name/Report TAS 112 Static Uplift Testing TAS 102 Static Uplift Testing TAS 102(A) Wind Tumiel Testing TAS 108 (Nail -On) Withdrawal Resistance Testing of screw vs. smooth shank nails Wind Tunnel Testing TAS 108 (Nail -On) Wind Tunnel Testing TAS 108 (Mortar Set) Static Uplift Testing TAS 101 (Mortar Set) Static Uplift Testing TAS 102 Static Uplift Testing TAS 102 Static Uplift Testing TAS 102 Static Uplift Testing TAS 102 Static Uplift Testing TAS 102 Static Uplift Testing TAS 102 Static Uplift Testing TAS 101 Static Uplift Testing TAS 101 Aerodynamic Multiplier Restoring Moments Due to Gravity nag Aug. 2006 Dec. 1991 Dec. 1991 Dec. 1991 Sept. 1993 Aug. 1994 Aug. 1994 May 1994 Oct. 1994 Feb. 1995 March, 1995 Dec. 1995 Dec. 1995 Sep. 1996 Dec. 1998 March 1999 Sep. 2006 Sep. 2006 NOA No.:12-0430.04 Expiration Date: 10 /05/16 Approval Date: 08/02/12 Page 3 of 10 3. LIMITATIONS: 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile applications, a static field uplift test in accordance with TAS 106 may required, refer to applicable building code. 3.3 Applicant shall retain the services of a Miami -Dade County Certified Laboratory to perform quarterly test in accordance with TAS 112, appendix `A'. Such testing shall be submitted to the Building 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 Eagle Roofing Products LLC Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle, Ponderosa Double Eagle Flat Concrete Roof Tiles 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) Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle, Ponderosa Double Eagle Flat Tile 11.4 1.42 1.03 Table 2: Aerodynamic Multipliers - A (ft3) Tile Profile A (ft3) A (ft3) Batten Application Direct Deck Application Bel Air, Bel Air Double Eagle, 0.301 0.278 Ponderosa, Golden Eagle, Ponderosa Double Eagle Flat Tile NOA No.:12- 0430.04 Expiration Date: 10/05/16 Approval Date: 08/02/12 Page 4 of 10 Table 3. Restoring Moments due to Gravity - Mg (ft -lbf) Tile Profile 3 ":12" 4 ":12" 5 ":12" 6 ":12" Greater than 7 ":12" Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle, Ponderosa Double Eagle Flat Tile Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck 7.48 7.71 7.37 7.59 7.22 7.44 7.05 7.27 6.86 7.07 Table 4: Attachment Resistance Expressed as a Moment - Mt (ft -Ibf) for Nall -On Systems Tile Profile Fastener Type Direct Deck (min 15/32" plywood) Direct Deck (min. 19/32" plywood) Battens Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle, Ponderosa Double Eagle Flat Tile 2 -10d Ring Shank Nails 30.9 38.1 17.2 1 -10d Smooth or Screw Shank Nail 7.3 9.8 4.9 2 -10d Smooth or Screw Shank Nails 14.0 18.8 7.4 1 #8 Screw 30.8 30.8 18.2 2 #8 Screw 51.7 51.7 24.4 1 -10d Smooth or Screw Shank Nail (Field Clip) 24.3 24.3 24.2 1 -10d Smooth or Screw Shank Nail (Eave Clip) 19.0 19.0 22.1 2 -10d Smooth or Screw Shank Nails (Field Clip) 35.5 35.5 34.8 2 -10d Smooth or Screw Shank NailsjEave Clip) 31.9 31.9 32.2 2 -10d Ring Shank Nails' 1 50.3 ) 65.5 1 48.3 1. installafion with a 4" tile headlap and fastemers are located a min. of 2W from head of tile. NOA No.:12- 0430.04 Expiration Date: 10/05/16 Approval Date: 08/02/12 Page 5 af 10 Table 5: Attachment Resistance Expressed as a Moment Mf (ft-Ibf) for Two Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle, Ponderosa Double Eagle Flat Tile Adhesive' 31.32 1 See manufactures component approval for installation requirements. 2 Flexible Products Company TileBond Average weight per patty 13.9 grams. air''" 2- Component Foam Roof Tile Adhesive AH -160 Average weight per patty 8 grams. Table 6: Attachment Resistance Expressed as a Moment - Mf (ft -Ibf) for Single Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle, Ponderosa Double Eagle Flat Tile 3M'" 2- Component Foam Roof Tile Adhesive AH -160 118.93 3M'm 2- Component Foam Roof Tile Adhesive AH -160 40.44 3 Large paddy placement of 45 grams of PolyProTA°. 4 Medium paddy placement of 24 grams of PolyProT". Table 7: Attachment Resistance Expressed as a Moment - Mf(ft -Ibf) for Mortar Set Systems Tile Profile Tile Application Attachment Resistance Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle, Ponderosa Double Eagle Fiat Tile Mortar Sets 43.9 5 Tile -Tite Roof Tile Mortar. APPROVED NOA No.:12- 0430.04 Expiration Date: 10/05/16 Approval Date: 08/02/12 Page 6 of 10 5. LABELING : All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo (See Detail Below), or following statement: "Miami Dade County Product Control Approved ". EAGLE FLORIDA BEL AIR, BEL AM DOUBLE EAGLE, PONDEROSA, GOLDEN EAGLE, PONDEROSA DOUBLE EAGLE CONCRETE ROOF TILE LABEL, SUMTERVILLE PLANT (LOCATED ON UNDERSIDE OF TILE) 6. BUILDING PERMIT REQUIREMENTS: 6.1 Application for building permit shall be accompanied by copies of the following. 6.1.1 this Notice of Acceptance. 6.1.2 Any other documents required by Building Official or Applicable building code in order to properly evaluate the installation of this system. NOA No.:12-0430.04 Expiration Date: 10 /05/16 Approval Date: 08/02/12 Page 7 of 10 PROFILE DRAWING BEL MR BEL MR DOUBLE EAGLE NOA No.:12- 0430.04 Expiration Date: 10 /05 /16 Approval Date: 08/02/12 Page 8 of 10 IMJM4! COUNTY DEPARTMENT OF PERMITTING, ENVIRONMENT, AND REGULATORY AFFAIRS (PERA) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Polyglass USA Inc. 150 Lyon Drive Fernley, NV 89408 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.govloera 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: Polyglass Polystaiek Underlayments LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami Dade County Product Control Approved ", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This revises NOA # 11 -0601.10 and consists of pages 1 through 8 The submitted documentation was reviewed by Alex Tigers. NOA No.: 11- 1229.01 Expiration Date: 09/13/16 Approval Date: 04 /05/12 Page 1 of 8 ROOFING COMPONENT APPROVAL Cate¢orv: Sub- Categorv: Material: Roofing Underlayment SBS , APP Self- Adhering Modified Bitumen PRODUCTS DESCRIPTION: Product Polystick MTS underlayment Manufacturing Location #2 Polystick IR-Xe underlayment Manufacturing Location #1 & #2 Polystick TU underlayment Manufacturing Location #1 & #2 Polystick TU Plus underlayment (Surface Printing) Manufacturing Location #2 Polystick TU P underlayment Manufacturing Location #2 Polystick Tile Pro Manufacturing Location #2 Polystick Dual Pro Manufacturing Location #2 Dimensions Roll: 65'8" x 3'33/8" 60 mils thick Roll: 65' x 3'3_3/8" Or65'x3' 60 mils thick Roll: 32'10" x 3,3 -3/8" 100 mils thick Roll: 65' x 3'33/8" 80 mils thick Roll: 32'10" x 3'3-3/8" 130 mils thick Roll: 61' x 3'3-3/8" 60 mils thick Roll: 61' x 3'3-3/8" 60 mils thick Test Specification TAS 103 TAS 103 and ASTM D 1970 TAS 103 and ASTM D 1970 TAS 103 and ASTM D 1970 Product Description A homogeneous, rubberized asphalt waterproofing membrane, glass fiber reinforced with polyolefinic film on the upper surface for use as an underlayment for metal roofing, roof tile, slate tiles and shingle underlayment. A fine granular /sand top surface self-adhering, APP polymer modified, fiberglass reinforced, bituminous sheet material for use as an underlayment in sloped roof assemblies. Designed as an ice & rain shield and as a flat roof tile underlayment. A heavy granuled surface self adhering, APP polymer modified, fiberglass or polyester reinforced, bituminous sheet material for use as an underlayment in sloped roof assemblies. Designed as a a roof tile underlayment. A rubberized asphalt self - adhering, glass - fiber/polyester reinforced waterproofing membrane. Designed as a metal roofing and roof tile underlayment. TAS 103 and A rubberized asphalt waterproofing membrane, ASTM D 1970 glass- fiber /polyester reinforced, with a granular surface designed for use as a tile roof underlayment. TAS 103 and ASTM D 1970 TAS 103 and ASTM D 1970 A rubberized asphalt self - adhering, glass - fiber /polyester reinforced waterproofing membrane. Designed as a metal roofing and roof tile underlayment. A rubberized asphalt self- adhering, glass - fiber/polyester reinforced waterproofing membrane. Designed as a metal roofing and roof the underlayment. NOA No.: 11- 1229.01 Expiration Date: 09/13/16 Approval Date: 04 /05/12 Page 2 of 8 MANUFACTURING PLANTS: 1. Hazelton, PA 2. Winter Haven, FL EVIDENCE SUBMITTED: Test Agency Exterior Research & Design, LLC Trinity I ERD PRI Asphalt Technologies Momentum Technologies, Inc. Test Identifier 11756.04.01 -1 11756.08.01 -1 02202.08.05 P5110.08.07 P10870.09.08 -R1 P10870.04.09 P33360.06.10 P33370.03.11 P33370.04.11 P36900.09.11 P37300.10.11 PRI01111 PUSA -005 -02 -01 PUSA -018 -02 -01 PUSA -035 -02 -01 PUSA -033 -02 -01 PUSA -055 -02 -02 PUSA -083 -02 -01 PUSA -089 -02 -01 JX20H7A RX14E8A DX23D8B DX23D8A Test Name/Report TAS 103 ASTM D 1970 TAS 103 TAS 103 TAS 103 TAS 103 /ASTM D4798 & G155 ASTM D1970 TAS 103 ASTM D 1623 TAS 103 /ASTM D4798 & G155 TAS 110 /ASTM D4798 & D1970 ASTM D 4977 ASTM D 4977 ASTM D 2523 TAS 103 ASTM D 1970 TAS 103 TAS 103 TAS 103 /ASTM D4798 & G155 TAS 103 /ASTM D4798 & G155 TAS 103 /ASTM D4798 & G155 TAS 103 /ASTM D4798 & G155 TAS 103 /ASTM D4798 & G155 Rids 04/27/01 08/14/01 08/29/05 08/29/07 12/04/08 04/13/09 07/01/10 03/02/11 04/26/11 09/01/11 10/19/11 04/08/02 01/31/02 07/14/03 09/29/06 01/12/06 12/10/07 06/30/08 07/06/09 04/01/08 11/09/09 02/18/10 02/18/10 NOA No.: 11- 1229.01 Expiration Date: 09/13/16 Approval Date: 04/05/12 Page 3 of 8 INSTALLATION PROCEDURES: Deck Type 1: Wood, non - insulated Base Sheet: One or more plies of ASTM D 226 Type II or ASTM D 2626. Fastening: Per FBC 1518.2 & 1518.4 Nails and tin caps 12" grid, 6" o.c. at a minimum 4" head lap. (for base sheet only) Membrane: Polystick membranes self-adhered. Surfacing: None 1. All nails in the deck shall be carefully checked for protruding heads. Re- fasten any loose decking panels, and sweep the deck thoroughly to remove any dust and debris prior to application. 2. Place the underlayment over metal drip edge in accordance with RAS 111. 3. Place the first course of membrane parallel to the cave, rolling the membrane to obtain maximum contact. Remove the release film as the membrane is applied. . All side laps shall be a minimum of 3-1A" and end laps shall be a minimum of 6." Roll the membrane into place after removing the release strip. Vertical strapping of the roof with Polystick is acceptable. Membrane shall be back nailed in accordance with applicable building code. 4. When applying the membrane in the valley, start at the low point and work to the high point, rolling the membrane from the center outward in both directions. 5. For ridge applications, center the membrane and roll from the center outward in both directions. 6. Roll or broom the entire membrane surface so as to have full contact with the surface, giving special attention to lap areas. 7. Flash vent pipes, stacks, chimneys and penetrations in compliance with Roof Assembly current Product Control Notice of Acceptance. 8. All protrusions or drains shall be initially taped with a 6" piece of underlayment. The flashing tape shall be pressed in place and formed around the protrusion to ensure a tight fit. A second layer of Polystick shall be applied over the underlayment. APPROVED NOA No.: 11- 1229.01 Expiration Date: 09/13/16 Approval Date: 04 /05/12 Page 4 of 8 GENERAL LIMITATIONS: 1. Fire classification is not part of this acceptance. 2. Polystick MTS, TU Plus, Tile Pro and Dual Pro may be used in asphaltic shingles, wood shakes and shingles, non - structural metal roofing, roof tile systems and quarry slate roof assemblies. IR-Xe, TU, and TU P may be used in all the previous assemblies listed except metal roofing. 3. Deck requirements shall be in compliance with applicable building code. 4. Polyglass Polystick membranes shall be applied to a smooth, clean and dry surface. The deck shall be free of irregularities. 5. Polyglass Polystick membranes and underlayments shall not be adhered directly over a pre- existing roof membrane as a recover system. 6. Polyglass Polystick membranes shall not be left exposed as a temporary roof for longer than the amount of days listed in the table below after application. Polyglass reserves the right to revise or alter product exposure times; not to exceed the preceeding maximum time limitations. Exposure Limltatio ns (days) Polystick MTS MTS IR-Xe TU TU Plus TU P Tile Pro Dual Pro Winter Haven, FL. 180 180 180 180 180 180 180 Hazelton, PA. N/A 30 30 180 N/A N/A N/A 7. All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code and Rule 9N -3 of the Florida Administrative Code. 8. In roof tile application, data for the attachment resistance of roof tiles shall be as set forth in the roof tile manufacturer's Notice of Acceptance. Polystick TU, TU Plus, and Tile Pro may be used in both adhesive set and mechanically fastened roof tile applications. Polystick IR Xe, and Dual Pro are limited to mechanically fastened roof tile applications. Polystick MTS is limited to mechanically fastened with battens roof tile applications. Polystick TU P may be used in both adhesive set and mechanically fastened roof tile applications with the exception of mortar set tile applications. 9. The maximum roof slope for use as roof tile underlayment for (direct-to-deck) tile assemblies shall be as follows: (See Table Below) Tile Profile Polystick MTS Polystick IR-Xe Polystick TU, TU Plus, TU P, Tile Pro Flat Tile Prohibited without battens 5:12 No limitation Profiled Tile Prohibited without battens Prohibited No limitation The above slope limitations can be exceeded only by using battens and counter battens in accordance with the Approved Tile System Notice of Acceptance and applicable Florida Building Code requirements. Battens are required for both loading and installation of tiles at all times. NOA No.: 11- 1229.01 Expiration Date: 09/13/16 Approval Date: 04 /05/12 Page 5 of 8 GENERAL LIMITATIONS: (CONTINUED) 10. Care should be taken during the loading procedure to keep foot traffic to a minimum and to avoid dropping of tile directly on the underlayment. Refer to Poly . ass' Tile loading detail below for loading procedure for all underlayments except Polystick MTS which %hall be loaded onto battens. w a 0 n r t0 Roofing Tiles :6 Max Per Stack) 12 11. Refer to prepared roofing system Product Control Notice of Acceptance for listed approval of this product with specific prepared roofing products. Polystick MTS, IR-Xe, TU, TU Plus, TU P, Dual Pro and Tile Pro may be used with any approved roof covering Notice of Acceptance listing Polystick MTS, IR-Xe, TU, TU Plus, TU P, Dual Pro and Tile Pro as a component part of an assembly in the Notice of Acceptance. If Polystick MTS, IR-Xe, TU, TU Plus, TU P, Dual Pro and Tile Pro is not listed, a request may be made to the Authority Having Jurisdiction (AHJ) or the Miami -Dade County Product Control Department for approval provided that appropriate documentation is provided to detail compatibility of the products, wind uplift resistance, and fire testing results. LABELING: 1. All membranes or packaging shall bear the imprint or identifiable marking of the manufacturer's name or logo, city and state of manufacturing facility and the following statement: "Miami -Dade County Product Control Approved" or the Miami -Dade County Product Control Seal as shown below. BUILDING PERMIT REQUIREMENTS: Application for building permit shall be accompanied by copies of the following. 1. This Notice of Acceptance. 2. Any other documents required by the Building Official or applicable building code in order to properly evaluate the installation of this materials. NOA No.: 11- 1229.01 Expiration Date: 09/13/16 Approval Date: 04 /05/12 Page 6 of 8 POLYGLASS GENERAL APPLICATION GUIDELINES FOR POLYSTICK MEMBRANES: 1. Polyglass does accept the direct application of Polystick underlayment membranes to wood decks. Installers are cautioned to refer to applicable local building codes prior to direct deck installation to ensure this is acceptable. Please also refer to applicable Product Data Sheets of the corresponding products. 2. All rolls, with the exception of Polystick TU Plus should be back-nailed in selvage edge seam as per Polyglass Back Nailing Guide. Nails shall be, 11 gauge ring shank type, applied with a minimum 1" metal disk as required in Dade County or simplex type nail as otherwise allowable in other regions, at a minimum rate of 12" o.c. Polystick TU Plus should be back nailed in designated area marked "nail area, area para clavar" on the face of membrane, with the above stated nails and/or disks. The head lap membrane is to cover the area being back-nailed. (Please refer to applicable local building codes prior to installation.) 3. All seal lap seams (selvage laps) must be rolled with a hand roller to ensure full contact. 4. All fabric over fabric; and granule over granule end laps, shall have a 6" wide, uniform layer of Polyglass Polyplus 55 Premium Modified Flashing Cement, Polyglass Polyplus 50 Premium MB Flashing Cement, Polyglass PG500 MB Flashing Cement, Mule -Hide 241 Premium Modified Flashing Cement, Mule -Hide 251 Premium Wet/Dry Elastomeric Flashing Cement, or Mule -Hide 42.1 Mod Bit Flashing Adhesive Trowel Grade mastic, applied in between the application of the lap. The use of mastic between the laps does not apply to Polystick MTS. 5. A maximum of 6 tiles per stack are allowed when loading tile on the underlayments. Refer to the Polyglass Tile Loading Guidelines. See General Limitations #9 and #10. 6. Battens and/or Counter - battens, as required by the tile manufacturers NOA's, must be used on all projects for pitch/slopes of 7"/12" or greater. It is suggested that on pitch/slopes in excess of 6 W' /12 ", precautions should be taken, such as the use of battens to prevent tile sliding during the loading process. 7. Minimum cure time after membrane installation & before loading of roofing tiles is Forty-Eight (48) Hours. 8. Polystick membranes may not be used in any exposed application such as crickets, exposed valleys, or exposed roof to wall details. 9. Repair of Polystick membranes is to be accomplished by applying Polyglass Polyplus 55 Premium Modified Flashing Cement, Polyglass Polyplus 50 Premium MB Flashing Cement, Polyglass PG500 MB Flashing Cement, Mule -Hide 241 Premium Modified Flashing Cement, Mule -Hide 251 Premium Wet/Dry Elastomeric Flashing Cement, or Mule -Hide 421 Mod Bit Flashing Adhesive Trowel Grade mastic to the area in need of repair, followed by a patch of the Polystick material of like kind should be set and hand rolled in place over the area needing such repair. Patching membrane shall be a minimum of 6 inches in either direction. The repair should be installed in such a way so that water will run parallel to or over the top of all laps of the patch. 10. All self-adhered membranes must be rolled to ensure full contact with approved substrates. Polyglass requires a mfitimum of 40 lbs for a weighted roller for the rolling of the field membrane. Hand rollers are acceptable for rolling of patches or small areas of the roof. Brooming may be used where slope prohibits rolling. 11. All approved substrates should be dry, clean and properly prepared, before any application of Polystick membranes commences. An approved substrate technical bulletin can be furnished upon request. It is recommended to refer to applicable building codes prior to installation to verify acceptable substrates. 12. The Polyglass Miami Dade Notice of Acceptance (NOA) approval for Polystick membranes and PolyProtector UDL can be furnished upon request by our Technical Services Department by calling 1 (800) 894 -4563. NOA No.: 11- 1229.01 Expiration Date: 09/13/16 Approval Date: 04/05/12 Page 7 of 8 13. Questions in regards to the application of Polyglass products should be directed to our Technical Services Department at 1 (800) 894 -4563. 14. Polyglass recommends that applicators follow good roofing practices and applicable procedures as outlined by the National Roofing Contractors Association (NRCA). PLEASE CHECK WITH LOCAL BUILDING CODES REGARDING LIMITATIONS OF SPECIFIC APPLICATIONS. LOCAL CODES MAY SUPERSEDE POLYGLASS REQUIREMENTS AND RECOMMENDATIONS. END OF THIS ACCEPTANCE NOA No.: 11- 1229.01 Expiration Date: 09/13/16 Approval Date: 04/05/12 Page 8 of 8