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RF-14-411
. BUILDING PERMIT APPLICATION Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 INSPECTION LINE PHONE NUMBER: (305) 762 -4949 A`'_- 2 0,.:14 FBC 20 1p� Master Permit No. F 3 I LI 1-1 Sub Permit No. ❑BUILDING ❑ ELECTRIC OOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLICWORKS CHANGE CONTRACTOR ❑ CANCELLATION SHOP DRAWINGS JOB ADDRESS: i/7 J Rt. /0? sr City: Miami Shores County: Miami Dade Zip: Folio /Parcel #: l l — 2Z3 / D ! -ro I b' Is the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): // /di A (1 Oil '� Phone#: ('t,3 9 /V4. /07 s T (// City: �c / rJ lU State: Pl0 64 Zip: 5313 r Tenant /Lessee Name: d 04x4'` Address: Phone #: Email: CONTRACTOR: Company Name: *--e000:1N►rON *'.41 C. Address: ' O• .aC,It. 1 1 1 9 Y City: A) . Q . t� State: p Qualifier Name: e_-f -¢ L IJ ),...e.,,,A.Ate 5 Phone #: SG. a^ i i 9731 Zip: 3 3t}0 E5" Phone #: — Ogg State Certification or Registration #: C C C D H - 4Q ( Certificate of Competency #: DESIGNER: Architect /Engineer: Phone #: Address: °-� City: State: ,t Zip: Value of Work for this Permit: $ /iot b Square /Linear Footage of Work: 2406 Q6 Type of Work: ❑ Addition ����''��� w -'� ❑ Demolition yp ❑ � Iteration w -` _ L Be �� ace Descript »n of rk: L , i % ree.' .4,i It a n tai,. =c C , §R. A ttckw+ +a 1 ^s, + t.,14r+r Specify color of color thru tlle: e0At afrz- 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 $ ON- Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. S rt ture J`�L t L (L67 t Owner or Agent The foregoing instrument was acknowledged before me this this I g day of a / . 20 L1 by who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign Print: My Commission Expires: j) e t1 SignaturecR4A Q . �I Contractor The foregoing instrument was acknowledged before me , day of 20 %, by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: CES E. CLARE Notary Public - State of Florida �, . Expires Oct 16, 2015 • I Commission # EE 138231 . (4, `' Banded Through National Notary Assn. gn: 47)QJLt.4., gt rint: 6 j C.r< at y Commission Expires: Q �� /(p ZO / * * * * ** * * * * * * * * * * * * * * * * * * *f * * * * * * ** * * * * * * ** APPROVED BY / /"--t1 Plans Examiner Structural Review „,,,,,,,, ,, FRANCES E: CLARE $ L�` , Notary Public - State of Florida M,fsaTesfspiaes00044 601 14. =; ,s,'” Commission # EE 138231 '''%,=.'.-$' Bonded Through National Notary Assn. fmTigrrj71:effrr Clerk (Revised02 /24 /2014)(Revised 5 /2 /2012)(Revised 3/12/2012) )(Revised 06 /10 /2009)(Revised 3 /15 /09)(Revised 7/10/2007) STATE OF FLO' 1A DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850) 487 -1395 1940 NORTH MONROE STREET 32399 -0783 TALLAHASSEE FL DZENUTIS PETER A JR ROOFMAN ZINC 911 W 15TH ST PO BOX 13148 NORTH PALM BEACH FL 33408 -3148 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our to barbeque businesses ran range efrom eep architects rid's to strong. from Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto wvrw.myflorldaIIcense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license! DETACH HERE STATE of FLORIDA AC# / 9 2 30 3 DEPARTMENT OF REGULATION USIESSS AND FROFESSIO 17/09/12 128004802 PING CONTRACTOR CCC044891 CERTIFIED DZENUTISs1P ROOFMAN IS CERTIFIED uader the provisions or ch.489 FS asyiration tats, AUG 31, 2014 14.2070900919 THIS DOCUMENT HAS A COLORED BACKGROUND • MICROPRINTING • LINEMARK '' PATENTED PAPER C# 6192303 STATE OF FLORIDA DHPARTSTRUCTIONSINIAUSTRYRLICMSLB OiliDi'T'ION SEW L12070900919 DATE BATCH NUMBER LICENSE NBR 07/09/2012 128004802 CCC044891.- The ROOFING CONTRACTOR Named below IS CERTIFIED pp Expiration date: dates:1 Chapter AUG UG 31,2014' 3` DZENUTXS, PETER A JR ROOFMAN INC 913. W 15TH ST PO BOX 13148 NORTH PALM BEACH RICK GOVERNOR FL 33408 -5686 nISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY ANNE M. GANNON CONSTITUTIONAL TAX COLLECTOR Serving Palm Beach County Serving you. P.O. Box 3353, West Palm Beach, FL 33402 -3353 **LOCATED AT** www.pbctax.com Tel: (561) 355 -2264 911 W 15TH STREET RIVIERA BEACH, FL 33404 TYPE OF BUSINESS OWNER CERTIFICATION # RECEIPT #/DATE PAID AMT PAID BILL # 23-0125 CW ROOFING CONTRACTOR DZENUTIS PETER ANDREW JR CCC044891 B13.1517146 - 08/21/13 $185.85 B40124083 This document is valid only when receipted by the Tax Collector's Office. ROOFMAN INC ROOFMAN INC PO BOX 13148 NORTH PALM BEACH, FL 33408 -7148 uIIuJLuLuIII ,III,IIJuILuIIIIIIII,'II ANNE M. GANNON CONSTITUTIONAL TAX COLLECTOR Serving Palm Beach County Serving you. B3 -64 STATE OF FLORIDA PALM BEACH COUNTY 2013/2014 LOCAL BUSINESS TAX RECEIPT LBTR Number: 200000626 EXPIRES: SEPTEMBER 30, 2014 This receipt grants the privilege of engaging in or managing any business profession or occupation within its jurisdiction and MUST be conspicuously displayed at the place of business and in such a manner as to be open to the view of the public. P.O. Box 3353, West Palm Beach, FL 33402 -3353 *`LOCATED AT** www.pbctax.com Tel: (561) 355 -2264 911 W 15TH STREET RIVIERA BEACH, FL 33404 TYPE OF BUSINESS OWNER CERTIFICATION # $ f 23-0081 ROOFING CONTRACTOR I DZENUTIS PETER ANDREW JR CCC044891 813.1 517147 - 08/21113 A 50D 840124084 This document is valid only when receipted by the Tax Collector's Office. B2 -64 ROOFMAN INC ROOFMAN INC PO BOX 13148 NORTH PALM BEACH, FL 33408 -7148 IuIIuuuIIIIIuuIIIIJIIuIIIIIIIIr r'IIIIIIIII'II STATE OF FLORIDA PALM BEACH COUNTY 2013/2014 LOCAL BUSINESS TAX RECEIPT LBTR Number: 200000625 EXPIRES: SEPTEMBER 30, 2014 This receipt grants the privilege of engaging in or managing any business profession or occupation within its jurisdiction and MUST be conspicuously displayed at the place of business and in such a manner as to be open to the view of the public. . a CERTIFICATE OF LIABILITY INSURANCE Date I 4/18/2014 Producer: Lion Insurance Company 2739 U.S. Highway 19 N. Holiday, FL 34691 (727) 938 -5562 This Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by the policies below. Insurers Affording Coverage NAIC # Insured: South East Personnel Leasing, Inc. & Subsidiaries 2739 U.S. Highway 19 N. Holiday, FL 34691 Insurer A Lion Insurance Company 11075 Insurer B: Insurer C: Insurer D: Insurer E: Coverages The policies of Insurance listed below have been issued to the Insured named above for the policy period indicated. Notwithstanding any requirement term or condition of any contract or other document with respect to which this certificate may be Issued or may pertain, the insurance afforded by the policies described herein is subject to all the terns, exclusions, and conditions of such policies. Aggregate limits shown may have been reduced by paid Gains. INSR LTR ADDL INSRD Type of Insurance Policy Number Policy Effective Date (MM /DD/YY) Policy Expiration Date (MM /DD/YY) Limits GENERAL LIABILITY Commercial General Liability Claims Made I, Occur Each Occurrence $ Damage to rented premises (EA occurrence) $ Med Exp $ Personal Adv Injury $ General aggregate limit applies D Policy ❑ Project per: LOC General Aggregate $ Products - Comp /Op Agg $ AUTOMOBILE LIABILITY ] Any Auto All Owned Autos Scheduled Autos Hired Autos Non -Owned Autos Combined Single Limit (EA Accident) $ Bodily Injury (Per Person) $ Bodily Injury (Per Accident) $ Property Damage (Per Accident) $ EXCESS/UMBRELLA LIABILITY ROccur ❑ Claims Made Deductible Each Occurrence Aggregate A Workers Compensation and Employers' Liability Any proprietor /partner /executive officer/member excluded? NO If Yes, describe under special provisions below. WC 71949 01/01/2014 01/01/2015 X I tWo C Statu- Limits I ER E.L Each Accident $1,000,000 E.L Disease - Ea Employee $1,000,000 E.L Disease - Policy Limits $1,000,000 Other Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 Descriptions of Operations /Locations/Vehicles /Exclusions added by Endorsement/Special Provisions: Client ID: 81-65 -748 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. & Subsidiaries that are leased to the following "Client Company": Roofman, Inc. Coverage only applies to injuries Incurred by South East Personnel Leasing, Inc. & Subsidiaries active employee(s), while working in: FL Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937 -2138 or by calling (727) 938 -5562. Project Name: ROOFING CONTRACTORS ISSUE 4 -17 -14 (MT) REISSUE 4 -18 -14 (MT) Benin Date 8/12/2011 CERTIFICATE HOLDER CANCELLATION MIAMI SHORES VILLAGE BUILDING DEPARTMENT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Should any of the above described policies be cancelled before the expiration date thereof, the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. �✓' . 210 South West 21s terrace Fort Lauderdale, Florida 33312 95-14 o a r ry or Quality Roofing Since 1964 7- picarknii E & F Roo Inc. Licensed& F • { t /''° f 54 ®re. 'L 1-Q1e_ % s Le.rrr ifs ra ao -NdeL do Co �lTt� -c fL1^ y✓1� +%- / V a RF 3 I [.fLl j/ Rio Vo �� " `"2Adozke To pro I//ate- IA) Drge P' off' c i o f Y 0 Ll 13 N _..�._.._..�._�..._... �.. �. �....�._....._....__.._.__�- __5_µµ5 E & F Roofing John R. Capers State License #CCC1325758 210 South West 21s`Terrace Fort Lauderdale Florida 33312 7.5/4 /4491-ZZoa 1 DAVID A. DACQUISTO, AICP PLANNING & ZONING DIRECTOR V//jaini - Ch,oN66 ?AI� DEVELOPMENT ORDER 10050 N.E. SECOND AVE. MIAMI SHORES, FLORIDA 33138 -2382 Telephone: (305) 795 -2207 Fax: (305) 756 -8972 File Number: PZ- 10 -13- 201357 Property Address: 443 NE 103 "1 St. Property Owner /Applicant: Address: Agent: Address: Hilda Hodge 443 NE 103 "d St. Miami Shores, FL. 33138 Lvorlee Iles 443 NE 103rd St. Miami Shores, FL. 33138 Whereas, the applicant Hilda Hodge (Owner), has filed an application for site plan review before the Planning Board on the above property. The applicant sought approval as follows: Special site plan review and approval. Metal Roof. Whereas, a public hearing was held on November 14, 2013 and the Board, after having considered the application and after hearing testimony and reviewing the evidence entered, finds: 1. The application was made in a manner consistent with the requirements of the Land Development Code of Miami Shores Village. 2. The conditions on the property and the representations made at the hearing merit consideration and are consistent with the requirements of the Land Development Code. The Board requires that all further development of the property shall be performed in a manner consistent with the site plan, drawings, and the conditions agreed upon at the hearing: 1) Approval is for a Sandstone color standing seam metal roof. 2) Applicant to obtain all required building permits before beginning work. 3) Applicant to meet all applicable code provisions at the time of permitting. 4) This zoning permit will lapse and become invalid unless the work for which it was approved is started within one (1) year of the signing of the development order by the board chair, or if the work authorized by it is suspended or abandoned for a period of at least one (1) year. Page 1 of 2 DO PZ- 10-13- 201357 Hodge The application with conditions was passed and adopted this 14th day of November, 2013 by the Planning and Zoning Board as follows: Mr. Abramitis YES Mr. Busta YES, Mr. Reese YES Mr. Zelkowitz ABSENT Chairman Fernandez YES / (3 Date f' chard M. Ferran. z Chairman, Planning Board DO PZ- 10- 13- 201357 Hodge Page 2 of 2 IVijami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 March 17, 2014 Permit No: RF14 -411 Building Critique Review 1. FBC. 2010, SECTION 105.3.5,...EVERY EMPLOYER AS CONDITION TO RECEIVING A BUILDING PERMIT, SHOW PROOF THAT IT HAS SECURED COMPENSATION FOR ITS EMPLOYEES AS PROVIDED IN SEC440.10 AND 440.38. FLORIDA STATUTE. Ismael Naranjo Building Official Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. amp- CERTIFICATE OF LIABILITY INSURANCE DATE (MMMIDDDDY YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WANED, 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 Maples Insurance Agency 1051 East Sample Road Pompano Beach, FL 33064 Phone (954)946-8940 Fax (954)946 -8942 CONTACT NAME: (NC. No. ExtI: (994)946-9940 FAX No): (994)946-8942 AADDRESS: maplesins@aol.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Atlantic Casualty INSURED Roofman, Inc. PO Box 13148 North West Palm Beach, FL 33408 INSURER B : 08/16/2013 INSURER C : EACH OCCURRENCE INSURER D : n COMMERCIAL GENERAL LIABILITY • • CLAIMS -MADE U OCCUR ❑ INSURER E : $ 100 000.00 INSURER F : $ 5,000.00 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSR SWVD POUCY NUMBER (MMM/DDD //YYYY) (MOM/UDD/YYYY) UMITS A GENERAL UABIUTY L0400018550 08/16/2013 08/16/2014 EACH OCCURRENCE $ 1,000,000.00 n COMMERCIAL GENERAL LIABILITY • • CLAIMS -MADE U OCCUR ❑ DAMAGE TO RENTED PREMISES (Ea nrence) $ 100 000.00 MED EXP (Any one person) $ 5,000.00 PERSONAL & ADV INJURY $ 1,000,000.00 • GENERAL AGGREGATE $ 1,000,000.00 GENTAGGREGATEUMITAPPUESPER: • POLICY n PRO- • LOC JECT PRODUCTS - COMP/OP AGG $ 1,000,000.00 $ AUTOMOBILE UABIUTY II ANY AUTO • AALLLOWNED ■ SCHEDULED NON -OWNED HIRED AUTOS • AUTOS • • COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ • UMBRELLA UAB II OCCUR • EXCESS UAB • CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ • DED • RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE N I A • TWORY IJMR • FOR E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L. DISEASE - EA EMPLOYE $ K s describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Roofing Contractor CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORED REPRESENTATIVE John Derosa ACORD 25 (2010/05) QF © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CITY HIGH- VELOCITY HURRICANE ZONES 4.s Section A (General Information) Master Permit No. .) ., Process No. Contractor's Name i P a��l✓��' /176, /03 <s r✓z • ROOF CATEGORY ❑ Low Slope ❑ hanically Fastened Tile ❑ Mortar/Adhesive Set Tile ❑ Asphaltic etas Panel/Shingles ❑ Wood Shingles/Shakes Shingles ❑ Prescriptive BUR -RAS 150 ROOF TYPE ❑ New Roof W R' roofing ❑ Recovering ❑ g Repair ❑Maintenance ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF) Job Address Section B (Roof Plan) Sketch Roof Plan: Illustrate all levels and sections, roof drains, scup • ti • verflow scuppers and overflow drains. include dimensions of sections and levels, col iden dimensions of elevated pressure zones and location of . : ra ts. m 1 HIGH - VELOCITY HURRICANE ZONES Florida Building Code Edition 2010 High Velocity Hurricane Zone Uniform Permit Application Form, Section D (Steep Sloped Roof System) J Roof System Manufacturer A Product Approval Number ( 3 0 % O. - O 2 Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations): P9: P2: P3: Maximum Design Pressure Product Approval Specific System: Method of tale attachment Roof Slope: °-f :12 Steep Sloped Roof System Description Deck Type: ype Underlayment• Insulation: Oc Fire Bar er: Fastener Type & Spacing: dhesiye Type: ype Cap Sheet: Roof Covering: Ridge Ven ti Oon7 Mean Roof Height: Type & Size Drip dge: SECTION R4402.13 HIGH VELOCITY HURRICANE ZONES — REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS R4402.13.1 Scope. As it pertains to the section, it is the responsibility of roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of the section. The provisions of Section R4402 govern the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner ant the contractor. The owner's initial in the designated space indicates that the item has been explained. 1. da w Aesthetics - Workmanship: the workmanship provisions of Section R4402 are for the purpose of providing that the roof system meets the wind resistance and water instruction performance standards. Aesthetics (appearance) are not a consideration with respect to workmanship provisions. Aesthetic issues such as color or architectural appearance, that are not part of a zoning code, should be addressed as part of the agreement between the owner and the contractor. 2. /I 11 Renailing wood decks: When replacing roofing, the existing wood roof deck may have to be renailed in accordance with the current provisions of Section R4403. (The roof deck is usually concealed prior to removing the existing roof system). 3. IkNi Common roofs: Common roofs are those which have no visible delineation between neighboring units (i.e., townhouses, condominiums, etc.) In buildings with common roofs, the roofing contractor and/or owner should notify the occupants of adjacent units of roofing to be performed. 4. k/ la Exposed Ceiling: Exposed, open beam ceilings are where the underside of the roof decking can be viewed from below. The owner may wish to maintain the architectural appearance; therefore, roofing nail penetration of the underside of the decking may not be acceptable. This provides the option of maintaining the appearance. 5. 11 /4 Ponding water: The current roof system and/or deck of the building may not drain well and may cause water to pond (accumulate) in low -lying areas of the roof. Pounding can be an indication of structural distress and may require the review of a professional structural engineer. Pounding may shorten the life expectancy and performance of the new roofing system. Pounding conditions may not be evident until the original roofing system is removed. Pounding conditions should be corrected. 6. 11 // Overflow scuppers (wall outlets): It is required that rainwater flows off so that the roof is not overloaded from a buildup of water. Perimeter /edge wall or other roof extension may block this discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance with the requirements of Sections R4402, R4403 and R4413. 7. N W Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of the structure assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting which can result in extending the service life of the roof. JLs.tede e3 1 Owner /A g ents Si natur Date Contractor Signature Date Revised on 7/9/2009 LD IVI iami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 OWNERS'S AFFIDAVIT OF EXEMPTION ROOF TO WALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE - BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PERSUANT TO SECTION 553.844 F.S. To: Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores, Fl 33138 Re: Owner's Name: Property Address: %a 44 Date: Roofing Permit Number: Dear Building Official: certify that I am not required to retrofit the roof to wall connections of my building because: 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. o 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) Laird. Signature 6_ i -1 cLQJ Print Name State of Florida County of Dade The undersigned, being the first duly sworn, deposes and says that he/she is the owner for the above property mentioned. Sworn to and subscribed before me this + 3 day of Notary Public, Sate of Florida at Large • 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. Than you must provide a building application from a General Contractor for the Roof to Wall connection Hurricane Mitigation. DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) 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 /economy GAF 1361 Alps Road Wayne, NJ 07470 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed and accepted by Miami -Dade County RER - Product Control Section to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Section (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. RER reserves the right to revoke this acceptance, if it is determined by Miami -Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: VersaShield® Fire - Resistant Roof Deck Protection and VersaShield® SokoTM Fire - Resistant Slip Sheet LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved ", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA revises NOA No. 11- 1110.09 consists of pages 1 through 3. The submitted documentation was reviewed by Juan E. Collao, R.A. NOA No.: 13- 1104.06 Expiration Date: 02/07/17 Approval Date: 02/20/14 Page 1 of 3 ROOFING ASSEMBLY APPROVAL Category: Sub - Category: Material: Roofing Underlayment Fiberglass SCOPE: This acceptance is for VersaShield® Fire - Resistant Roof Deck Protection (a.k.a " VersaShield® Underlayment") and VersaShield® Solot Fire - Resistant Slip Sheet (a.k.a " VersaShield SoloTM"), as described in this Notice of Acceptance, for use with approved prepared roof assemblies. Designed to comply with the Florida Building Code and the High Velocity Hurricane Zone of the Florida Building Code. PRODUCT DESCRIPTION: Manufactured by Applicant Dimensions VersaShield® Fire- 42" x 100' rolls Resistant Roof Deck Protection VersaShield® Solo"' 72" x 166.7' rolls Fire - Resistant Slip Sheet MANUFACTURING LOCATION: 1. Conover, NC EVIDENCE SUBMITTED: Test Asencv, PRI Construction Materials Underwriters Laboratories Inc. PRI Asphalt Technologies, Inc. Test Specifications ASTM D 226 Type II Product Description Non - Asphaltic fiberglass -based underlayment and/or fire barrier. UL790 Non - Asphaltic fiberglass -based slip sheet and/or fire barrier. Test Identifier GAF - 270 -02 -02 ELK -063 -02 -01 99NK45831 1ONK11990 R19254 08CA37926 08CA49140 ELK -069 -02 -01 BRY -003 -02 -01 BRY -003 -02 -01 Test Name/Report ASTM D 226 TAS 100 UL790 UL790 ASTM D 226 UL790 TAS 100 TAS 117(B) TAS 114 (H) Date 11/15/10 09/27/01 03/21/00 05/18/11 09/13/01 09/23/09 03/04/02 03/19/02 INSTALLATION: 1. VersaShield® Fire - Resistant Roof Deck Protection or VersaShield® SoloTM Fire - Resistant Slip Sheet shall be installed in strict compliance with applicable Building Code. 2. VersaShield® Fire - Resistant Roof Deck Protection or VersaShield® Solo TM Fire - Resistant Slip Sheet shall be installed with a minimum 4 -inch head lap in a shingle layer fashion. 3. VersaShield® Fire - Resistant Roof Deck Protection shall be mechanically fastened with approved fasteners in compliance with Florida Building Code 1518.2 when used in lieu of a code prescribed ASTM D 226 Type II underlayment. NOA No.: 13- 1104.06 Expiration Date: 02/07/17 Approval Date: 02/20/14 Page 2 of 3 LIMITATIONS: 1. Fire classification is not part of this acceptance, refer to a current Approved Roofing Materials Directory for fire ratings of this product 2. This acceptance is for prepared roofing applications. Minimum deck requirements shall be in compliance with applicable building code. 3. VersaShield® Fire - Resistant Roof Deck Protection shall not be left exposed as a temporary roof for longer than 30 days of application. VersaShield® Solo TM Fire - Resistant Slip Sheet shall not be left exposed to the weather. 4. VersaShield® Fire - Resistant Roof Deck Protection and VersaShield® Solon' Fire - Resistant Slip Sheet are a component used in roof assemblies. Roof assemblies are approved under specific assembly Notice of Acceptance. 5. VersaShield® Fire - Resistant Roof Deck Protection or VersaShield® SoloTM Fire - Resistant Slip Sheet may be used with any approved roof covering Notice of Acceptance listing. VersaShield®Fire- Resistant Roof Deck Protection or VersaShield® SoloTM Fire - Resistant Slip Sheet may be used as a component part of an assembly in the Notice of Acceptance. If VersaShield® Fire - Resistant Roof Deck Protection or VersaShield® SoloTM Fire - Resistant Slip Sheet 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. 6. VersaShield® Fire - Resistant Roof Deck Protection and VersaShield® SoloTM Fire - Resistant Slip Sheet are a non- asphaltic underlayment that may be used as a fire barrier for prepared roof assemblies. For fire classification of specific roof assemblies using VersaShield® Fire - Resistant Roof Deck Protection or VersaShield® SoloTM Fire - Resistant Slip Sheet refer to a current Approved Roofing Materials Directory for fire ratings of this product. 7. All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code and Rule 61G20 -3 of the Florida Administrative Code. LABELING: All membranes or packaging shall bear the imprint or identifiable marking of the manufacturer's name or logo, city and state of manufacturing facility, yellow line to identify the ASTM Standard designation or logo, and the following statement: "Miami -Dade County Product Control Approved" or the Miami -Dade County Product Control Seal as shown below. APPROVED 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 Building Official or Applicable building code in order to properly evaluate the installation of this material. APPROVED' END OF THIS ACCEPTANCE NOA No.: 13- 1104.06 Expiration Date: 02/07/17 Approval Date: 02/20/14 Page 3 of 3 DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES (RER) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Metal Sales Manufacturing Corporation 545 South 3rd Street, Suite 200 Louisville, KY 40202 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 /economy SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials. The documentation submitted has been reviewed and accepted by Miami -Dade County RER - Product Control Section to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction (AHJ). This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product Control Section (In Miami Dade County) andf or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested `for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. RER reserves the right to revoke this acceptance, if it is • determined by Miami -Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Magna -Loc 16" 24ga Steel Non- Structural Roof Panel LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state and following statement: "Miami -Dade County Product Control Approved ", unless otherwise noted herein. RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change in the applicable building code negatively affecting the performance of this product. TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the materials, use, and /or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed, then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA renews NOA #08- 1006.04 and consists of pages 1 through 6. The submitted documentation was reviewed by Alex Tigera. MIAMIDADE COUNTY APPROVED NOA No.: 13- 0905.02 Expiration Date: 12/12/18 Approval Date: 11/28/13 Page 1 of 6 ROOFING SYSTEM APPROVAL: Category: Sub - Category: Material: Maximum Design Pressure Roofing Metal, Panels(Non - Structural) Steel -123.5 psf TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT: Test Product Product Magna -Loc 16" 24ga, Steel Non - Structural Roof Panel Magna -Loc Two Piece Clip Trim Pieces Dimensions 1= various w = 16" min. 24 ga. Min. Yield Strength: 56ksi Length (Top): 4 -114" Length (Bottom): 3 -1/2" Width (Bottom): 11/2" Height: 21/2" Thickness: 0.064" 1= varies w = varies MANUFACTURING LOCATION L Sellersburg, IN. EVIDENCE SUBMITTED Test Agency Valspar Corporation Farabaugh Engineering and Testing Inc. Specifications TAS 110 TAS 125 TAS 125 TAS 110 Test Identifier Various Various T247 -08 T242 -08 Description Preformed, standing seam, coated, prefinished, steel panels. Two -piece metal clip. Coated steel or aluminum trim pieces. Test Name /Report Date Salt Spray, ASTM B117 2006 Accelerated Weathering, 2006 ASTM G23 TAS 100 TAS 125 08/26/08 08/25/08 NOA No.: 13- 0905.02 Expiration Date: 12/12/18 Approval Date: 11/28/13 Page 2 of 6 APPROVED ASSEMBLIES: System: Magna -Loc 16" 24ga Steel Non - Structural Roof Panel Deck Type: Wood, Non - insulated Deck Description: New Construction 19/32" or greater plywood or wood plank. Slope Range: 2 ": 12" or greater Maximum Uplift See Table A Below Pressure: Deck Attachment: In accordance with applicable Building Code, but in no case shall it be less than 8d annular ring shank nails spaced 6" o.c. In reroofing, where the deck is less than 19/32" thick (Minimum 15/32 ") The above attachment method must be in addition to existing attachment. Underlayment: Minimum underlayment shall be an ASTM D 226 Type II installed with a minimum 4" side -lap and 6" end -laps. Underlayment shall be fastened with corrosion resistant tin -caps 4nd 12 gauge 1 Y4" annular ring -shank nails, spaced 6" o.c. at all laps and two staggered rows 12" o.c. in the field of the roll or any approved underlayment having a current NOA. Fire Barrier Board: Any approved fire barrier having a current NOA. Refer to a current fire directory listing for fire ratings of this roofing system assembly as well as the location of the fire barrier within the assembly. See Limitation # 1. Valleys: Valley construction shall be in compliance with Roofing Application Standard RAS 133 and with Metal Sales Manufacturing Corporation's current published installation instructions. Metal Panels and Install the Magna -Loc 16" 24ga Steel Non - Structural Roof Panel" including flashing Accessories: penetrations, valleys, end laps and accessories in compliance "DMC Association of Regional Manufacturers" current, published installation instructions and in compliance with the minimum requirements detailed in Roofing Application Standard RAS 133. Panels shall be installed with approved "Magna -Loc Two -Piece Clips" over the male rib side lap spaced at a maximum listed in Table A below, parallel to the roof slope, fastened with two (2) #12-11 screws of sufficient length for minimum 'h" penetration through the structural deck. Install the adjacent panel with the female end over the male and clip seam. Seam the panels with a mechanical seamer to form a 900 seam. TABLE A - MAXIMUM DESIGN PRESSURES Roof Area Field Perimeter and Corner' Perimeter and Corner' Option 1 Option 2 Maximum Design Pressure: -95.22 psf -101 psf -123.5 psf Maximum Clip Spacing: 30" o.c. 15" o.c. 8" o.c. 1. Extrapolation not allowed NOA No.: 13- 0905.02 Expiration Date: 12/12/18 Approval Date: 11/28/13 Page 3 of 6 SYSTEM LIMITATIONS 1. Fire classification is not part of this acceptance; refer to a current Approved Roofing Materials Directory for fire ratings of this product. 2. The maximum designed pressure listed herein shall be applicable to all roof pressure zones (i.e. field, perimeters, and corners). Neither rational analysis, nor extrapolation shall be permitted for enhanced fastening at enhanced pressure zones (i.e. perimeters, extended corners and corners). 3. Panels may be rolls formed in continuous lengths from eave to ridge. Maximum lengths shall be as described in Roofing Application Standard RAS 133 4. All panels shall be permanently labeled with the manufacturer's name and/or logo, and the following statement: "Miami -Dade County Product Control Approved" or with the Miami -Dade County Product Control Seal as seen below. All clips shall be permanently labeled with the manufacturer's name and/or logo, and/or model. MIAMI•DADE COUNTY APPROVED 5. 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. MIAMI-DADE COUNTY APPROVED NOA No.: 13- 0905.02 Expiration Date: 12/12/18 Approval Date: 11/28/13 Page 4 of 6 factory applied sealant PROFILE DRAWINGS MIAMI-DADE COUNTY APPROVED DETAIL A 16" coverage 4 MAGNA -LOC 16" WIDE 24 GA. ROOF PANELS MAGNA -LOC TWO -PIECE CLIP NOA No.: 13- 0905.02 Expiration Date: 12/12/18 Approval Date: 11/28/13 Page 5 of 6 DETAIL B END OF THIS ACCEPTANCE MIAMI DADE COUNTY APPROVED NOA No.: 13- 0905.02 Expiration Date: 12/12/18 Approval Date: 11/28/13 Page 6 of 6 • -> Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 208311 Permit Number: RF- 3- 14-411 Scheduled Inspection Date: June 16, 2014 Inspector: Rodriguez, Jorge Owner: HODGE, HILDA Job Address: 443 NE 103 Street Miami Shores, FL 33138 -2456 Project <NONE> Contractor: ROOFMAN INC Permit Type: Roof Inspection Type: Final Roof Work Classification: Metal Phone Number Parcel Number 1122310150160 Phone: (561)719 -8737 Building Department Comments RE- ROOF TEAR OFF OLD ROOF REPLACE ROTTEN ROOF RENAIL SHEATHING DRY IN WITH 30 POUND Infractio Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments /20x9,61,,.>"v June 13, 2014 For Inspections please call: (305)762 -4949 Page 8 of 32 • `4 RE: Permit # kC1311/1/// Miami Shores Village Building Department INSPECTION AFFIDAVIT D7,y_As (Print name and circle License Type) License #: On or about 4 /0/-4- 2/q v (Date & time) 403 NQ> Secondary water barrier work at 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 DATE: licensed as a (n) Contractor / Engineer / Architect, FS 468 Building Inspector , I did personally inspect the roof deck nailing and /03 S° i / Rale � (Complete Job Site Address) 33/39' Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S) State of Florida County of Dade: The undersigned, being the first duly sworn, deposes and says that he/she is the contractor for the above property mentioned. Sworn to and subscribed before me this dike ' �► d , f Notary Public, Sate of Florida at Large `General, Building, permit # and add Revised on 5/21/2009 LISA JOANNE EIVANUOII martingstaskisqtler0 IV ..r �•'•.� 1 •or' oraar,�i \r. R4WOIFD ior � 1� ` F.S. t0 ale e such uds an inspection. 'c EX IRL; 1017 153 elosieefuce., tographs of each plane of the roof with