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RF-13-1044 w � t Miami Shores Village I - .r MM aY A131 Buildin Department t Y 1 050 N.E.2nd Avenue Miami Shores Florida 33138 Tel:(305)795.2204 Fax: (305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 l� BUILDING Permit No. PERMIT APPLICATION Master Permit No.-f 1 2_5 Permit Type: BUILDING ROOFING JOB ADDRESS: 10050 NE 12 AVE City: Miami Shores County: Miami Dade zip: 33138 Folio/Parcel#: 11-3205-019-0370 Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder):ANDREW CURZON Phone#:3052981619 Address: 10050 NE 12 AVE City: MIAMI SHORES State: FL Zip. 33138 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: CONTRERA ROOFING CORP Phone#: 3055736604 Address: 144 NE 26 ST City: MIAMI State: FL Zip: 33137 Qualifier Name: ROBERTO CARLOS CONTRERAS Phone#: 3055736604 State Certification or Registration#: CCC057793 Certificate of Competency#: Contact Phone#: 7864878393 Email Address: CONTRERASROOFING @BELLSOUTH.NET DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$24,000.00 Square/Linear Footage of Work: 3849 Type of Work: UAddition DAlteration UNew URepair/Replace ODemolition Description of Work: REROOF TO TILE Aa,V Aj2—o Color thru tile: Submittal Fee$ Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ • 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,BEATERS,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 approved and a reinspection fee will be charged. Signature 4XZ1 Signature Owner or Agent Contractor The foregoing instrument was acknowledged before the this The foregoing instrument was acknowledged before me this L2 day of M? 20 3 by Cio l' day of P^�,j ,20 �3,by who is p oer any known a or who has produced who i ersonally knov . , me or who has produced o did take an oath. as identification and who did take an oath. NO R.t NOTARY PUBLIC: E pum.go 44 p i IfAy Ceetm. �Yt, t5 im d o _ z, Sign. — Sigrt Print: fj A- Print:<1,. �, C Otto #F tAA�i n My Commission Expires: My Co, ioh agi-reg- APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/1=012)(Revised 07/10/(7)(Revised 06/10=M)(Revised 3/15/04) i . J I • Miami shores Village mail Building Department 10050 N.E.2nd Avenue jrl Ink Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNERS'S AFFIDAVIT OF EXEMPTION ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE- BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PERSUANT TO SECTION 553.844 F.S. To: Miami Shores Village Building Department Date: 10050 NE 2nd Ave Miami Shores, Fl 33138 Re: Owner's Name: ANDREW CURZON Property Address: 10050 NE 12 AVE MIAMI SHORES FL 33138 Roofing Permit Number: Dear Building Official: I ANDREW CURZON certify that I am not required to retrofit the roof to wall connections of my building because: x The just valuation for the structure for purpose of ad valorem taxation is less than $300,000.00. Please attach proof of ad valorem taxation. ❑The building was constructed in compliance with the provisions of the Florida Building Code (FBC)or with the provisions of 1994 edition of the South Florida Building Code(1994 SFBC) �s ANDREW CURZON Signature Print Name State of Florida County of Dade The undersigned, being the first duly swom, deposes and says that he/she is the owner for the above property mentioned. Sworn to and subscribed before me this 0 day of NSA JMKRDW Marry pdm-No m»0 • •s my Cartm.Ex�+fs Oct Yt,t0ls Notary Public, Sate of Florida at Large ' g•� e' cc.�"�",.""�"y#EE t h litonded.WfMwN1�11N1�y✓�. • When the just valuation of the structure for purpose of ad valorem taxation is equal to or more than$300,000.00,and the building was not constructed with FBC nor a 1994 SFBC.Then you must provide a building application from a General Contractor for the Roof to Wall connection Hurricane Mitigation. Revised on 5!2112009 Miami-Dade My Home 5/13J13 12:06 PM My Home „w M AMKIMM H, Show Me: Legend Search By: _ Property ee Boundary Selected Property Text only Property Appraiser Tax Estimator - Street Property Appraiser Tax Highway Comparisons Miami-Dade County Summary Details: water 9rt' 10050 NE 12 AVE ailing y ANDREW CURZON E 10050 NE 12 HORES FL AVE MIAMI W+ 3138 k n- , Pro a Information: ' 1400 SGL FAMILY- 1-3250 SQ ` Y 1 RESIDENTIAL- '> ` INGLE FAMILY $ oota e:: 380 12,148.78 SQ FT Aerial Photography-2012 0 115 ft 8aT Built: °" 1953 lAMI SHORES SEC 8 EV PB 43-67 LOT 16& 5FT OF LOT 15 BLK 177 LOT SIZE My Home I Property Information I Property Taxes P IRREGULAR OR 13310- IM '43310587 1 OR 27212- y Neighborhood I property Appraiser 604 0310 01 Home I Using Our Site I Phone Directory I Privy!I Disclaimer Assessment Information: 2012 2011 nd Vatic $175,596 $146,33 CH Value: °$180 209 $180 20 If you experience technical difficulties with the Property Information application, et Value $355,805 326 53 or wish to send us your comments,questions or suggestions sedTalue: °, $355 805 326 53 please email us at webmaster. Taxable Value Information: ear: 3 2012 2011 Web Site Applied Applied ®2002 Miami-Dade County. Exemption! Exemption/ All rights reserved. axing ° Taxable Taxable Value: Value: ionais $0/$355,8051$01$326,539 < " n :.; $0/$355,8051$01$326,5391 u: $0/$355,8 01$326,539 Board:, 01$355,8 0/$326.53 Sale Information: Dato '" 3!2010 E Ainouid $410,000 O/R:;; 7212-4604®� http://gisims2.miamidade.gov/myhome/propmap.asp Page 1 of 2 . . y q ROOM ASSEMBLIES AND ROOFTOP STRUCTURES MAY E �O 13 CITY Florida Building Code Edition 2010 High-Velocity Hurricane Zone Uniform Permit Application Form. Section A(General Information) COPY Master Permit No. Process No. Contractor's Name CONTRERA ROOFING Job Address 10050 NE 12 AVE ROOF CATEGORY Low Slope Mechanically Fastened Tile Mortar/Adhesive Set Tile Asphaltic Shingles ❑ Metal Panel/Shingles Wood Shingles/Shakes Prescriptive BUR-RAS 1511 R ROOF TYPE New Roof Reroofing ❑Recovering �epair Maintenance • ROOF SYSTEM INFORMATION Low Slope Roof Area(SF) Steep Sloped Roof Area(SF) Total(SF) 3849 3849 • Section B (Roof Plan) e 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. • • R t L' 0 LU • � W 'L w C/) U J 2 c � L ZA o w °- C!3 o z Q o N tT] CO � 15.34 2010 FLORIDA BUILDING CODE--BUILDING �, ROOFASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2010 High-Velocity Hurricane Zone Uniform Permit Application Form. Section D (Steep Sloe Roof System) : Roof System Manufacturer: BORAL ROOFING Notice of Acceptance Number: 12-0222.02 Minimum Design Wind Pressures, If Applicable{From RAS 127 or Calculations_): 1. 39.1 P2: 68.1 P3. 100.7 • ■ c maximum design pressure 38.7 from noa specific system R • Steep ■ Deck Type: 1XMG �_ \\ Type Underlayment: 1#30 LB Roof Slope: I 3 12 Insulation: • • Fire Barrier: N/A i s Ridge Ventilation? Fastener Type&Spacing: 11/4 RS NAILS N/A iZRn"o�o�FIELD ROG 64 S J Adhesive Type: 3M/POLYFO km i Type Cap Sheet: #90 LB Mean Roof Height: 12 \ Roof Covering: barcelona 900 concrete 61e color truem ifierida blend \ Type&Size 3X324GAGALVANIZEDI Drip Edge: R • 15.36 2010 FLORIDA BUILDING CODE—BUILDING I ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2010 c High-Velocity Hurricane Zone Uniform Permit Application Form. Section (Tile Calculations) Fos'Moment based file systems,choose either Method I or 2.Compare the values for Mr with the values from Mf.If the Mf values are greater than or equal to the Mr values,for each area of the roof,then the the attachment method is acceptable. Method I"Moment Based Tile Calculations Per RAS 12T' (Pt: 39.1 ®.313 = 12.24)-Mg:8.05 =Mrt 4.19 Product Approval Mf 38.7 R (P2: 68.1 ® 0.313=-91.32)-Mg: 8.05 =A4r2 13.27 Product Approval Mf 38.7 (P3:100.7 ® 0.313 =-3J-5Z)-Mg:8.05 =K3 23.47 Product Approval Mf 38.7 • Method 2"Simplified Tile Calculations Per Table Below" ; R Required Moment of Resistance(Mr)From Table Below Product Approval A4 R M,required Moment Resistance` Mean Roof Height Roof Slope 16 20' 25' 30' 40' ; 2:12 34.4 36.S 38.2 39.7 42.2 3:12 32.2 34.4 36.0 37A 39.8 K 4:12 30,4 32.2 33.8 36.1 37.3 5:12 i 28.4 30.1 1 31.6 32.8 34.9 r 6:12 26A 28.0 29.4 30.5 32.4 712 24.4 25.9 27.1 282 30.0 *Must be used in conjunction with a list of moment based the systems endorsed by the Broward County Board of Rules and Appeals. For Upliftbased the systems use Method 3.Compared the values for F'with the valises for Fr.If the F values are pr'eaterthanorequal to the Fr values. for each area of the roof,then the the attachment method is acceptable. ; Method 3"Uplift Based Tile Calculations Per RAS 127" ; (Pl: Q L - 0 w-=-J-W. p cos ®=Frt Product Approval P[]-...._ ; (P2: O L = ow-= �-W0 cos =Fr2 Product Approval FO- R (P3: 0 L = 0 w:= -W. p cos =Fr3 Product Approval FU- Where to I )btaln Information Descripfta Svmbol Mftm to find Design Pressure PI or P2 or P3 RAS127 Table Iorbyaneuginewingana lysisptgxwedbyPBbasedonASCE7 ; Mean Roof Fight H Job site s Roof Slope Job Site Aerodynamic Multiplier Product Approval Restoring Moment due to Gravity Ms Product Approval ; Y k Attachment Resistance Mf Product Approval Required Moment Resistance M Calculated Minimum Attachment Resistance FO Product Approval Required Uplift Resistance Fr Calculated Average Tile Weight W Product Approval L=length Tile Dimensions Product Approval , W=width ■ All calculations must be submitted to the building official at the time of permit application. •` Y Y 2010 FLORIDA BUILDING CODE--BUILDING 15.37 Ii s 0 MIAMI, MIAMI-DADE COUNTY PRODUCT CONTROL SECTION DEPARTMENT OF PERMITTING,ENVIRONMENT,AND REGULATORY AFFAIRS(PERA) 11805 SW 26 Street,Room 208 BOARD AND CODE ADMINISTRATION DIVISION Miami,Florida 33175-2474 T(786)315-2590 F(786)315-2599 NOTICE OF ACCEPTANCE (NOA) www.miamidade.gov/sera Boral Roofing,LLC 7575 Irvine Center Drive,Suite 100 Irvine,CA 92618 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. i DESCRIPTION:Barcelona 900 Concrete 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 renews and revises NOA#07-0220.04 and consists of pages 1 through 7. The submitted documentation was reviewed by Alex Tigera. NOA No.: 12-0222.02 MAMP°A°.;C UNW Expiration Date: 04/26/17 Approval Date: 04/19/12 Page 1 of 7 ROOFING ASSEMBLY APPROVAL Catep-ory_ Roofing Sub-Category: Roofing Tiles Material: Concrete Deck Tvye• Wood I. SCOPE This NOA approves a system using Barcelona 900 Concrete Roof Tile, as manufactured Boral Roofing LLC in Lake Wales, FL. and described this Notice of Acceptance. For locations where the pressure requirements, as determined by applicable Building Code does not exceed the design pressure values obtained by calculations in compliance with RAS 127 using the values listed in the installation section herein. The attachment calculations shall be done as a moment based system.. 2. PRODUCT DESCRIPTION Manufactured by Test Product Applicant Dimensions Specifications Description Barcelona 900 1= 17" TAS 112 High profile,interlocking,one-piece,'S' w= 13" shaped,high-pressure extruded concrete roof %2"thick file equipped with three nail holes. For direct deck or battened nail-on,mechanically fastened,mortar set or adhesive set applications. Trim Pieces Length:varies TAS-112 Accessory trim,boosted Barcelona, concrete Width: varies roof pieces for use at hips,rakes,ridges and varying thickness valley terminations manufactured for each tile profile. 2.1 MANUFACTURING LOCATION 2.1.1. Lake Wales,FL. 2.2 SUBMITTED EVIDENCE: Test Agency Test Identifier Test Name/Report Date Redland Technologies 7161-03 Static Uplift Testing Dec. 1991 Appendix III TAS 102&TAS 102(A) Redland Technologies 7161-03 Wind Tunnel Testing Dec. 1991 Appendix II TAS 108(Nail-On) Redland Technologies P0402 Withdrawal Resistance Sept. 1993 Testing of screw vs. smooth shank nails Redland Technologies Letter Dated Aug. 1, Wind Tunnel Testing Aug. 1994 1994 TAS 108(Nail-On) NOA No.: 12-0222.02 14"l-DADECOUNWM Expiration Date: 04/26/17 Approval Date: 04/19/12 Page 2 of 7 Redland Technologies P0631-01 Wind Tunnel Testing July 1994 TAS 108(Mortar Set) Professional Service Industries, IC-1320-94 Physical Properties Feb. 1995 Inc. TAS 112 The Center for Applied 25-7688-3 TAS 101 (Adhesive Set) June 1996 Engineering,Inc. 25-7688-10 TAS 101 (Mortar Set) July 1996 The Center for Applied 25-7688-5 Static Uplift Testing June 1996 Engineering,Inc. TAS 102 (3"Headlap,Nails,Direct Deck,New Construction) The Center for Applied 25-7688-4 Static Uplift Testing June 1996 Engineering,Inc. TAS 102 (4"Headlap,Nails,Clips) Celotex Corporation 520111-3 Static Uplift Testing Dec. 1998 Testing Services 520191-2-1 TAS 101 March 1999 Walker Engineering,Inc. Calculations Aerodynamic Multiplier March 1999 Walker Engineering,Inca Calculations Two Patty Adhesive Set April 1999 System Walker Engineering,Inc. Evaluation 25-7183 March 1995 Calculations Walker Engineering,Inc. Evaluation 25-7094 February 1996 Calculations Walker Engineering,Inc. Evaluation 25-7496 April 1996 Calculations Walker Engineering,Inc. Evaluation 25-7584 December 1996 Calculations 25-7804b-8 25-7804-4&5 25-7848-6 Walker Engineering,Inc. Evaluation Restoring Moments Due to February 2007 Calculations Gravity Nutting Engineers 122 TAS 112 January 2007 NOA No.: 12-0222.02 VdAMNOADECOIUNrtt Expiration Date: 04/26/17 Approval Date: 04/19/12 Page 3 of 7 3. LIMITATIONS 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set file applications, a static field uplift test shall be performed in accordance with TAS 106. 3.3 Applicant shall retain the services of a Miami-Dade County Certified Laboratory to perform quarterly test in accordance with TAS 112, appendix `A'. Such testing shall be submitted to the Building Code Compliance Office for review. 3.4 Minimum underlayments shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.5 30/90 hot mopped underlayment applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayment material manufacturers published literature. 3.6 This acceptance is for wood deck applications. Minimum deck requirements shall be in compliance with the applicable Building Code. 4. INSTALLATION 4.1 Barcelona 900 Concrete Roof Tile and its components shall be installed in strict compliance with Roofing Application Standard RAS 118,RAS 119,and RAS 120. 4.2 Data For Attachment Calculations Table 1: Average Weight(W)and Dimensions (I x w ) Tile Profile Weight-W(lbf) Length-1 (ft) Width-w (ft) Barcelona 900 11.5 1.417 1.08 Table 2: Aerodynamic Multipliers -)L(ft) Tile '%(ft) ;L (ft) Profile Batten Application Direct Deck Application Barcelona 900 0.289 0.313 Table 3: Restoring Moments due to Gravity-M9 (ft-lbf) Tile 2":12" 3":12" 4"•12" 5"•12" 6":12" 7":12"or Profile greater Barcelona Battens Direct Battens Direct Battens Direct Battens Direct Battens Direct Battens Direct 900 Deck Deck Deck Deck Deck Deck 7.28 8.13 7.21 8.05 7.10 7.93 6.96 7.78 6.79 7.61 6.61 7.40 NOA No.: 12-0222.02 MIAMMAOECOUfVTY Expiration Date: 04/26/17 11 Approval Date: 04/19/12 Page 4 of 7 Table 4: Attachment Resistance Expressed as a Moment- Mf(ft-lbf) for Nail-On Systems Tile Fastener Type Direct Deck Direct Deck Battens Profile (min 15/32" (min. 19/32" plywood) plywood) Barcelona 900 2-10d Ring Shank Nails 28.6 41.2 19.4 1-10d Smooth or Screw Shank Nail 5.1 6.8 2.8 2-10d Smooth or Screw Shank Nails 6.9 9.2 7.3 1 .#8 Screw 20.7 20.7 18.1 2.#8 Screws 43.2 43.2 29.8 1-10d Smooth or Screw Shank Nail 23.1 23.1 19.0 Field Clip) 1-10d Smooth or Screw Shank Nail 29.3 29.3 24.0 Eave Clip) 2-10d Smooth or Screw Shank Nails 27.6 27.6 38.6 Field Clip) 2-10d Smooth or Screw Shank Nails 38.1 38.1 41.8 Eave Clip) Table 5: Attachment Resistance Expressed as a Moment Mf(ft-lbf) for Two Patty Adhesive Set Systems Tile Tile Application Minimum Attachment Profile Resistance Barcelona 900 Adhesive 29.3 1 See manufactures component approval for installation requirements. 2 Dow Chemical TileBond Average weight per patty 10.7 grams. Polyfoam Product,Inc.Average weight per patty 8 grams. Table 6: Attachment Resistance Expressed as a Moment- Mf(ft-lbf) for Single Patty Adhesive Set Systems Tile Tile Application Minimum Attachment Profile Resistance Barcelona 900 Pot oam Pol ProTm 66.5 Polyfoam Pol ProTm 38. 3 Large paddy placement of 63 rams of Pol ProTm. 4 Medium paddy placement of 24 rams of Pol ProTm. Table 7: Attachment Resistance Expressed as a Moment- Mf(ft-lbf) for Mortar Set Systems Tile Tile Attachment Profile Application Resistance Barcelona 900 Mortar Set 241 5. Tile-Tite Roof Tile Mortar ' NOA No.: 12-0222.02 raar�a Counmr Expiration Date: 04/26/17 Approval Date: 04/19/12 Page 5 of 7 5. LABELING 5.1 All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo as detailed below,or following statement: "Miami-Dade County Product Control Approved". LABEL FOR BARCELONA 900 TILE(LAKE WALES FL PLANT 2) LOCATED UNDERNEATH TILE 6. BUILDING PERMIT REQUIREMENTS 6.1 Application for building permit shall be accompanied by copies of the following: 6.1.1 This Notice of Acceptance. 6.1.2 Any other documents required by the Building Official or applicable building code in order to properly evaluate the installation of this system. NOA No.: 12-0222.02 MMMMADECOUNTYM Expiration Date: 04/26/17 Approval Date: 04/19/12 Page 6 of 7 PROFILE DRAWING NAIL HOLES OVERLOCK s 3518° 93 UNDERLOCK BARCELONA 900 CONCRETE ROOF TILE END OF THIS ACCEPTANCE ECOU�vrx NOA No.: 12-0222.02 N aoM►o Expiration Date: 04/26/17 Approval Date: 04/19/12 Page 7 of 7 K1 ,a MIAMI-DARE COUNTY PRODUCT CONTROL SECTION DEPARTMENT OF PERMITTING,ENVIRONMENT,AND REGULATORY AFFAIRS(PERA) 11805 SW 26 Street,Room 208 BOARD AND CODE ADMINISTRATION DIVISION Miami,Florida 33175-2474 T(786)315-2590 F(786)315-2599 NOTICE OF ACCEPTANCE (NOA) vvww.miamidade.eov/sera 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 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: 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 MIAM14=ECOUNTY Expiration Date:05/10/17 ..., Approval Date:05/10/12 Page 1 of 7 ROOFING COMPONENT APPROVAL: Category: Roofing Sub Category: Roof file adhesive Materials: Polyurethane SCOPE: This approves 3MTM 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 NIA 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 file adhesive. MANUFACTURING LOCATION: 1. Tomball,TX. PHYSICAL PROPERTIES: Prove Test Results Density ASTM D 1622 1.6 Ibs./ft.3 Compressive Strength ASTM D 1621 18 PSI Parallel to rise 12 PSI Perpendicular to rise Tensile Strength ASTM D 1623 28 PSI Parallel to rise Water Absorption ASTM D 2127 0.08 Lbs./Ft2 Moisture Vapor Transmission ASTM E 96 3.1 Perm/Inch Dimensional Stability ASTM D 2126 +0.07%Volume Change @-40°F.,2 weeks +6.0%Volume Change @I 58T, 100%Humidity,2 weeks Closed Cell Content ASTM D 2856 86% NOA No.: 12-0228.18 �noe Cota+mr Expiration Date:05/10/17 ...O 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 Amen cv Test Identifier Test Name/Report Date Center for Applied Engineering #94-060 TAS 101 04/08/94 257818-IPA TAS 101 12/16/96 25-7438-3 SSTD 11-93 10/25/95 25-7438-4 25-7438-7 SSTD 11-93 11/02/95 25-7492 SSTD 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 file 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 the adhesive with their file assemblies shall test in accordance with TAS 101 with section 10.4 as modified herein. F _ W 2 F'= MS NOA No.: 12-0228.18 C�� wecotnvrr Expiration Date:05/10/17 Approval Date:Page 3 o 12 Pa e3of7 g 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 file assembly NOA. 3. 3MrM 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 file 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 RTF1000 or ProPackO 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. 3M m 2-Component Foam Roof Tile Adhesive AH-160 placement and minimum patty weight shall be in accordance with the Placement Details'herein. Each generic the profile requires the specific placement noted herein. Table 1:Adhesive Placement For Each Generic Tile Profile Tile Profile Placement Detail Single Paddy Weight Two Paddy Weight per Min.(grams) paddy Min.(grams) Flat,Low,High Profiles #1 35 N/A High Profile(2 Piece Barrel) #1 17/side on cap and 34/ an NIA Flat,Low,High Profiles #2 24 N/A Flat,Low,High Profiles 1 #3 1 8 NOA No.: 12-0228.18 hUAM14DADE COUKrY Expiration Date:05/10/17 Approval Date:05/10/12 Page 4 of 7 LABELING: All Wrm 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 Nell through Plastic cement Paddy mened Tile) Nell through Plastic cement wuleftnuffft underialf-rit 1 1 101n. 21n EMCOIM Fast EIRCOLM Fae we*A Em course o*. Em course only: Esve closure EVISCIMA Keep adhosive appm)L Keepadhesive app m edge 41n.uptornweeoss 4 In.up hm wee0ift Nall through plaslic,cement pa*Reftegh Th) 1)Place enough adhesive to achieve 17 to 23 thtft"rk ment square We In confect with the pan tHe steep Pilch appftdons Non through pleft amid �izl 2)Turn covers upside down.Place adhesive 112 h To I h From outside edge of cover too, Then Install the Via. 0 undedwood 10 2 IrL 0 Ewcoluse DUN EmClosure Re Keeep eftesive 41nup top from Fesda of Ore save Is. shean Abut secant course of pan tiles.Ensure am end of 013donal pen and covertilesare Polrd-up MM W at save be. on WngbdhW edgesolft Em closure wee pAole Feeds (Moftw—) NOA No.: 12-0228.18 Expiration Date:05/10/17 JAPPROVEDIL— Approval Date:05/10112 Page 5 of 7 ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY Nall ftwo*plastic cement Paddy Men"TOO) Nall through plastic cement Paddy Mans*THe) Undalwyment o Undedayment 7 in. 7F I nm EMCCUM Fascia Fascla Weephole EMCOUM Eave clesum Dflp edge Nail through plastic cement Paddy Menuth T119) Undedayment 7 in. In. Eavo Clmre Em Cause Fesda NOA No.: 12-0228.18 Expiration Date:05/10/17 APPROVED Approval Date:05/10/12 Page 6 of 7 ADHESIVE PLACEMENT DETAIL 3 DOUBLE PATTY Nall through plastic cement Paddy Nall through plastic cement Single paddy under the (between go) Undedayment Single paddy between file Paddy 2 In.x 7 In.medium 0 (under tile) she paddy save 077%. -- course only 40"Al Single paddy n.x 3 In. TV' 3 In: under file 4 x 3 in. it In. 2 In. 21 4 In. Single Single paddy on under- paddy on layment under- layment Single paddy Fascia Save course on top of tile Wee*W Single paddy 2 h X 71n.medurn Em Eave closure on top of file size paddy am % Course Fascia course only Drip edge Nall through plastic cement Single paddy under die Single paddy between tile 3 In.x 3 In. 4 In. Single paddy on underlayment 2 Single paddy Em Closure on top of the 2 In.x 7 In.medlum Es"Course Fascia stm paddy save course only END OF THIS ACCEPTANCE NOA No.: 12-0228.18 ILMAMMADE COUNTYM Expiration Date:05/10/17 Approval Date:05/10/12 Page 7 of 7 NOTICE OF COMMENCEMENTf � ��'� F;CORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION CFN '�013 R O3 9 2 3 5 a OR, Bk 28635 Ps 22694, Qps) PERMIT NO. 1 ��� TAX FOLIO NO.11-3205-019-M70 HARVEY 1V§f17CLER,s OF CO COURT HARVEY RUVIt�4 CLERY, t!F' COURT i1IA11I-DARE COUNTYP FLORIDA STATE OF FLORIDA: LAST PAGE COUNTY OF MIAMI-DADE: THE UNDERSIGNED hereby gives notice that Improvements will be made to certain real property,and In accordance with Chapter 713,Florida Statutes,the following information is provided in this Notice of Commencement. Space above reserved for use of recording office 1,Legal description of property and street/address: 10050 NE V AVE MIAMI SHORES FL 33138 2.Description of Improvement: RE ROOF 3.Owni*s)name and address: ANDREW CURZON 10050 NE 12 AVE MIAMI SHORES FL 33138 Interest in property: OWNER Name and address of fee simple titleholder 4.Contractor's name,address and phone number. COWRERA ROOFING CORP.144 N f CERi7FYfJtet IMs b e y 0fM0 5.Surety:(Payment bond required by owner from contractor,if any) I In tt ofibe gg Name,address and phone number. A.D. Amount of bond$ HARVEY s w Corms �,, � 6.Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices o Povided Section 713.13(1)(a)7., Florida Statutes, Name,address and phone number 8. In addition to himself,Owners designates the following persons)to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name,address and phone number 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER:ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART 1, SECTION 713,13. FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION.IF YOU INTEND TO OBTAIN FINANCING,CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signature(s)of Owners)or Owner(s)'Authori Offlcer/Director/Partner/Manager Prepared By d c-/L' Prepared By Print Name Print Name TdWOfflce Title/Office STATE OF FLORIDA COUNTY OF MIAMI-DADE f� The for oin i t was acknowledged befo me this��day of .y.-f By g C 9- Y ❑Individually,or ❑as for Personally known,or ❑produced the following type of identifi tion: JOYCE R.OWN Signature of Notary Public: N Nmft Print Name: _� 1 (SEAL) �''►� ` 6ended Tluortr io�(lbGryr Aqn. VERIFICATION PURSUANT TO SECTION 92.525 FLORIDA STATUTES Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true,to the best of my knowledge and belief. Signatur s}o Owners)or Owner(s)'s Authorized Officer/Director/Partner/Manager who signed above: By BY 123.01-b2 PAGE f f DATE(MM/DONYYY) CERTIFICATE OF LIABILITY INSURANCE 03/15/2013 01:36 PM 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 cerficate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement.a statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAM Highpoint Risk Services LLC PNoNE(AIC,No,aM: (800)728-0623 rAxlac,wor(972)404-0380 5501 LSJ Freeway, Suite 1200 E-NM AOOPA Dallas, TX 75240 INSURERS AFFORDING COVERAGE NAIL S INSURER A:companion Property and Csawalty Inure company 12157 INSURED: Aspen Staff Leasing, Inc. 1/c/f: INSURERS: CONTRERA ROOFING CORP. (ICA) INSURER C: 144 N.E. 26TH STREET INSURER D: MIAMI, FL 33137 INSURER E: Phone: (786) 487-8393 Fax: (305) 573-6604 INSURER F: COVERAGES CERTIFICATE NUMBER: AC12-1501569-1134947 REVISION NUMBER: I HIS 15,TEO)GF-RTIf-Y iNSUKANct:Uslhu BELOW HAVE BEEN tSSUFE)TO THE INSURED NAME ABOVE FOR D-It POLICY PaKlOu INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT W I TH RESPECT TO W HIGH 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. NR TYPE OF INSURANCE LRR POLICY NUMBER DAPOLICY EFF DA POLICY EXP LIMITS IYYI GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PR&M T(Ea NrED nee) $ CLAIMS MADE r--1 OCCUR a MED EXP(Arty one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG POLICY M j LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO ALL OWNED AUTOS ❑ ❑ SCHEDULED AUTOS BODILY INURY(Per academ) $ HIRED AUTOS PROPERTY DAMAGE $ (Per accklant) NON-OWNED AUTOS UMBRELLA LINE CLAIMS-MADE EACH OCCURRENCE $ EXCESSLUM OCCUR 11 F-1 AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ OR RS COMPENSATION D x S - EMPLOYERS'LIABILITY ANY PROPERIETOR/EXECUTTVE YIN E.L.EACH ACCIDENT $ 1000000 OFFICER.MEMBER EXCLUDED? MN (Mandatory in NH) y, WA DPE26272740260 04/01/2013 04/01/2014 EL.DISEASE-EAEMPLOYEE $ 1000000 If yes,describe under EL DISEASE-POLICY LIMIT $ SPECIAL PROVISION below 1000000 DESCRIPTION OF OPERATIONS/LOCATIONSNMICLES(AUachedACORDIM,Additional Remarks Schedule,If more space Is required ROOFING CONTRACTOR CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH MIAMI SHORES VI THE POLICY PROVISIONS. 10050 NE 2 AVE MIANI SHORES, FL 33138 AUT14ORtZEDREPRESE14TATN'E .��-�'�4 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION.All right reserved e _ 47a.Npr-"J6 ..V.01-0 WA.Vi: .• L3:CENSE NSI� 3200SS�4. CCC059793 ROC?F1RGO1�TTOR Pa `t DNS CM- a ►eId be :rw =Fl ol X" the provisions o Cbap F '�. iiration date: AUG 31, 2014,; ` M79RAR R}Oy1��ER +� 5 1.v`E,.• .. Cbl1P7G E ��.rr;�1110.. .,' as a+g 144 RS: 26 STRSST MIAMI FL 3:3139 m CC R g w9QN O 1` +CR VARY DISPLA A� QUYREO BY LAWN - , MIAMI-DADE COUNTY 2012 LO CAE BUSINESS TAX RECEIPT '' 2043 & FIRBT-CLAD TAX COLLECTOR MIAMI-DAgE COUNTY STATE Of#?1:ORIbA 140 W.FLAGLER Si: EXPIRES SEP!'-30,2014_ U.S.POSTAGE Is MI,FL t MUST BE DISPLAYED AT PLACE OF BUSINESS '^ PAID MIAMI,FL 33130 LtANT TO COUNTY CODE CHAPTER BA 'Fl. t PERMIT NO.231 THIS IS NOT A BILL-DO NOT PAY 590.026-2 RENEWAL BUS NAME t L'OC TION j CONTRERA ROOFING CORP R�c�IPTNO' 615462-9 144 HE 26 ST 33137 MIAMI i OwNER d� 60MOTRERA ROOFING CORP r, EMP OYE /S r�r E ��W IS &PAW&VICE BUSINESS 1 pQ TAX mwmpr.R FAMATM Co LAWS" oF Mm Io0umv OR Crum um DO WrFaMARD ' , CONTRERA ROOFING CORP M Rte+ap 144 HE 26 ST Tais MIAMI FL 33137 corotm"rwc 08/20/2012 60030000405 _ -000045.00 �aa��ata��t�ta��a� �t�aaa�s�naea� �faa�a} ra�aaa�a���t0 SEE OTHER SIDE -^-' ST ATE OF FL OR p� � '"�` * 1i�+cxIrATiON -' C3' .� 0 i „ .i .- 5E( LO906a10r�r NBR 9 Q9 "R 802C:x # 011290 y s Lssr�.e saa Chapter &9 - 2011 `$ NO'SI to PSORM RF t T© SS h4 ONLY. IF IT Rt30 0 Co" = - �r LAW = FL 3131 u ='uk �• ` CRAKES$ W, DRAGO _ r �L CRI T SECRETARY � Inspection Worksheet ' Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-191346 Permit Number: RF-5-13-1044 Scheduled Inspection Date:August 19,2013 Permit Type: Roof Inspector: Rodriguez,Jorge Inspection Type: Final Roof Owner: CURZON,ANDREW Work Classification: Tile Job Address:10050 NE 12 Avenue Miami Shores, FL Phone Number Parcel Number 1132050190370 Project: <NONE> Contractor: CONTRERA ROOFING CORP Phone: (305)389-0228 Building Department Comments RE-ROOF TO TILE Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed I, Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. August 16,2013 For Inspections please call: (305)762-4949 Page 11 of 33 s Florida International Engineering and Testing Lab LLC Fel * Ee 16701 SW 117 Avenue, Miami,FL 33177 FLORIDA INTERNATIONAL ENGINEERING Telephone:(305)378-1991-Fax: (305)378-1997 &TESTING LAB INSIGHT-INNOVATION-INTEGRATION Miami-Dade Lab Certification#07-0612.11-State of Florida ca#27273 --------------------------------------------------------------------------------------------------------------------- SITE SPECIFIC INFORMATION Owner's Name: Job Address: 101>0 O 1 ��► Roofing Contractor: 6►3 L5 FA V-4 Permit Number: V.-S �� •- 1 V !!544 Type of Tile: COP Approximate Roof Height: feet Slope:_ Approximate Square Footage: 31 8 JD ft2 Type of Access to Roof: Ladder OtherRequired Testing rc 35 lbs. Testing Equipment: F. .g.VOx Shim o Instrument Date Installed: �' Date of Inspection: TEST RESULTS P=PASS,F=FAIL Test P or F Test P or F Test P or F Test P or F Test P or F Location Location Location Location Location 1 21 A.4 5, 41 61 81 2 22 42 62 82 3 23 43 63 83 4 1 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 1 59 79 99 20 40 60 80 100 IN ACCORDANCE WITH THE CRITERIA OF PROTOCOL TAS 106,THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CONTROL TEST. ADDITIONAL TEST INFORMATION AAAA 1 111181, Perimeter Width: ft RESPF� I YBW ED BY: Area Units or ft2 No.of Tests ®®®,��P � E N Perimeter 72,200 ►sir' No 63107 "•92 ® .G Field 8 Corners �( Hips&Ridges '2. ® V e a r s 10 V ! ® �O N A%�6 to 5111". • a'•• ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■�'I■■■■■■■■■■■■■■■■■■■■■!!■��■■ems�■■■ ■■■■■■■■■I■■■I■■\■N■r■\iiN11P-5071 WAW .MEN■■■ ■■■■■■■■ilk!■I'■■■ R" na■ ' % ■`ZJ■r7►�!�c±- ■■■■ OWW"Am No ENE ■■■■■■■■■1■■■l��r�r�■■e�■■■■��■[nil■[�' ��■,'!1■■■■ ■■■■■■■■�!J■■I «aWi■��� +�����■���■�■111■ail■■■■ ■■■■■■■■■irJ■■■■■■■■■■■■■■■■■■■■; iii Z■■ ■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ i, �+ - R g Miami Shores Village sun p,,,M Building Department 10050 N.E.2nd Avenue ' + �+ Miami Shores, Florida 33138 A�R��pp► Tel: (305) 795.2204 Fax: (305) 756.8972 RE: Permit# ^ 13 —04 l 1 DATE: mt M INSPECTION AFFIDAVIT I ns \v C—D n-k e-y-✓� licensed as a(n)Contractor/Engineer/Architect, (Print name and circle License Type) FS 468 Building Inspector License#: C CC_Q 13 On or about — j ^ I �D , I did personally inspect the roof deck nailing and (Date&time) Secondary water barrier work at 60 C �J. F . / 2- (Complete Job Site Address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual(Based on 553.844 F.S) SZ Signature State of Florida County of Dade: The undersigned, being the first duly swom,deposes and says that he/she is the contractor for the above property mentioned. Swom to and subscribed before me this day of �`� .• ! ®® Notary Public,Sate of Florida at Large V% *General,Building,Residential,or Roofing Contractors or any individual certified under 468 F.S.to make sucli an ins 'on. is`of each plane of the roof with permit#and address#clearly shown marked on the deck for each inspection Revised on 5/21/2009