RF-12-2039Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 180832 Permit Number: RF -10 -12 -2039
Scheduled Inspection Date: May 06, 2013
Inspector: Bruhn, Norman
Owner: NIELSEN, TODD
Job Address: 9900 NE 13 Avenue
Miami Shores, FL 33138-
Project: <NONE>
Contractor: QUALITY ROOFING CONTRACTORS INC
Permit Type: Roof
Inspection Type: Final Roof
Work Classification: Tile /Flat
Phone Number
Parcel Number 1132050090130
Phone: (305)953 -3333
Building Department Comments
RE -ROOF TO A NEW COLORTRHU TILE ROOF AND FLAT
Infractio Passed Comments
INSPECTOR COMMENTS
False
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
May 06, 2013
For Inspections please call: (305)762 -4949
Page 8 of 48
F.I.E.
FLORIDA INTERNATIONAL ENGINEERING
&TESTING LAB
INSIGHT•INNOVATION•INTEGRATION
Florida International Engineering and Testing Lab LLC
16701 SW 117 Avenue, Miami, FL 33177
Telephone: (305) 378- 1991 -Fax: (305) 378 -1997
Miami -Dade Lab Certification # 07- 0612.11 -State of Florida ca #27273
Owner's Name:
Job Address:
co G70 N-
Roofing Contractor: 'Q.} A 1,
Permit Number ®'CZ. ' 9
SITE SPECIFIC INFORMATION
VLA
1—/Z•
12-
Type of Tile:
Approximate Roof Height: 2.4 feet Slope:
l Ladder
Type of Access to Roof:
OtherRequired Testing For e:J 35 lbs.
Date Installed: 3/5 / 13,
mom• I l� v �-Z
c+✓g. . I IVi td, I(I
St-}o 4sc,, r
Approximate Square Footage:
Testing Equipment: F. E. 1f0x Shimpo Instrument
Date of Inspection:
t( r)
TEST RESULTS
P= PASS, F= FAIL
Test
Location
P or F
Units or ft2
Test
Location
P or F
Test
Location
P or F
Test
Location
P or F
Test
Location
P or F
1
P A
{f O
21
p4,,,, 6
41
'
61
to*
;�
81
2
t'
22
•
42
.
62
1
82
3
23
43
63
83
4
24
44
64
84
5
25
45
65
85
6
26
46
66
86
7
27
47
67
87
8
28
48
68
88
9
29
49
69
89
10
30
:
50
70
90
11
31
51
71
91
12
32
52
72
92
13
33
53
73
93
14
34
54
74
94
15
•
35
55
75
95
16
36
56
76
96
17
37
57
77
97
18
38
58
78
98
"
19
39 ,
59
79
99
20
/
40• <.;
60
_
80
r
100
IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL TAS 106, THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST.
ADDITIONAL TEST INFORMATION
Perimeter Width: 3 ft
Area
Units or ft2
No. of Tests
Perimeter
'47+0
14:0
Field
24 Qe20
1
Corners
Hips & Ridges
{f O
RESPECTFULLY SUBMITTED BY:
V a V,
af (to
Vinayagar M. Balakrishnan V
State of Florida Lic # 63107
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‘o 1/2-- keA
DING
PERMIT APPLICATION
FBC 201c�
Permit Type: BUILDING i iOFING)
is i S . res Village
Building epartm t
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
OCT ft 5 NV
' ermit No. t�7 —"
Master Permit No. I�-- IZ-203q V
Owner 'sName(FeeSimpleTitleholder) Laura M. Rodriguez Phone# (305) 804 -8805
Owner's Address 9 9 0 0 N. E_. 1 3 th AvPn u P
City Miami Shores State F1 nri d Zip 33138
Tenant/Lessee Name Phone #
Email
Job Address (where the work is being done) 9900 • N . E . 13th Avenue
City Miami Shores Village _ County Miami -Dade
FOLIO /PARCEL# 1 1 -3205- 009 -01 30
Is Building Historically Designated YES
Zip 33138
NO
Contractor'sCompanyNamauality Roofinq Contractor
Contractor's Address 13800 N. W. 1 s t Avenue
City Miami
Qualifier Name Carlos Aocho
State Certificate or Registration No. RC 0 0 5 8 6 2 7
Contact Phone ( 305) 953 -3333
State
F
Flood Zone
Phone# ( 305) _ 953 -3333
la.
Zip 33168
Phone# (786) 367 -2029
Certificate of Competency No. 0 0 0 01 7 8 8 9
E -mail qualityro f1ngRR@yahnnr•nm
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ 28,000.00
Type of Work: []Addition ['Alteration
Describe Work: Reroof
roo .
• -
• •
Square / Linear Footage Of Work: 4 5 0 0 s g f t.
❑New ® Repair/Replace 500 tt. Flat
U Demolition
1.t
Submittal Fee $�� Permit Fee $ 'jam /"�- CCF $
Notary $ Training/Education Fee $
CO /CC $
Technology Fee $
Scanning $ Radon $ DP,: R $ Bond $
Double Fee $ Violation date: ( ,,
Total Fee Now ue $ �., %`P 'A .
Structural Review. $
�r
See Reverse side a
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 Fi FCTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDMONERS, ETC
OWNER'S AITADAVIT: 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 RECD "'' :.) A NOTICE OF
COMMENCEMENT MAY RESULT IN Y PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY, IF Y U INTEND TO OBTAIN
FINANCING, CONSULT WITH YOUR LENDER i R AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT."
Notice
promis
whose
for the
inspects
o Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
erty ' subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
on which occur ` seven (7) days after the building permit is issued- In the absence of such posted notice, the
i
oved and einspection fee will be charged.
Own ` or Agent
The foregoing instrument was acknowledged before me
day of Oct ,2O/ , by - id( k,z-,
who is personally known to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
Contractor
The foregoing instrument was acknowledged before me this ce7V
day of - • , 20 ha., by eAzio,r c)
who is persona y known to me or who has produced
as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
VOTARY PUBLIC -STATE OF FLORIDA
Print:
My Commission Expires.p,,,,,,, Marylou Hernandez NOTARYPLtSIIylou h erij 1711
ry My Commission Expir: Marylou Hernandez
Commission #DD930046 Commission #DD930046
Expires: OCT. 10, 2013 Expires: OCT. 10, 2013
BONDED THRU ATLA`TIC BONDL* G CO., INC BONDED THRU ATLANTIC BONDING CO., INC
#*** *dta4�YaY�Y•haY�rrotedeotr***Y�Y �kcZYTHiaUitAieYJ e:**C1dek�YaYkk 4e�Y�Y******* k**** aksY**** aY1k*a***k*** k4c********k dcvY, Y9roY4cdeoYaY*** ***dc*aYdr3***
APPROVED BY
91/1_, Plans Examiner
Engineer
(Revised 07 /10 /07XRevised 06/10/2009)
Zoning
Clerk checked
SECTION R4402.13
HIGH VELOCITY HURRICANE ZONES — REQUIRED OWNERS NOTIFICATION FOR R FING
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.
Additi ally, the following items should be addressed as part of the agreement between the owner ant the
contra s_• 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
p • ding 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
h as color or architectural appearance, that are not part of a zoning code, should be addressed as part of
ement between the owner and the contractor.
2. i` Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be
tliiled in accordance with the current provisions of Section R4403. (The roof deck is usually concealed prior
t . mo 'ng the existing roof system).
3. 1 Common roofs: Common roofs are those which have no visible delineation between neighboring
,i s (i.e., townhouses, condominiums, etc.) In buildings with common roofs, the roofing contractor and/or
i J ,°er .hould notify the occupants of adjacent units of roofing to be performed.
1 Exposed Ceiling: Exposed, open beam ceilings are where the underside of the roof decking can
7 viewed from below. The owner may wish to maintain the architectural appearance; therefore, roofing nail
enetration of the underside of the decking may not be acceptable. This provides the option of maintaining the
arance.
Ponding water. The current roof system and /or deck of the building may not drain well and may
use water to pond (accumulate) in low-lying areas of the roof. Pounding can be an indication of structural
di tress and may require the review of a professional structural engineer. Pounding may shorten the life
pectancy and performance of the new roofing system. Pounding conditions may not be evident until the
nal roofing system is removed. Pounding conditions should be corrected.
Overflow scuppers (wall outlets): It is required that rainwater flows off so that the roof is not
rloaded from a buildup of water. Perimeter /edge wall or other roof extension may block this discharge if
ow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in
rdance with-the requirements of Sections R4402, R4403 and R4413.
Ventilation: Most roof structures should have some ability to vent natural airflow through the
r of the structure assembly (the building itself). The existing amount of attic ventilation shall not be
ay be beneficial to consider additional venting which can result in extending the service life of the
07.141( /— L��� -G L ey /V f
Contractor Signature Date
Revised on 7/9/2009 LD
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
n C �L iel
3y /off "�
Florida Budding Code Edition 20'V- + ° r
Nami �tio-,
High Velocity Hurricane Zone Uniform Permit Ap uxtion form.
Section A (General Infornaatic BY
Master Permit No.
Contractor's Name Quality Roofing Contractor
Job Address 9900 N.E. 13th Avenue
ROOF CATEGORY
❑ Mechanically Fastened Tile
❑ Asphaltic Shingles ❑ Metal Panel/Shingles
❑ Prescriptive BUR -RAS 150
ROOF TYPE
❑ New Roof XX Reroofing ❑ Recovering
ti Low Slope
ROOF SYSTEM
INFORMATION
Inc.
DATE
EDERAL
STATE ANU CC IJN','f RULES AND REGULATIONS
ISJ Mortar /Adhesive Set Tile
0 Wood Shingles/Shakes
❑ Repair ❑ Maintenance
Low Slope Roof Area (SF) 5 0 0 s g f t Steep Sloped Roof Area (SF$ 5 0 0 s g f t Total (SF)5 0 0 0 s g f t.
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.
■ ■■ M IMIZI■■■■■ ■■■■■ ■ ■■■■■■
■ ■Li-- ■ ■= ■ ■ ■ ■ ■ ■ ■ ■ ■■ ■ ■ ■ ■ ■■
■■■ri■11■■ ■■■■■■ ■■■■■■■ ■ ■■
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■1■■ ■1' ■ ■ ■,u■uu11■■ ■�■
■■i■■ ■r ■ ■■■ ■■■2111 ■'
■■hip■ ■■1i! /■ ■ ■■ ■■■■■■ ■• %■I■ u
■ ■111■ ■ ■1 /I■ ■■ ■ ■■ ■■■■■■% ■ ■IUS
■ ■Ill
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INIFINIMM1111111111111111111111111111111111111111111111111E1111111
■ ■■■■■ir ■■ :l ■ir•■l■■■ ■■■
15.34 2010 FLORIDA BUILDING CODE — BUILDING
ROOF ASSEMBLIES ARID ROOFTOP STRUCTURES
15.36
Florida Building Code Ed°Ition 2010
High - Velocity Hurricane Zone Uniform Permit Application Form.
Section D (Steep Sloped Roof System)
Roof System Manufacturer: Hanson Roof Tile
Notice of Acceptance Number: 10-0706.07
Minimum Design Wind Pressures, If Applicable (From RAS 127 or
Calculations:
1: -39.1 P2: -68.1 P3: -100.7
Roof Slope:
3 : 12
Steep Sloped Roof System Description
Deck Type:
wood 1 X 6
Type Underlayment:
Ridge Ventilation?
Insulation:
(1) 301b. ASTM D -226
N/A
Fire Barrier:
Mean Roof Height 18 '
N/A
Fastener Type & Spacing:
Adhesive Type:
6110/c
1 1/4" R/S nails 2 rows
self adhering
Type Cap Sheet:
Polystick TU Plus
Roof Covering:
Hanson Hacienda Doubl
Type & Size
Drip Edge:
3 X 3 26 ga.
galv.
@ 1
12
e rr
2010 FLORIDA BUILDING CODE — BUILDING
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
Florida Building Code Edition 2010
High - Velocity Hurricane Zone Uniform Permit Application Form.
Section C (Low Slope Application)
FIU in specific roof assembly components
and identify manufacturer
(If a component is not used, identify as "NA")
System Manefacturer: CAF Material Corporation
Product Approval No. 07- 1219.09
Design Wind Pressures, From RAS 128 or Calculations:
P1: -42.8 P2: -71.7 p3: -108.0
Max. Design Pressure, from the specific Product
Approval system:
Deck mod
Type:
Gauge/Thickness. 1 X 6
Slope: .5
Anchor/Base Sheet & No. of Ply(s): N/A
Anchor/Base Sheet Fastener/Bondi Material:
N/A
Insulation Base Layer: .
Base insulation Size and 'thickness: N/A
N/A
Base insulation Fastener/Bonding Material:
Top insulation Layer: N/A
Top insulation Size and Thickness: N/A
Top Insulation Fastener/Bonding
Matrg.
Base Sheet(s) & No. of Ply(s):. (1) #75 Base
•
Sh 1 1 / 4" Fastener/Bonding Material:
Ply Sheet(s) & No. of Piy(s): (2) Plies of plv lv
Mar 1 tene pincl aasphalt:
Top ply:GAF Mineral Cap sheet
ToQPty Fad =Aping t
2010 FLORIDA BUILDING CODE —BUILDING
surfacing: N/A
Fastener Spacing for Anchor/Base Sheet Attachment
Field: 9 ° oc @ Lap, # Rows 2 0 9 ' oc
Perimeter. 6 . oc C# Lap,* Rows 4 f# 6 " oc
Corner. 6 " oc 0 Lap,* Rows 4 e 6 ° oc
Number of Fasteners Per insulation Board:
Field N/A
Perimeter N/A Cow N/A
Illustrate Components Noted and Details as
Applicable:
Woodblocking, Gutter, Edge Termination, Stripping,
Flashing, Continuous Cleat, Cant Strip, Base Flashing,
Counter Flashing, Coping, Etc.
lndlcate: Mean Ftdof Height, Parapet Height, Height of
Base Flashing, Component Material, Material Thickness,
Fastener_Type, Fastener Spacing or Submit Manufactur-
ers Details that Comply ri RAS 111 and Chapter 16
or
vFT.
;1i"
Parapet
Height
Il'
Mean
Roof
Height
15.35
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
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 or2. Compare the values for Mr with the values from Mf. If the Mf values are greater than or
equal to the Mr values, for each area of the roof, then the tile attachment method is acceptable.
Method 1 Moment Based Tile Calculations Per RAS 127"
(P1.-39-1 x ?289 _ =11 _30) - Mg 6.80 = mil 4.50 Product Approval Mf 86.61
(P2: -68.1 x a ,289 =19.68) - Mg: 6.80 = v 12.88 ProductApprowal Mf 86.61
(p3: 100.'& a .289 = 29.10) _ Mg; 6.80 =ma 22.30 Product Approval Mt. 86.61
Method 2 "Simplified 15ie Calculations Per Table Below"
Required Moment of Resistance (Mr) From Table Below Product Approval Mg
Mr required Moment Resistance*
Mean Roof Height -►
Roof Slope 4
15'
20'
25'
30'
40'
2:12
34.4
36.5
38.2
39.7 •
422
3:12
32.2
34.4
36.0
37.4
39.8
4:12
30.4
32.2
33.8
35.1
37.3
5:12
28.4
30.1
31.6
32.8
34.9
6:12
26.4
28.0
29.4
30.5
32.4
7:12
24.4
25.9
27.1
28.2
30.0
*Must be used in conjunction with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals.
For Uplift based tile systems use Method 3. Compared the values for F with the values for Fr. If theF values are greater than or equal to the F,. values,
for each area of the roof, then the tile attachment method is acceptable.
Method 3 "Uplift Based Tile Calculations Per RAS 127"
(P1• x L = x w:= ) - W: x cos 0 = Frl Product Approval F
(P2: x L = x w: _ ) - W: x cos 0 = Fi2 Product Approval F
(P3: x L = x w: = ) - W: x cos 0 = Fri Product Approval F
Where to Obtain Information
Description
Symbol
Where to find
Design Pressure
PI or P2 or P3
RAS 127 Table 1 orby an engineering analysisprepared by PE based on ASCE7
Mean Roof Height
H
Job Site
Roof Slope
0
Job Site
Aerodynamic Multiplier
R
Product Approval
Restoring Moment due to Gravity
Mg
Product Approval
Attachment Resistance
Mf
Product Approval
Required Moment Resistance
Mg
Calculated
Minimum Attachment Resistance
P'
Product Approval
Required Uplift Resistance
Fr
Calculated
Average Tile Weight
W
Product Approval
Tile Dimensions
length
W
Product Approval
All calculations must be submitted to the bolding official at the time of permit application.
2010 FLORIDA BUILDING CODE - BUILDING 15.37
PR1AP�1
COUNTY
BUILDING CODE COMPLIANCE OFFICE (BCCO)
PRODUCT CONTROL DIVISION
MIAMJ -DADE COUNTY, FLORIDA
METRO -DADE FLAGLER BUILDING
140 WEST FLAGLER STREET, SUITE 1603
MIAMI, FLORIDA 33130 -1563
(305) 375-2901 FAX (305) 375 -2908
NOTICE OF ACCEPTANCE (NOA)
Hanson Roof Tile
1340 SW 34th Ave
Deerfield Beach, FL 33442
SCOPE:
This NOA is being issued under the applicable rules and regulations governing the use of construction
materials The documentation submitted has been reviewed by Miami -Dade County Product Control
Division and accepted by the Board of Rules and Appeals (BORA) to be used in Miami Dade County
and other areas where allowed by the Authority Having Jurisdiction (AHJ).
This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product
Control Division (In Miami Dade County) 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. BORA reserves the right to revoke this acceptance, if it is determined by Miami -Dade
County Product Control Division that this product or material fails to meet the requirements of the
applicable building code.
This product is approved as described herein, and has been designed to comply with the Florida Building
Code including the High Velocity Hurricane Zone of the Florida uildung Code.
DESCRIPTION: Hanson Hacienda Double Roll Roof Tile
LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state
and following statement "Miami Dade County Product Control Approved ", unless otherwise noted
herein
RENEWAL of this NOA shall be considered after a renewal application has been filed and there has
been no change in the applicable building code negatively affecting the performance of this product.
TERMINATION of this NOA will occur after the expiration date or if there has been a revision or
change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an
endorsement of any product, for sales, advertising or any other purposes shall automatically terminate
this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of
NOA.
ADVERTISEMENT:. The NOA number preceded by the words Miami -Dade County, Florida, and
followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is
displayed, then it shall be done in its entirety.
INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its
distributors and shall be available for inspection at the job site at the request of the Building Official.
This revises NOA No. 09- 0928.03 and consists of pages 1 through 6.
The submitted documentation was reviewed by Alex Tigera.
GITI 1.471•7•11
APPROVEDI
NOA No.: 10-0706.07
Expiration Date: 12/16/12
Approval Date: 09/15/10
Page 1 of 6
ROOFING ASSEMBLY APPROVAL
Category:
Sub Category:
Material:
Roofing
Roofing Tile
Concrete
1. SCOPE
This approves a roofing system using Hanson Hacienda Roof Tile, as manufactured by
Hanson Roof Tile in Hobe Sowz4 Florida and as described in Section 2 of this Notice of
Acceptance. For the locations where the pressure requirements, do not exceed the values
listed in section 4 herein. The attachment calculations shall be done as a moment based
system.
2. PRODUCT DESCRIPTION
Manufactured by
Applicant Dimensions
Length: 171/4"
Hanson "Hacienda" Width: 13"
'A" thick
Trim Pieces
Length: varies
Width: varies
Varying thickness
2.1 EVIDENCE SUBMITTED
Test Agency
Redland Technologies
Professional Service
Industries, Inc.
The Center for Applied
Engineering, Inc.
Test
Specifications
Test Identifiier
7161 -03
7161 -03
7161 -03
P0402
TAS 112
TAS 112
P0631 -01
Letter Dated Aug. 1, 1994
224 -47099
94-060B
94-084
25- 7094 -1
25- 7094 -7
25- 7094 -4
Product
Description
Low profile, interlocking, extruded concrete
roof tile equipped with two nail hole and
double roll ribs. For direct deck or battened
nail -on, mortar or adhesive set applications.
Accessory trim, concrete roof pieces for use
at hips, rakes, ridges and valley terminations.
Manufactured for each tile profile.
Test Name/Report
PA 102
PA 102(A)
PA 108
Withdrawal Resistance Testing of
screw vs. smooth shank nails
PA 108
PA 108
Date
Dec. 1991
Dec. 1991
Dec. 1991
Sept. 1993
July 1994
Aug. 1994
PA 112 Sept 1994
PA 101
PA 101
PA 102
PA 102
PA 102
March, 1994
May 1994
Oct. 1994
Oct. 1994
Oct. 1994
NOA No.: 10-0706.07
Expiration Date: 12/16/12
Approval Date: 09/15/10
Page 2 of 6
Test Aaencv,
Celotex Coiy°rai,ion
Testing Services
Walker Engineering, Inc.
IBA Consultants, Inc.
3. LIMITATIONS
Test Identifier
Test Name/Report Date
Project No. 307025 PA 100 Oct. 1994
Test #MDC -76
25- 7183 -1 PA 102
25- 7183 -2 PA 102
25- 7214 -2 PA 102
25- 7214 -6 PA 102
528454 -2 -1
520109 -2
Calculations
2381 -249
PA 101
Feb. 1995
Feb. 1995
March, 1995
March, 1995
Sep. 1998
Dec. 1998
Aerodynamic Multiplier March 1999
TAS 112 09/20/07
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 inay be 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 Hanson `Hacienda' Roof Tile and its components shall be installed in strict compliance with
Roofing Application Standard RAS 118, 119, & 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)
Hanson Hacienda
10.0
1.4375
1.08
NOA No.: 10-0706.07
Expiration Date: 12/16/12
Approval Date: 09/15/10
Page 3 of 6
Hacienda Tile
Tile ( ) A ()
Profile Batten Application Direct Deck Application
0.267 0.289
Table 2: Aerodynamic Multipliers - A (f e)
11
Tile
Profile
Hanson
Hacienda
Tile
Table 3: Restoring Moments due to Gravity - MA (ft-Ibf)
3 ":12" 5 ": 12"
Battens
5.92
Direct
Deck
6.80
4 ": 12"
Battens Direct
Deck
5.82 6.69
6": 12"
Battens Direct
Deck
5.70 6.55
Tile
Profile
Hanson
Hacienda
Tile
Battens Direct
Deck
5.56 6.39
7": 12" or
greater
Battens Direct
Deck
5.41 6.22
Table 4: Attachment Resistance Expressed as a Moment - Mf (ft-lbf)
For Nail -On Systems
Fastener Type
2-10d Ring Shank
Nails
1 -10d Smooth or
Screw Shank Nail
Direct Deck
(Min 15/32"
plywood)
Direct Deck
(Min. 19/32"
plywood)
Battens
27.8
37.4
28.8
2 -10d Smooth or
Screw Shank Nails
1 #8 Screw
2 #8 Screw
8.8
11.8
4.1
16.4
21.9
7.1
25.8
25.8
1 -10d Smooth or
Screw Shank Nail
(Field Clip)
1 -10d Smooth or
Screw Shank Nail
(Eave Clip)
47.1
47.1
24.3
24.3
22.9
49.1
24.2
2 -10d Smooth or
Screw Shank Nails
(Field Clip)
2 -10d Smooth or
Screw Shank Nails
(Eave Clip)
19.0
19.0
22.1
35.5
35.5
34.8
31.9
31.9
32.2
2 -10d Ring Shank 1 43,0
Nails'
67.5 50.9
1 Installation with a 4" tile headlap and fasteners are located a min. of 2W from head of tile.
NOA No.: 10-0706.07
Expiration Date: 12/16112
Approval Date: 09/15/10
Page 4 of 6
Ta
le 5: Attachment Rest nce < :.areseed as a Moment Mf (ft-ibf)
F . r Two Patty Adhesiive Set Systems
Profile
Tile
pplicatiou
Hanson Hacienda Tile
Adhesive
Minimum Attachment
Resistance
26.1'
2 See manufactures corn, nent approval for installation requirements.
3 Flexible Products Company TileBond Average weight per patty 11.4 grams.
Polyfoam Product, inc. Average weight per patty 8 grams.
Table 5: chment Resistance Expressed as a Moment - Mt (ft-113f)
For Single Patty Adhesive Set Systems
The Application
Tole
Profile
Minimum Attachment
Resistance
Hanson ! acienda Tile
Polyfoam PolyProTe
86.614
Polyfoam PolyProTh4
4 Large paddy placement of 54grams of PoiyPron".
5 Medium paddy placement of 24grams of PolyPro/v.
45.53
Table 7: chment €- kesistance Expressed as a Moment
For M , r r Set Systems
- Mi (ft-ibf)
Tile
rofale
Hanson Hacienda Tile
Tile
Application
Mortar Set'
Attachment
Resistance
20.60
5. LABELING
All tiles s" 11 bear the imprint or identifiable marking of a manufacturer's name or logo
(See !1?. tail Below), or following statement "Miami -Dade County Product Control Approved ".
a
son
S i:l CENDA i OF TELE
TELL ENTIFICATION MARX (LOCATED N UNDERSIDE OF TILE)
UIIL ING PERMIT REQUIRE ` 1 NTS
6.1 Application for baiiilding permit 0(211 be accompanied by copies of the following.
6.1.1 This Notice of Acceptance.
6.1.2 Any other documents required by the ! uilding Official or applicable
building code in order to properly evaluate the installation of this
system.
' ^PP OVED,,
:iA
NOA No.: 10-0706.07
Expiration Date: 12/16/12
Approval Date: 09/15/10
Page 5 of 6
FASTENER HOLES
OFIL,E DRAWINGS
OVERLOCK
UNDERLOCK
HANSON HACIENDA CONCRETE ROOF TILE
E OF `:1 S ACCEPTANCE
NOA No.: 10- 0706.07
Expiration Date: 12/16/12
Approval Date: 09/15/10
Page 6 of 6
A
DEPARTMENT OF PERMITTING, ENVIRONMENT, AND REGULATORY AFFAIRS (PERA)
BOARD AND CODE ADMINISTRATION DIVISION
NOTICE OF ACCEPTANCE (NOA)
MIAMI -DADE COUNTY
PRODUCT CONTROL SECTION
11805 SW 26 Street, Room 208
Miami, Florida 33175 -2474
T (786) 315 -2590 F (786) 315 -2599
w.miamidade.aov /aura
Polyglass USA Inc.
150 Lyon Drive
Fernley, NV 89408
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 Polystick Underlayments
LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following
statement: "Miami -Dade County Product Control Approved ", unless otherwise noted herein.
RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no
change in the applicable building code negatively affecting the performance of this product.
TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the
materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product,
for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any
section of this NOA shall be cause for termination and removal of NOA.
ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the
expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be
done in its entirety.
INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and
shall be available for inspection at the job site at the request of the Building Official.
This revises NOA # 11- 0601.10 and consists of pages 1 through 8
The submitted documentation was reviewed by Alex Tigera.
NOA No.: 11- 1229.01
Expiration Date: 09/13/16
Approval Date: 04 /05/12
Page 1 of 8
ROOFING COMPONENT APPROVAL
Category:
Sub- Category:
Material:
Roofing
Underlayment
SBS , APP Self- Adhering Modified Bitumen
PRODUCTS DESCRIPTION:
Product
Polystick MTS
underlayment
Manufacturing Location
#2
Polystick 1R-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/$"
60 mils thick
Roll:
65' x 3'33/$"
Or 65'x 3'
60 mils thick
. Roll:
32'10" x 3'3 -3/$"
100 mils thick
Roll:
65'.x 3'33/8"
80 mils thick
Roll:
32' 10" x 3'33/8"
130 mils thick
Roll:
61' x 3'33/8"
60 mils thick
Roll:
61' x 3'33/8"
60 mils thick
Test Product
Specification Description
TAS 103 A homogeneous, rubberized asphalt
waterproofing membrane, glass fiber reinforced
with polyolefinic film on the upper surface for
use as an underlayment for metal roofing, roof
tile, slate tiles and shingle underlayment.
TAS 103 and A fine granular /sand top surface self- adhering,
ASTM D 1970 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.
TAS 103 and A heavy granuled surface self adhering, APP
ASTM D 1970 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.
TAS 103 and A rubberized asphalt self - adhering, glass -
ASTM D 1970 fiber /polyester reinforced waterproofing
membrane. Designed as a metal roofing and roof
tile underlayment.
TAS 103 and
ASTM D 1970
TAS 103 and
ASTM D 1970
TAS 103 and
ASTM D 1970
A rubberized asphalt waterproofing membrane,
glass- fiber /polyester reinforced, with a granular
surface designed for use as a tile roof
underlayment.
A rubberized asphalt self-adhering, glass -
fiber /polyester reinforced waterproofing
membrane. Designed as a metal roofing and roof
tile underlayment.
A rubberized asphalt self-adhering, glass -
fiber /polyester reinforced waterproofing
membrane. Designed as a metal roofing and
roof tile underlayment.
NOA No.: 11- 1229.01
Expiration Date: 09/13/16
Approval Date: 04/05/12
Page 2 of 8
MANUFACTURING PLANTS:
1. Haze1ton, PA
2. Winter Haven, FL
EVIDENCE SUBMITTED:
Test Aaencv
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
Date
04/27/01
08/14/01
08/29/05
08/29/07
12/04/08
04/13/09
07/01/10
03/02/11
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 11 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 eave, rolling the membrane to obtain maximum contact.
Remove the release film as the membrane is applied. . All side laps shall be a minimum of 3 - %z" 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.
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 Limitations (days)
_
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 1R-Xe, and Dual Pro are limited to mechanically
fastened roof tile applications. Polystick MTS is limited to mechanically fastened with battens roof file
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 Polyglass' Tile loading detail below for loading procedure for all
underlayments except Polystick MTS which shall be loaded onto battens.
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.
;APPROVEDi
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 421 Mod Bit Flashing Adhesive Trowel
Grade mastic, applied in between the application of the lap. The use of mastic between the laps does not apply
to Polystick MTS.
5. A maximum of 6 tiles per stack are allowed when loading tile on the underlayments. Refer to the Polyglass
Tile Loading Guidelines. See General Limitations #9 and #10.
6. Battens and/or Counter - battens, as required by the tile manufacturers NOA's, must be used on all projects for
pitch/slopes of 7 "/12" or greater. It is suggested that on pitch/slopes in excess of 6'/a "/12 ", precautions
should be taken, such as the use of battens to prevent tile sliding during the loading process.
7. Minimum cure time after membrane installation & before loading of roofing tiles is Forty-Eight (48) Hours.
8. Polystick membranes may not be used in any exposed application such as crickets, exposed valleys, or
exposed roof to wall details.
9. Repair of Polystick membranes is to be accomplished by applying Polyglass Polyplus 55 Premium Modified
Flashing Cement, Polyglass Polyplus 50 Premium MB Flashing Cement, Polyglass PG500 MB Flashing
Cement, Mule -Hide 241 Premium Modified Flashing Cement, Mule -Hide 251 Premium Wet/Dry Elastomeric
Flashing Cement, or Mule -Hide 421 Mod Bit Flashing Adhesive Trowel Grade mastic to the area in need of
repair, followed by a patch of the Polystick material of like kind should be set and hand rolled in place over
the area needing such repair. Patching membrane shall be a minimum of 6 inches in either direction. The
repair should be installed in such a way so that water will run parallel to or over the top of all laps of the
patch.
10. All self - adhered membranes must be rolled to ensure full contact with approved substrates. Polyglass
requires a minimum of 40 lbs for a weighted roller for the rolling of the field membrane. Hand rollers are
acceptable for rolling of patches or small areas of the roof. Brooming may be used where slope prohibits
rolling.
11. All approved substrates should be dry, clean and properly prepared, before any application of Polystick
membranes commences. An approved substrate technical bulletin can be furnished upon request. It is
recommended to refer to applicable building codes prior to installation to verify acceptable substrates.
12. The Polyglass Miami -Dade Notice of Acceptance (NOA) approval for Polystick membranes and
PolyProtector UDL can be furnished upon request by our Technical Services Department by calling 1 (800)
894 -4563.
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
DEPARTMENT OF PERMITTING, ENVIRONMENT, AND REGULATORY AFFAIRS (PERA)
BOARD AND CODE ADMINISTRATION DIVISION
NOTICE OF ACCEPTANCE (NOA)
MIAMI -DADE COUNTY
PRODUCT CONTROL SECTION
11805 SW 26 Street, Room 208
Miami, Florida 33175 -2474
T (786) 315 -2590 F (786) 315 -2599
www.miamidade.Eov /oera
3M Company
3M Center Building 0220- 05 -E-06
St. Paul, MN. 55144 -1000
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 AIIJ 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: 3MTM 2- Component Foam Roof Tile Adhesive AH -160
LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following
statement: "Miami -Dade County Product Control Approved ", unless otherwise noted herein.
RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change
in the applicable building code negatively affecting the performance of this product.
TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the
materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for
sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of
this NOA shall be cause for termination and removal of NOA.
ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the
expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done
in its entirety.
INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and
shall be available for inspection at the job site at the request of the Building Official.
This renews and revises NOA# 11- 0124.04 and consists of pages 1 through 7.
The submitted documentation was reviewed by Alex Tigera.
NOA No.: 12- 0228.18
Expiration Date: 05/10/17
Approval Date: 05 /10/12
Page 1 of 7
ROOFING COMPONENT APPROVAL:
Category:
Sub Category:
Materials:
Roofing
Roof tile adhesive
Polyurethane
SCOPE:
This approves 3M 2- Component Foam Roof Tile Adhesive AH -160 as manufactured by 3M Company as
described in Section 2 of this Notice of Acceptance. For the locations where the design pressure requirements, as
determined by applicable building code, does not exceed the design pressure values obtained by calculations in
compliance with Roofing Application Standard RAS 127, for use with approved flat, low, and high profile roof tiles
system using 2- Component Foam Roof Tile Adhesive AH -160. Where the attachment calculations are done as a
moment based system for single patty placement, and as an uplift based system for double patty systems
PRODUCTS MANUFACTURED BY APPLICANT:
Product Dimensions Test Product Description
Specifications
3MTM 2- Component Foam N/A TAS 101 Two component polyurethane foam adhesive
Roof Tile Adhesive AH-
160
Foam Dispenser RTF 1000 . N/A Dispensing Equipment
ProPack® 30 & 100 N/A Dispensing Equipment
PRODUCTS MANUFACTURED BY OTHERS:
Any Miami -Dade County Product Control Accepted Roof Tile Assembly having a current NOA which list moment
resistance values with the use of 2- Component Foam Roof Tile Adhesive AH -160
roof tile adhesive.
MANUFACTURING LOCATION:
1. Tomball, TX.
PHYSICAL PROPERTIES:
Property,
Density
Compressive Strength
Tensile Strength
Water Absorption
Moisture Vapor Transmission
Dimensional Stability
Closed Cell Content
Test
ASTM D 1622
ASTM D 1621
ASTM D 1623
ASTM D 2127
ASTM E 96
ASTM D 2126
ASTM D 2856
Results
1.6 lbs. /ft.3
18 PSI Parallel to rise
12 PSI Perpendicular to rise
28 PSI Parallel to rise
0.08 Lbs./Ft2
3.1 Perm /Inch
+0.07% Volume Change @ -40° F., 2 weeks
+6.0% Volume Change @158°F., 100% Humidity, 2
weeks
86%
NOA No.: 12- 0228.18
Expiration Date: 05/10/17
Approval Date: 05/10/12
Page 2 of 7
Note: The physical properties listed above are presented as typical average values as determined
by accepted ASTM test methods and are subject to normal manufacturing variation.
EVIDENCE SUBMITTED:
Test Agency Test Identifier Test Name/Report Date
Center for Applied Engineering #94 -060 TAS 101 04/08/94
257818 -1PA TAS 101 12/16/96
25- 7438 -3 SSTD 11 -93 10/25/95
25- 7438 -4
25- 7438 -7 SSTD 11 -93 11/02/95
25 -7492 SSTD 11 -93 12/12/95
Miles Laboratories NB- 589 -631 ASTM D 1623 02/01/94
Polymers Division
Ramtech Laboratories, Inc. 9637 -92 ASTM E 108 04/30/93
Southwest Research Institute 01- 6743 -011 ASTM E 108 11/16/94
01- 6739 -062b[1] ASTM E 84 01/16/95
Trinity Engineering 7050.02.96 -1 TAS 114 03/14/96
Celotex Corp. Testing Services 528454 -2 -1 TAS 101 10/23/98
528454 -9 -1
528454 -10 -1
520109 -1 TAS 101 12/28/98
520109 -2
520109 -3
520109 -6
520109 -7
520191 -1 TAS 101 03/02/99
520109 -2 -1
LIMITATIONS:
1. Fire classification is not part of this acceptance. Refer to the Prepared Roof Tile Assembly for fire rating.
2. 3MTM 2- Component Foam Roof Tile Adhesive AH -160 shall solely be used with flat, low, & high tile profiles.
3. Minimum underlayment shall be in compliance with the Roofing Application Standard RAS 120.
4. Roof Tile manufactures acquiring acceptance for the use of 3MTM 2- Component Foam Roof Tile Adhesive AH-
160 roof tile adhesive with their tile assemblies shall test in accordance with TAS 101.
5. Roof Tile manufactures acquiring acceptance for the use of HANDI -STICK roof tile adhesive with their tile
assemblies shall test in accordance with TAS 101 with section 10.4 as modified herein.
1 t
F -W
F'- \2j
MS
NOA No.: 12- 0228.18
Expiration Date: 05/10/17
Approval Date: 05/10/12
Page 3 of 7
INSTALLATION:
1. 3MTM 2- Component Foam Roof Tile Adhesive AH -160 may be used with any roof tile assembly having a current
NOA that lists uplift resistance values with the use of 3MTM 2- Component Foam Roof Tile Adhesive AH -160.
2. 3MTM 2- Component Foam Roof Tile Adhesive AH -160 shall be applied in compliance with the Component
Application section and the corresponding Placement Details noted herein. The roof tile assembly's adhesive
attachment with the use of 3MTM 2- Component Foam Roof Tile Adhesive AH -160 shall provide sufficient
attachment resistance, expressed as an uplift based system, to meet or exceed the uplift resistance determined in
compliance with Miami -Dade County Roofing Application Standards RAS 127. The adhesive attachment data is
noted in the roof tile assembly NOA.
3. 3M111 2- Component Foam Roof Tile Adhesive AH -160 and its components shall be installed in accordance with
Roofing Application Standard RAS 120, and 3M Company's 3MTM 2- Component Foam Roof Tile Adhesive AH-
160 Operating Instruction and Maintenance Booklet.
4. Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by 3M Company. 3M
Company shall supply a list of approved applicators to the authority having jurisdiction.
5. Calibration of the Foam Dispenser RTF1000 dispensing equipment is required before application of any adhesive.
The mix ratio between the "A" component and the "B" component shall be maintained between 1.0 -1.15 (A): 1.0
(B). The dispense timer shall be set to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No
other settings shall be approved.
6. 3MTM 2- Component Foam Roof Tile Adhesive AH-160 shall be applied with Foam Dispenser RTF 1000 or
ProPack® 30 & 100 dispensing equipment only.
7. 3MTM 2- Component Foam Roof Tile Adhesive AH -160 shall not be exposed permanently to sunlight.
8. Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after 3MTM 2-
Component Foam Roof Tile Adhesive AH -160 has been dispensed.
9. 3MTM 2- Component Foam Roof Tile Adhesive AH -160 placement and minimum patty weight shall be in
accordance with the Placement Details' herein. Each generic tile profile requires the specific placement noted
herein.
Table 1: Adhesive Placement For Each Generic Tile Profile
Tile Profile
Placement Detail
Single Paddy Weight
Min. (grams)
Two Paddy Weight per
paddy Min. (grams)
Flat, Low, High Profiles
#1
35
N/A
High Profile (2 Piece Barrel)
#1
17 /side on cap and 34 /pan
N/A
Flat, Low, High Profiles
#2
24
N/A
Flat, Low, High Profiles
#3
8
NOA No.: 12- 0228.18
Expiration Date: 05/10/17
Approval Date: 05/10 /12
Page 4 of 7
LABELING:
All 3MT f 2- Component Foam Roof Tile Adhesive AH 160 containers shall comply with the Standard Conditions
listed herein.
BUILDING PERMIT REQUIREMENTS:
As required by the Building Official or applicable building code in order to properly evaluate the installation of this
system.
ADHESIVE PLACEMENT DETAIL 1
SINGLE PATTY
1) PIS enough adhesive to achieve 17toa3 Optional taster
square Indies lc contact with the pan die pitch applications
2) Tumeoveis upside de m. Place adhesive 112 In
Tolht From outside edge of cover dbl.
Thee Install the tile.
NOA No.: 12- 0228.18
Expiration Date: 05/10/17
Approval Date: 05/10/12
Page 5 of 7
ADHESIVE PLACEMENT DETAIL 2
SINGLE PATTY
NOA No.: 12- 0228.18
Expiration Date: 05/10/17
Approval Date: 05 /10/12
Page 6 of 7
ADHESIVE PLACEMENT ETAIL 3
DOUBLE PATTY
END OF THIS ACCEPTANCE
NOA No.: 12-0228.18
Expiration Date: 05/10/17
Approval Date: 05/10/12
Page 7 of 7
HUD -1
A. S,, ,,ement Statement (HUD-1)
OMB Approval No. 2502 -0265
B. Type of Loan
0 1. FHA 0 2. RHS
0 4. V.A. 0 5. Cony. l
ns.
® 3. Conv. Unins.
6. File Number
215520ma
7. Loan Number
5898
ID:
6. Mortg. Ins. Case Num.
C. NOTE: This form is fumished
to give you a statement of actual settlement costs. Amounts paid to and by the settlement agent are shown. Items
paid outside the closing; they are shown here for informational purposes and are not included in the totals.
marked "(p.o.c.)" were
D. NAME OF BORROWER:
Address of Borrower.
E. NAME OF SELLER:
Address of Seller.
F. NAME OF LENDER:
Address of Lender:
G. PROPERTY LOCATION:
H. SETTLEMENT AGENT:
Place of Settlement:
1. SETTLEMENT DATE:
Laura Rodriguez
9900 NE 13th Avenue, Miami Shores, Florida 33138
Graciella D. Nielsen, a single woman
Wells Fargo Bank, NA.
2701 Wells Fargo Way, Minneapolis, Minnesota 55467 -3605
9900 NE 13 Avenue, Miami Shores, Florida 33138
COVENTRYTITLE, INC.
10691 N. Kendall Drive, SUITE 307, Miami, Florida 33176
9/21/12 DISBURSEMENT DATE: 9/21/12
lotion
Phone: 305-595 -3195
J. Summary o .orrower s ransac ion
100. Gross amount due from borrower.
101. Contract sales price
1
875,000.00
-- - -
`400. Gross amount due to seller:
401. Contract sales price
675,000.00
Personal
402. Personal property
102. property
103. Settlement charges to borrower (Line 1400)
20,809.83
403.
104.
404.
105.
405.
Adjustments for items paid by seller in .advance:
City/town taxes
Adjustments for items paid by seller in advance:
406. City/town taxes
106.
107. County taxes
407. County taxes
108. Assessments
408. Assessments
109.
409.
410.
110.
411.
111.
412.
112.
120. Gross amount due from borrowe r.
200. Amounts paid or in behalf of borrower:
money
695,809.83
5,000.00
420. Gross amount due to seller.
500. Reductions in amount due to seller:
501. Excess deposit (see instructions)
676,000.00
-
201. Deposit or earnest
new loans)
540,000.00
502. Settlement charges to seller (line 1400)
50,035.00
202. Principal amount of
loan(s) taken subject to
503. Existing loan(s) taken subject to
203. Existing
mortgage
504. Payoff of first mortgage lit
615,962.84
204. Principal amount of second
505. Payoff of second mortgage loan
205. Tolerance Credit
506.
206.
Tolerance
1,350.00
507. Deposit is being disbursed as proceeds
207. Over
mortgage held by seller
508. Principal amt of mortgage held by seller
208. Principal amt of
509.
209.
209a.
Adjustments for items unpaid by seller
1
509a.
Adjustments for items unpaid by seller:
510. City /town taxes
210. City/town taxes
from 01/01/12 to 07/31!12
9,002.16
511. County taxes from 01/01/12 to 07/31/12
9,002.16
211. County taxes
512. Assessments
212. Assessments
513.
213.
514.
214.
515.
215.
516.
216.
517.
217.
518.
218.
519.
219.
220. Total paid byffor borrower.
300. Cash atsettlement #romltoborrower..
301. Gross amount due from borrower (line 120)
555,352.16
-
695,809.83
520. Total reductions In amount due seller.
600. Cash at settlement to /from seller:
601. Gross amount due to seller (line 420)
602. Less total reductions In amount due seller pine 520)
603. Cash ( • To • From ) Seller:
675,000.00
675,00000
(675,000.00)
302. Less amount paid by/for the borrower (line 220)
(555,352.16)
140,457.67
0.00
303. Cash ( F From • To )Borrower.
The Public Reporting Burden for this collection of information is estimated at 35 minutes per response for collecting, reviewing, and reporting the data. This agency
may not collect this information, and you are not required to complete this form, unless it displays a currently valid OMB control number. No confidentiality Is assured;
this disclosure is mandatory. This is designed to provide the parties to a RESPA covered transaction with information during the settlement process.
DoubleTime®
Urban Development
Page 2
* PCC (B) = Paid outside of dosing by borrower
* POC (5) = Paid outside of dosing by seller
DoubleTime®
Paid from
Soiler's
Funds at
Settlement
L. Settlement charges
Paid from
Borrower's
Funds at
Settlement
700. Total Real Estate Broker Fees $4c- x.00 ,r-
Division of commission (line 700) as follows:
701. $ 20,250.00 to Landel Realty -Jose Garcia
702. $ 20,250.00 to Landel Realty -Karin Garcia
703. Commission paid at settlement
40,500.00
704.
705. to
800.Item5 Payable in Connection with Loan
801. Our origination charge $895.00 (from GFE #1)
802. Your credit or charge (points) for the specific interest rate chosen $1,350.00 (from GFE #2)
803. Your adjusted origination charges to Wells Fargo Bank NA. (from GFE A)
2,245.00
804. Appraisal fee to RELS VALUATION (from GFE #3) 495.00 POC (B)*
805. Credit report to RELS CREDIT (from GFE #3)
• 11.00
806. Tax service to (from GFE 43)
807. Flood certification to (from GFE #3)
808. to
809. to
810. to
811. to
812. to
813. to
Be Paid in Advance
900. Items Reauired by Lender to
901. Daily interest charges from 09/21/12 to 10/01/12 (, 51.7800 /day (from GFE #10)
517.80
902. Mortgage insurance premium for months to (from GFE #3)
903. Homeowner's insurance premium L 1 years to Tower Hill Insurance Group (Loon GFE #11)
3•950.53
904. Flood Insurance Premium for 1 years to ALLSTATE
2,641.00
905. Windstorm Insurance Premium for 1 : - to CITIZENS
6,545.00
000. Reserves Deposited with Lender
1001. Initial deposit for your escrow account (from GFE #9)
1002. Homeowner's insurance months (rH, per month
1003. Mortgage insurance months (ra per month
1004. Property taxes months (1c, per month
1005. Flood insurance months (r i per month
1006. Windstorm Insurance Pre months (c t per month
1007. months Cra Per month
1008. months (c8, per month
1009. Aggregate accounting adjustment
1100. Title Charges
1,147.50
1101. Tide services and lender's tide insurance (from GFE #4)
1102. Settlement or closing fee to COVENTRY TITLE, INC. $750.00
1,000.00
1103. Owner's title insurance to Old Republic Nat. Tide1COVENTRYTITLE (from GFE #5)
3,450.00
OF6- 3450.00
1104. Lender's tide insurance to Old Republic Nat. T1ItaCOVENTRYTITLE $397.50
MF6- 25.00;8.1- 25;F9- 347.50
1105. Lender's title policy limit $540,000.00
1106. Owner's tide poky limit $675,000.00
1107. Agent's potion of the total tide insurance premium $2,693.25 to COVENTRYTITLE, INC.
1108. Underwriter's potion of the total tide insurance premium $1,15425 to Old Republic National Tide Insurance Compar
1109. Abstractor title search to COVENTRYTITLE, INC.
250.00
1110. Document Preparation Fee to BRADLEY K. HANAFOURDE
1111. Lien Letter/Search to Florida Lien Search, Inc.
210.00
1112. Courier/Wire Fee to COVENTRYTITLE, INC.
75.00
1113. to
1200. Government Recording and Transfer Charaes
1201. Government recording charges (from GFE #7)
190.00
1202. $18.50 Mortgage(s) $171.50 Releases $0.00 $190.00
Deed
1203. Transfer taxes (from GFE #8)
City /Countytax/starmps Deed $0.00 Mortgage(s) $1,080.00
2,970.00
1204.
State tax /stamps Deed $4,050.00 Mortgage(s) $1,890.00
4,050.00
1205.
1206.
1207.
1208.
1300. Additional Settlement Charges
Required services that you can shop for (from GFE #8)
c�92
1301.
to E. BELTRAN &ASSOCIATES, $495.00
1302. Survey
Viations to Miami -Dade County
25.00
3 32500
1303. Code
Water Bill/Balance to MIAMI DADE WATER & SEWE
1304. Final
Fee to Wells Fargo Real Estate Tax $78.00
1305. Tax Service
Certification Fee to WFFS $19.00
1306. Flood
to
1307.
1308. to
1309.
1400. Total Settlement Charaes
20,809.83
50,035.00
* PCC (B) = Paid outside of dosing by borrower
* POC (5) = Paid outside of dosing by seller
DoubleTime®
SETTLEMENT CHARGES AND LOAN TERMS
Page 3
Settlement Charges
:i�,."h�,lr$�'��� -„ �'_�C..,�. z�....,.'�.s'?�. 0/.w, '•t'�^%
.'��.�.'�`'�'�.5:??' � .« «� ..
�. t m .q � 4
� _. •:u�• j� 'm'. .. ....
Our origination charge
# 801
$895.00
$895.00
Your credit or charge (points) for the specific interest rate chosen
# 802
$.00
$1,350.00
Your adjusted origination charges
# 803
$895.00
$2,245.00
Transfer taxes
# 1203
$2,979.00
$2,970.00
C€trStat'krTattanorfo {e«,.,._
$ 540,000.00
Your loan term Is
_ =
�r
$190.00
Government recording charges
# 1201
Daily interest charges from
$273.50
Appraisal fee
# 804
Homeowner's insurance premium for
$495.00
$495.00
Credit report
# 805
# 904
$11.00
$11.00
Title services and lender's title insurance
# 1101
$.00
$1,14750
$1,147.50
Tax Service Fee
# 1305
$495.00
$78.00
$78.00
Flood Certification Fee
# 1306
819.00
$19.00
Over Tolerance
# 206
$.00
$- 1,350.00
$2.024.00
$590.50
o
$- 1,433.50 or 0.00%
Ch4f9es
$ 540,000.00
Your loan term Is
e n
$0.00
Initial deposit for your escrow account
# 1001
$.00
Daily interest charges from
# 901
$983.82
$517.80
Homeowner's insurance premium for
# 903
$7,992.00
$3,950.53
Rood Insurance Premium for
# 904
$.00
$2,641.00
Windstorm Insurance Premium for
# 905
$.00
$6,545.00
Survey
# 1302
$500.00
$495.00
Your initial loan amount is
$ 540,000.00
Your loan term Is
30.0000 years
Your initial interest rate is
3.5 %
Your initial monthly amount owed for principal, interest,
and any mortgage insurance is
$ 2,424.85 includes
F Principal Fr Interest r Mortgage Insurance
Can your interest rate rise?
0 No 0 Yes , it can rise to a maximum of .003. The first change will be
on and can change again every u
Every change date, your interest rate can increase or decrease
by .00%. Over the life of the loan, your interest rate is guaranteed to never be
lover than .004 or higher than .00
Even if you make payments on time, can your loan
balance rise?
0 No 0 Yes , it can rise to a maximum of $ .00
Even if you make payments on time, can your monthly
amount owed for principal, interest, and mortgage
insurance rise?
) No 0 Yes , the first increase can be on id the monthly amount
owed can rise to $ .00
The maximum It can ever rise to is $ .00
Does you loan have a prepayment penalty?
® No 0 Yen , your maximum prepayment penalty Is $ .00
Does your loan have a balloon payment?
No 0 Yes , you have a balloon payment of $ .00 ie in
years on 00/00/0000 .
Total monthly amount owed including escrow
account payments
® You do not have a monthly escrow payment for items, such as property
taxes and homeowner's insurance. You must pay these items directly yourself.
0 You have an additional monthly escrow payment of $ .00
that results In a total Initial monthly amount owed of $ 0.00 its includes
principal, interest, any mortgage insurance and any Items checked below:
r Property taxes r Homeowner's insurance
r Flood Insurance r. W i ndstorm Insurance Premium for
r r
Note: If you have any questions about the Settlement Charges and Loan Terms listed on this fom, please contact your lender.
DoubleTlme®
HUD -1 SETTLEMENT STATEMENT ADDENDUM
File Number. 215520ma
I have carefully reviewed the HUD -1 Settlement Statement and to the best of my knowledge and belief, it Is a
true and accurate sta ment of all receipts and disbursements made on my account or by me In this transaction.
I father certify t yh a e received a copy of the HUD -1 Settlement Statement
Borrower(s)
driguez
r iella D. Nielsen
Seller(s)
Settlement Agent
The HUD -1 Settlement Statement which I have prepared is a true and accurate account of this transaction. I
have caused or will cause the funds to be disbursed in accordance with this statement.
COVENTRY TITLE, INC.
By:
Date:
WARNING: It Is a crime to knowingly make false statements to the United States on this or any other similar
form. Penalties upon conviction can include a fine and imprisonment. For details see: Title 18 U.S. Code
Section 1001 and Section 1010.
DoubleTime®
NOTICE OF CO ENCEMENT
A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION
PERMIT NO TAX FOLIO No.1 1 - 3205 -009 -0130
STATE OF FLORIDA:
COUNTY OF MIAMI -DADE:
STATE OF FL
1 HEREBY CER
-Original filed in thi
11111111111111111111111111111111111111111 I1!1
C FH 2012R08014034
OR SE. 28348 P 0232; (1Ps
RECORDED 11/07/2012 O9052 5
HARVEY RUVINp CLERK OF COURT
MIAMI - DACDE COUNTY? FLORIDA
LAST PAGE
RIDA, COUNTY OF LADE
FY file t this is at pyofthe
r
u6�
day of
A020 /2_-,
and Ck cial Sds4.
CLERK = "irc f racy CO2irts
rD.C.
THE UNDERSIGNED hereby gives notice that improvements will be made tq,o
property, and in accordance with Chapter 713, Florida Statutes, the following ItIttlItteti§ti
is provided in this Notice of Commencement. By
1. Legal description of property and street/address: 9900 N . E . 13th Avenue
Miami Shores, Florida 33138
2. Description of improvement: Reroof to a new Tile and Flat Cap sheet roof.
3. Owner(s) name and address: Laura M. Rodriguez
9900 N.E. 13tn Avenue Miami Shores, Fl 33138
Interest in property: Owner
Name and address of fee simple titleholder: N/A
4. Contractor's name and address: Quality Roofing Contractor, Inc.
13800 N.W. 1st Avenue Miami, Fl
5. Surety: (Payment bond required by owner from contractor, if any)
Name and address: N/A
Amount of bond $ 00
6. Lender's name and address: N/A
33168
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: N/A
8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided
in Section 713.13(1)(b), Florida Statutes.
Name and ad • ress: N/A
piration
date
f this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a
d)
ignature of Owner
Print Owner's Name3
Sworn to and subscribed before me this
Notary Public
Print Notary's Name
My commission expires:
123.01 -52 PAGE 4 8/02
Mary nU ernai1aez
untUtission #DD9300/16
Expires: OCT. 10, 2013
BONDED THRO ATLANTIC C BOti"DI G CO., INC.
Prepared.byMarylou Hernandez
,2°/A . Quality Roofing Contractor
Address:13800 N.W. 1st Avenue
Miami, i?1 33168
(305) 953 -3333
Ntrt
CUMULATIVE SUBSTANTIAL IMPROVEMENT
VERIFICATION WORK SHEET
In accordance with 1'EMA regulation and Miami Shores Village Flood Damage Prevention Ordinance the
costs of all improvements must be monitored. The costs of any improvements in the past 12 months and the
costs of any proposed improvements must be shown on the worksheet. The cost of improvements must
include demolition, raw and finished materials (include those donated), labor (including volunteer and self -
performed), construction supervision and management, and overhead and profit. A list of items the costs of
which are to be included as well as those excluded is attached for your reference. (A Copy of the Contract
must be attached)
PROPERTY OWNER: (� A- 0 r l(�CsI
PERMIT #
ADDRESS:
FOLIO NUMBER: FLOOD ZONE:
BASE FLOOD ELEVATION:
FREEBOARD: EAST OF FL.CCCL:
COST OF PAST IMPROVEMENTS (12'MONTIIS)
COST OF PROPOSED IMPROVEMENTS: 81 000 • vD
(ATTACH COPY OF CONTRACT)
F OTAL CUMULATIVE COST OF .i 1 ROVEMENTS (past
VALUE OF PRINCIP
and proposed) 2 )1! 0®• c
raisal): $0k3 k3 '1 153 • ��
PLANREVIEWER:
PLAN
SIGNATURE:
Zq 2��2 E
DATE:
REVIEWER
SUBSTANTIAL IMPROVEMENT / DAMAGE LIST
(NOTE: THIS LIST IS INTENDED FOR GUIDANCE ONLY, AND IS NOT ALL INCLUSIVE)
ITEMS TO BE INCLUDED
ALL STRUCTUAL ELEMENTS,
INCLUDING
Foundations including;
Spread footing, Continuous footing,
isolated footing, piles and pile caps
Slabs including; Monolithic, floating,
elevated
Walls including; Exterior walls, Bearing
walls, Shear walls
Beams, Tie Beams, Columns and Posts
Wood decking, Floor and Roof Sheathing
Trusses, Joist
Windows /Doors
ALL BUILDING ELEMENTS, INCLUDING
Interior Partitions, Walls, Columns
Drywall, Ceilings,
Built in Furniture, Cabinets, Vanities
All Fixtures
Flooring, Tile, Carpet, Stone, Linoleum,
ect.
All Finishes including Drywall, Paint,
Stucco Plaster, Paneling, Tile, Marble,
and Moldings
Roofing Material
ALL HARDWARE
ALL UTILITY and SERVICE
EQUIPMENT
HVAC
Electrical System and Equipment
Plumbing System and Equipment
Security System and Equipment
Central Vacuum System
Plumbing Fixtures
Lighting Fixtures and Ceiling Fans
Water Systems including
Softeners /Filtration
Created on June 2009
ALSO:
All Labor and other Costs associated with
Demolition, Removing, Replacing,
Installing Building or Altering Building
Components
Construction Management / Supervision
Overhead and Profit
Equivalent cost for:
Donated Materials
Volunteer Labor (including owners and
friends)
Any Improvements Beyond Pre - damaged
Condition, including;
Utility Upgrades
Code Upgrades
ITEMS TO BE EXCLUDED
Plans and Specifications
Survey Costs
Elevation Certificate Costs
Permit fees
Debris Removal
Items not considered to be REAL Property
Rugs, Furniture, Refrigerator,
Appliances not Built -in
Outside Improvements, Including;
Landscaping
Sidewalks
Patios
Fences
Yard lights
Sheds
Gazebos
Irrigation
Pool
Folio
11- 3205 - 009 -0130
Property Address
9900 NE 13 AVE
Owner Name(s)
GRACIELLA D NIELSEN
Mailing, Address
9900 NE 13 AVE
MIAMI SHORES FL
33138 -2635
Primary Zone
1400 SGL FAMILY - 3001 -3250 SQ
Use Co
0001 RESIDENTIAL - SINGLE FAMILY
Beds /Baths /Half
4/5/0
Floors
1
Living Units
1
Adj. Sq. Footage
4,219
Lot Size
19,096 SQ FT
Year Built_
1951
Legal Description
EARLETON SHORES PB 43 -80
LOTS 16 -17 & E25FT LOT 15 BLK 1
LOT SIZE 108.500 X 176
OR 21071 -0661 02 2003 1
OR 21071 -0661 0203 00
Current
Previous
Year
2012
2011
Land Value
$330,103
$275,087
Building Value
$383,483
$385,737
Market Value
$713,586
$660,824
Assessed Value
$645,184
$626,393
Current
Previous
Year
2012
2011
Homestead
$25,000
$25,000
2nd Homestead
$25,000
$25,000
Senior
$0
$0
Veteran Disability
$0
Civilian Disability
$0
$0
Widow(er)
so
$0
Disclaimer:
MIAMI -DADE COUNTY
OFFICE OF THE PROPERTY APPRAISER
PROPERTY SEARCH SUMMARY REPORT
Honorable Pedro J. Garcia
Property Appraiser
Aerial Photography 2012
If+
Current
Previous
Year
2012
2011
Exemption /Taxable
Exemption /Taxable
County
$50,000 / $595,184
$50,000 / $576,393
School Board
$25,000 / $620,184
$25,000 / $601,393
City
$50,000 / $595,184
$50,000 / $576,393
Regional
$50,000 / $595,184
$50,000 / $576,393
Date
Amount Recording
Book -Page
Qualification Code
2/2003
$800,000
21071 -0661
Sales which are qualified
6/1979
$175,000
10411 -2279
Sales which are qualified
The Office of the Property Appraiser and Miami -Dade County are continually editing and updating the tax roll and GIS data to reflect the latest property information
and GIS positional accuracy. No warranties, expressed or implied, are provided for data and the positional or thematic accuracy of the data herein, its use, or its
interpretation. Although this website is periodically updated, this information may not reflect the data currently on file at Miami -Dade County's systems of record.
The Property Appraiser and Miami -Dade County assumes no liability either for any errors, omissions, or inaccuracies in the information provided regardless of the
cause of such or for any decision made, action taken, or action not taken by the user in reliance upon any information provided herein. See Miami -Dade County full
disclaimer and User Agreement at http: / /www.miamidade.gov /info /disclaimer.asp.
Property information inquiries, comments, and suggestions email: pawebmail @miamidade.gov
GIS inquiries, comments, and suggestions email: gis @miamidade.gov
Generated on: Friday, October 26, 2012