RF-15-342 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-245683 Permit Number: RF-2-15-342
Scheduled Inspection Date: October 19, 2015 Permit Type: Roof
Inspector: Rodriguez,Jorge
Inspection Type: Final Roof
Owner: PALMA,ADRIAN AND MARTHA Work Classification: Tile
Job Address: 174 NE 109 Street
Miami Shores, FL 33161- Phone Number (305)310-3751
Parcel Number 1121360090100
Project: <NONE>
Contractor: GEN-EX BUILDERS, LLC Phone: (305)525-2545
Building Department Comments
RE- ROOF TILE COLOR THRU RED infractio Passed Comments
INSPECTOR COMMENTS False 10-16-15 Re schedule for
Monday due to weather
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-245662.
10-16-15 Re schedule for Monday due to weather
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
October 16, 2015 For Inspections please call: (305)762-4949 Page 17 of 32
♦S.OR s G
<< Miami Shores Vkkkage
loss soffit" Building Department
oma` 10050 N.E.2nd Avenue
ORiDp Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit# o?—�..� DATE: /�
INSPECTION AFFIDAVIT
HENRY LOUDEN
licensed as a (n)Contractor/Engineer/Architect,
(Print name and circle License Type) FS 468 Building Inspector
License#: CGC 060092
On or about 23 /S I did personally inspect the roof deck nailing
d
(Date&time)
Secondary water barrier work at 174 NE 109 STREET, MIAMI SHORES, FL 33161
(Complete Job Site Address)
Based upon that examination I have de rmined the i ation was done according to the Hurricane Mitigation Retrofit
Manual (Based on 553.844 F.S) �J
Signature
State of Florida
County of Dade:
The undersigned, being the first duly sworn, deposes and says that he/she is the contractor for the above property
mentioned.
Sworn to and subscribed before me this "Y day of TA �P
1
Notary Public, Sate of Florida at Large A90 —
ANAM.�
No Public-StW of Florida
My Comm.ExOm Apr 3,2017
Commiwion#FF 4366
'General,Building,Residential,or Roofing Contractors or any individual certified under 468 F. ne of the roof with
permit#and address#dearly shown marked on the deck for each inspection Ew
Revised on 5/2112009
ACB2 Engineering Inc.
Testing-& Engineering Services
Certification of Authorization #8131 Roof Tile Uplift Test Report
Tel: 954-245.8976; Fax: 954.301.7776
5230 NE 18 Avenue
Fort Lauderdale, FL 33334
Attention: Miami Shores Village, Building Division,
10050 NE 2nd Avenue, Miami Shores, FL 33138
Client: Gen- Ex Builders, LLC
Test Date: 3/2/2015 Permit#RF-2-15-342
Palma Residence
Property Address: 17yNE 109 Street, Miami Shores, FI
Roof Pitch: Type of Tile: Roof Area:
4 in 12 Boral Roof Tile 17.00 squares
Tile Attachment Method: Two Component Polyurethane Foam Adhesive-Poly Pro H 160
Field Instrument : IMADA Force Gauge 0-100 Serial number:243454
Test Location Total Number of Tests Field Uplift Pull Test Test results
Perimeter Area: 7.00 sq 7 As per FBC 2010 Passed
Field Area: 10.00 sq 10 As per FBC 2010 Passed
No. of Corner: 6 6 As per FBC 2010 Passed
Ridge Areas: 90 PCs 7 As per FBC 2010 Passed
Important:
These laboratory results can change due to future weather impacts and/or unavoidable roof
traffic.Therefore,this report represents the TAS 106 results at the time of the test.
Please see attached a Roof Sketch for this project.
Cordially,
AC62 Engi ng Inc. (NOA 09-1005.01)
Antonio do, PE
Fla. . 316466
42-c
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