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RF-13-1230Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 192736 Permit Number: RF -6 -13 -1230 Scheduled Inspection Date: June 12, 2013 Inspector: Rodriguez, Jorge Owner: Job Address: 162 NW 106 Street Miami Shores, FL 33150 -1248 Project: <NONE> Contractor: MIAMI ROOFING SYSTEMS INC Permit Type: Roof Inspection Type: Final Roof Work Classification: Repair Roof Phone Number Parcel Number 1121360080060 Building Department Comments REPAIR ROOF Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. June 11, 2013 For Inspections please call: (305)762 -4949 Page 19 of 38 0)\'» 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 Permit Type: BUILDING JOB ADDRESS: 162 NW 106 Street City: FBC 20 Permit No. kF-if —�a4J a Master Permit No. Miami Shores County: Miami Dade zip: 33150 Folio/Parcel #: Is the Building Historically Designated: Yes NO X OWNER: Name (Fee Simple Titleholder): Claudio R. Cedrez & wife Elienay Address: 162 NW 106 Street Flood Zone: Phone #: 305 - 613 -9406 City: Miami Shores State: fl Zip: 33150 Tenant/Lessee Name: nia Phone #: Email: ccedrez @aol.com CONTRACTOR: Company Name: Miami Roofing Systems, Inc. Phone #: 305 - 754 -5554 Address: 667 NW 101 Street City: Miami ii State: FL Zip: 33150 Qualifier Name: --S vi e Y 2. Li v -I ne z_ Phone #: State Certification or Registration #: Certificate of Com etency #: Contact Phone #: 6.p.1 164 Email Address: (KaCirn i t 036 6 e,p r. k.n. C n DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ J, Square/Linear Footage of Work: Type of Work: ❑Addition DAlteration UNew X2epair/Replace Description of Work: Qp r /00 srpr- ❑Demolition Color thru tile: ******** ** * * **** ** ****** * * *** * ** * **** ** Fees******* * * * * ** * **: * ** ** * * * **** ** ** *** ** ***mix ** Submittal Fee $ Permit Fee $ 7Ce° CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 1 1 D 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 commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be a, proved end a reinspection fee will be charged. Signature / `I Si nature g — g caner o 4111k 4 ,/ Contractor i The foregoing instrument was acknowledged before me this M " The foregoing instrument was acknowledged before nme�this '� " " day of i , 20 0 , by �ICI�� i e cadre, day of SOW- , 20/3_, by -Savo e r e Mae o' 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. who is personally known to me or who has produced NOTARY PUBLIC: APPROVED BY NOTARY PUBLIC: Plans Examiner Zoning Structural Review Clerk (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) D , R A CERTIFICATE OF LIABILITY INSURANCE DA 12/10/2012 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 (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). PRODUCER FRANKCRUM INSURANCE AGENCY, INC. 100 S. MISSOURI AVE. CLEARWATER FL 33756 CONTACT NAME: (A/C, C No, E■q: 1- 800-277-1620 X4800 FAX , , No): 727- 797-0704 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC1/ INSURER A: FRANK WINSTON CRUM INSURANCE CO. 11600 INSURED FrankCrum 1 -800- 277 -1620 100 S MISSOURI AVENUE CLEARWATER FL 33756 INSURER B: INSURER 0: INSURER D: INSURER E: EACH OCCURRENCE INSURER F: $ COVERAGES CERTIFICATE NUMBER: 126609 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 POUCY NUMBER POLICY EFF - (MMIDDIYYYY) POLICY EXP (MM/DD/YYYY) OMITS GENERAL LIABILITY COMMERCIAL GENERAL UABIUTY _ EACH OCCURRENCE $ DAMAGE TO RENTED PREMISES (Ea occurrence) $ CLAIMS -MADE OCCUR MED EXP (My one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GENT. AGGREGATE LIMIT APPUES PER nPROJECT {LOC PRODUCTS - COMP/OP AGG $ --IPOUCY $ AUTOMOBILE UABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE UMIT (Ea accident) - _ $ BODILY INJURY (Par person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAE EXCESS UAB OCCUR CLAIMS-MADE EACH OCCURRENCE $ _ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yea, describe under DESCRIPTION OF OPERATIONS below N/A WC201300000 - 1/1/2013 1/1/2014 X TORY UMITS ER EL EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L DISEASE- POUCY UMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) THIS CERTIFICATE REMAINS IN EFFECT PROVIDED THE CLIENTS ACCOUNT IS IN GOOD STANDING WITH FrankCrum. COVERAGE IS NOT PROVIDED FOR ANY EMPLOYEE FOR WHICH THE CLIENT IS NOT REPORTING HOURS TO FrankCrum. COVERAGE IS NOT PROVIDED FOR STATUTORY EMPLOYEES OF THE CLIENT. EFFECTIVE 05/02/2005, APPLIES TO 100% OF THE EMPLOYEES OF FrankCrum LEASED TO MIAMI ROOFING SYSTEMS, INC. 305- 754 -5332 CERTIFICATE HOLDER CANCELLATION CITY OF MIAMI SHORES ATTN: BUILDING DEPT. 10050 NE 2ND AVE. MIAMI SHORES, FL 33138y.4:'"'„' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 01988 -2010 ACORD CORPORATION. All rights reserved. Jan 1513 09:35a QUALITY INSURANCE p.7 ACORD,,, CERTIFICATE OF LIABILITY INSURANCE DATEik48WDU/YYYY) 1/15/2013 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. QUALITY INSURANCE 8724 SW 72 ST MIAMI, FL 33173 (305) 595 -9191 INSURED MIAMI ROOFING SYSTEMS, INC 667 NW 101 STREET MIAMI, FL 33150 INSURERS AFFORDING COVERAGE NAIC# INSURER A: CANAL XNDEMNITY INSURANCE CO. INSURER R: INSURER C: INSURER D: INSURER E: COVERAGES 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 WfTH 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIL) CLAIMS. �aR TR �- rasen TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE DATE(MM/DD,YY1 POLICYIDCPIRATION DATE(MM/DD/YY) LIMITS A X GENERAL LIABILITY X I COMMERCIAL GENERAL LIABILITY 01/18/14 EACH OCCURRENCE $ 1,000,000 PREMISES SESVEa HEN I LB occu anus) $ 50,000 CLAIMSMADE ( OCCUR MED EXP ;Any one person) PERSONAL &AOVINJURY GENERAL AGGREGATE PRODUCTS - COMPtOP AGG $ 1,000 $ 1:000,000 $ 2,000,000 X iB /I DED 2500 GL100987 -02 01/18/13 X IP /D DED 2500 GENT AGGREGATE LIMIT APPUES PER: J POLICY SiGOj I I LOC S 1,00 0 , 00 0 AUTOMOBILE LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS COMBINED SINGLE LIMIT (Ea accident) $ BOOILYINJURY (Per person) r BODILY INJURY (Peraccitlent) -- $ PROPERTY DAMAGE (Peraccident} GARAGE LIABILITY AUTO ONLY- EAACCIDENT $ ANYAUTO OTHERTHAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY OCCUR I i CLAIMS MADE EACH OCCURRENCE S AGGREGATE $ $ DEDUCTIBLE 3 I RETENTION $ $ WORKERS COMPENSATIONAND EMPLOYERS LIASIUTY ANY PROPRIETOR/PARTNER'EXECUTIVE OFFICER/NEMBER E11CUUDED7 ifyes.desaibeunder SPECIAL PROVISIONS below j TRYLA ITS 1 IOER E.L EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE- POLICY LIMIT $ :SCRIPTICN OTHER OF OPERATIONS it nrATirmie rwuV-I ec rev", 1 l ,nwto r.,,a- ....., r.. ...-. —. _ -__. ERTIFICATE HOLDER CANCELLATION CITY OF MIAMI SHORES BUILDING DEPARTMENT 10050 NE 2 AVE. MIAMI SHORES, FL 33138 .FAX: (305) 756 -8972 1 :ORD25(2001f08) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO TH. FT, BUT F • RE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY REPRESENTATIVES. AUTHORIZED REPRESENTATIVE UPON THE .ER, ITS AGENTS OR ACORD CORPORATION 1988 546622 -2 BUSINESS NAME / LOCATION MIAMI ROOFING SYSTEMS INC 667 NW 101 ST 33150 UNIN DADE COUNTY THIS 1S NOT A BILL FIRST -CLASS U.S. POSTAGE t PAID MIAMI, FL PERMIT NO. 231 DO NOT PAY RENEWAL RECEIPT NO.- 570624-8 STATE# CCC058322 OWNER MIAMI ROOFING SYSTEMS INC Sec. Type of Business WORKER /S BUILDING CONTRACTOR 3 THIS Is O46A MCIALTY BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE HOLDER TO VIOLATE ANY EXISTING REGULATORY OR ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT EXEMPT THE HOLDER FROM ANY OTHER PERMIT OR UCENSE NNOTAC RTITIFICATION OFF THE HOLDER'S OUAUFICA- TIONS. PAYMENT RECEIVED CO LLECTOCTOER COUNTY TAX 07/13/2012 60000000447 000075.00 SEE OTHER SIDE DO NOT FORWARD MIAMI ROOFING SYSTEMS INC JAVIER MARTINEZ PRES 667 NW 101 ST MIAMI FL 33150 1111111111111111111111i11111$ 11111111111111111111111111M11 THIS DOCUMENT HAS A COLORED BACKGROUND • MICROPRINTING • LINEMARK DI LA AS REG UiRED KEN LAWSON SECRETARY 1 Miami Shores Village 1005} N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Project Address Parcel Number Applicant 53 NE 98 Street Miami Shores, FL 1132060131140 Block: Lot: ALINA VOGTNER Owner Information Address Phone Cell ALINA VOGTNER 53 98 Street MIAMI SHORES FL 33138- (954)452 -0110 11940 PICCADILLY Place DAVIE FL 33325- Contractor(s) ORONI INC Phone Cell Phone (305)685 -0412 Valuation: Total Sq Feet: $ 38,000.00 600 1 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: R3 Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Yes Certificate Date: Bond Retum : Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: REMODEL Classification: Residential KITCHEN AND MASTER Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Permit Fee Plan Revje , Fee (Engineer) ScanninRee Technol Fee 0 Total:.' Amount $22.80 $17.10 $17.10 $7.60 $200.00 $1,140.00 $60.00 $36.00 $30.40 $1,531.00 Pay Date Pay Type Invoice # RC -4 -13 -47500 04/26/2013 Check #: 1151 06/10/2013 Credit Card Amt Paid Amt Due $ 200.00 $ 1,331 00 $ 1,331.00 $ 0.00 Available Inspections: 1 Inspection Type: Fill Cells Columns Final PE Certification Window Door Attachment Framing Insulation Drywall Screw Window and Door Buck Review Planning Review Structural Review Structural Review Electrical Review Electrical Review Mechanical Review Mechanical Review Mechanical Review Building Review Building Review Plumbing Review Plumbing ry L.1 Finalce Copy ZO- Junall 0, 2013 NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. 4 MIAMI SHORES VILLAGE 10050 NE 2ND AVE MIAMI SHORES, EL 33138. (305) 795 -2207 Sale 75175372 10.'13 #: 497 mina Code; r; ID; 0610 1YC Ref #: 16:0, Ezp; Iltx Invoice #; MI $ 1915,51 , $ 01 $ 1915.58 s:Tee to aav above total amount ling to card issuer agreement ;._,t agreement if credit vouc, er) IGLESIAS JR/ORLANDO Merchant Coat/ • MIAMI SHORES VILLAGE REG 06-10-20131609 C07 MC 01 081283 1 BLDG. PERMIT $1, 1.[0 1 Ems. PERMIT $159.10 1 BLDG. PERMIT $241.14 1 per. PONT $244.34 TL $14 975 - i CHARGE $1,975.58 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 53 NE 98 Street Miami Shores, FL 1132060131140 Block: Lot: ALINA VOGTNER 1 Owner Information Address Phone Cell ALINA VOGTNER 53 98 Street MIAMI SHORES FL 33138- (954)452 -0110 1 11940 PICCADILLY Place DAVIE FL 33325- Contractor(s) ALL AIR SOLUTIONS INC Phone CeII Phone Tons: Additional Info: Classification: Residential Approved: In Review Comments: Date Denied: Scanning: 1 Date Approved: : In Review Type of Work: BATH EXHAUST FAN Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.25 $2.25 $0.20 $150.00 $3.00 $0.80 $159.10 Pay Date Pay Type Invoice # MC -5-13 -47812 06/10/2013 Credit Card Amt Paid Amt Due $159.10 $0.00\ Available Inspections: Inspection Type: Final Rough Duct Underground Finance Copy NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. June 10, 2013 4 1 Miami Shores Village 10056 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Protect Address Parcel Number Applicant 53 NE 98 Street Miami Shores, FL 1132060131140 Block: Lot: ALINA VOGTNER 11940 PICCADILLY Place DAVIE FL 33325- Contractor(s) A & C PORTELA PLUMBING Phone 305/343 -2115 Cell Phone Valuation: Total Sq Feet: $ 4,000.00 600 1 Type of Work: remodel kitchen and bath Type of Piping: Additional Info: Bond Retum : Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $2.40 $3.37 $3.37 $0.80 $225.00 $3.00 $3.20 $241.14 Pay Date Pay Type Invoice # PL -5-13 -47813 06/10/2013 Credit Card Amt Paid Amt Due $ 241.14 $ 0.00\ Available Inspections: Inspection Type: Top Out Final Underground Finance Copy NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. June 10, 2013 4 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 53 NE 98 Street Miami Shores, FL 1132060131140 Block: Lot: ALINA VOGTNER 1 Owner Information Address Phone CeII ALINA VOGTNER 53 98 Street MIAMI SHORES FL 33138- (954)452 -0110 11940 PICCADILLY Place DAVIE FL 33325- Contractor(s) Phone CeII Phone ATLANTIS ELECTRICAL CORP (305) 551 -4043 Valuation: Total Sq Feet: $ 6,000.00 600 1 Type of Work: RENOVATION Additional Info: Classification: Residential Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $3.60 $3.37 $3.37 $1.20 $225.00 $3.00 $4.80 $244.34 Pay Date Pay Type Amt Paid Amt Due Invoice # EL -5-13 -47811 06/10/2013. Credit Card $ 244.34 $ 0.00 Available Inspections: Inspection Type: 1 Finance Copy NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county. AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, STATE AGENCIES, OR FEDERAL AGENCIES. June 10, 2013 4 ROOF ASSEMBLES AND ROOFTOP STRUCTURES < r JUN 0 4 2013 Florida Building Code Ed High- Velocity Hurricane zone Uniform Permit itio Ap liat��i AL oA'■ CS Miami- Sh'. Village Proc -sq —_ Contractor's Name Job Address ❑ Low Slope ❑ Asphaltic Shingles T to COMPLIANCE STATE ANuCCU Rai ° ALL FEDERAL ❑ Mechanically Fastened Tile : Adlli a tfitU CATIONS ❑ Metal Panel /Shingles ❑ Wood Shingles /Shakes ❑ Prescriptive BUR -RAS 150 ROOF TYPE ❑ New Roof ❑ Reroofing ❑ Recovering Low Slope Roof Area (SF) ROOF SYSTEM INFORMATION Repair ❑ Maintenance Steep Sloped Roof Area (SF) 100 Total (SF) 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. momisimmmiummenemsrasiimmo II"IIEIiIj'III' t , FLORIDA BUILDING CODE — BUILDING ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 HIgh - Velocity Hurricane Zone Uniform Permit Application Form. Section C (Low Slope Application) Surfacing: Fill in specific roof assembly components and identify manufacturer (If a component is not used, identify as "NA ") System Manufacturer: Product Approval No.: 1 D ig 3 d Design Wind Pressures, From RAS 128 or Calculations: Pmax1: q . i Pmax2: Pmax3: l ' Max. Design Pressure, from the specific Product Approval system:..] Deck: Type: Gauge/Thickness: Slope: Anchor/Base Sheet & No. of PIy(s): Anchor/Base Sheet Fastener /Bonding Material: 014 1U 114 Insulation Base Layer: Base Insulation Size and Thickness: Base Insulation Fastener /Bonding Material: Top Insulation Layer: N / 4 ,l /1 r►- Top Insulation Size and Thickness: Top Insulation Fastener /Bonding Material: h I 10, Base Sheet(s) & No. of Piy(s):Pyl,1 04 }'a% Bs She t Fas)ener/ ondi g Ma erial: Ply Sheet(s) & No. of PIy(s): 1,-) / 4 Fastener Spacing for Anchor /Base Sheet Attachment: Field: (t' " oc @ Lap, # Rows , @ 4?' oc Perimeter: CO " oc @ Lap, # Rows Lt @� " oc Corner: " oc @ Lap, # Rows @ ",i)" oc Number of Fasteners Per Insulation Board: Field Perimeter k`it)- Corner frig 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 FT... Parapet Hecht._ . Ply Sheet Fastener /Bonding Material: Top Ply: 1. ') fi% J C (- /4.. ip J tJ Fes Top Ply Fastener /Bondi Material: —re KC-17-1 FLORIDA BUILDING CODE — BUILDING FT ~ r�tZ d[ 14 (mot Mean Roof Height MIAMI -D COUNTY ,;. DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Firestone Building Products Company, LLC 250 East 96th Street Indianapolis, IN 46240 -3702 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: Firestone Modified Bitumen Roof Systems 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 NOA revises NOA No.10- 1230.02 and consists of pages 1 through 41. The submitted documentation was reviewed by Jorge L. Acebo. MIAMI -DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 33175 -2474 T (786)315 -2590 F (786) 31525 -99 ttitivw.mian�idade.«uy /eI oieorn MIAMI•DADE COUNTY APPROVED NOA No.: 11- 0119.09 Expiration Date: 03/08/16 Approval Date: 05/02/13 Page 1 of 41 Membrane Type: Deck Type 1!: Deck Description: System Type E(3): APP Wood, Non - insulated 19 42' or greater plywood or wood plank Base sheet mechanically fastened. All General and -System - ;imitations apply. Base Sheet: Fastening #1: Fastening #2: Ply Sheet: Membrane: Surfacing: Maximum Design Pressure: One ply of Firestone MB Base or MB Base M mechanically fastened to the wood deck as described below: Base sheet shall be lapped 4" and fastened with Firestone All- Purpose fasteners with 3" Round Metal Plates 12" o.c. in the lap and two rows staggered in the center of the sheet 12" o.c. Base sheet shall be lapped 4" and fastened with approved roofing nails and tin caps 6" o.c. at the lap and two rows staggered in the center of the sheet 6" o.c. (Optional) One or more plies of Firestone MB Base, Ply IV, Ply IV (4) M, Ply VI or Ply VI-(6) M.piy sheet or other listed-base sheet applied-in a-full- mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs./sq.; or one ply Firestone APP 160-P torch applied. OR (Optional) One or more plies of Firestone SBS Glass Torch Base or SBS Poly Torch -Base torch - adhered, One ply of APP 180, APP 180 -P, APP 180 UltraWhite, APP 180 FR, APP 180 FR UltraWhite torch applied parallel to the base ply, with overlaps staggered 12 ". (Optional) Any coating, listed below, used as a surfacing, must be listed within a current NOA. Install one of the following: 1. Gravel or slag at 400 Tb. and 300 lb., respectively, set in a flood coat of type III or IV asphalt at 60 lb. /sq.. 2. Karnak No. 97, No. 97 AF or No. 169 at an application rate of 11/2 gal /sq.. —52.5 psf (See General Limitation #7) NOA No.: 11- 0119.09 Expiration Date: 03/08/16 Approval Date: 05/02/13 Page 34 of 41 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 lbs. /sq., 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 sidelap 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 lbs. /sq. 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 Engineer, 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 with 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 comers). 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.) 10. 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. END OF THIS ACCEPTANCE NOA No.: 11- 0119.09 Expiration Date: 03/08/16 Approval Date: 05/02/13 Page 41 of 41 SECTION 1524 HIGH VELOCITY HURRICANE ZONES- REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 Scope. As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with the required roofmg permit, 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 designated space 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) are not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the agreement between the owner and the contractor. 2. Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Building Code. (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 (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 owner provides the option of maintaining this appearance. 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 roo mg system is removed. Ponding conditions should be corrected. L6. 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 with the requirements of: Chapter 15 and 16 herein and the Florida Building Code, Plumbing. 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of the structural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. Exception: Attic spaces, designed by a Florida - licensed engineer or registered architect to eliminate the attic venting, venting shall not b requ' d. Owner's /Agent's Signature: Date: / Contractor's Signature: . , 1_ Permit Number: Property Address: