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RF-15-1614 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-249523 Permit Number: RF-6-15-1614 Scheduled Inspection Date: December 24,2015 Permit Type: Roof Inspector: Rodriguez,Jorge Inspection Type: Final Roof Owner: , Work Classification: Repair Roof Job Address:70 NW 105 Street MIAMI SHORES, FL 33150-1242 Phone Number (305)793-0002 Parcel Number 1121360131210 Project: <NONE> Contractor: ANTHONY B WILSON ROOFING INC Phone: (305)251-9123 Building Department Comments REPAIR NE CORNER OF MAIN FRONT STRUCTURE infractio Passed Comments CLAY TILE AT VALLEY. INSPECTOR COMMENTS False REC COAT DETACH REAR STRUCTURE WHITE MASTIC Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-237910. Provide pictures of repair and uplift test Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. December 23,2015 For Inspections please call: (305)762-4949 Page 11 of 21 Lab Report No. 125437 Fl.®RIDA TEC PROVIDING SOLUTIONS TO THE ROOFING INDUSTRY C.A.#30448 Lab Certificate#13-0507.02 CONCENTRATED UPLIFT LOAD TESTING ON ROOF TILE TO COMPLY WITH METRO-DADE COUNTY PROTOCOL TAS-106 PROPERTYADDRESS: 70 NW 105th St,Miami Shores PERMIT No: RF6-15-1614 ROOFING OWNER: SQUARES: 1 CONTRACTOR: Anthony Wilson Roofing ROOFPITCH: INSPECTOR TILE TYPE: Spanish "S INITIAZ S: 7C ATTACHMENT.• Polyfoam TEST DATE: 12/22/2015 Testing Equipment: Di ital Chatillon DFIS 200 Test Tabulation Required Testing Force:35 Ibs No. RESULT No. RESULT No. RESULT No. RESULT No. RES ULT 1 Passed THIS ROOF HAS:PASSED ® FAILED Q THE STATIC UPLIFT IN ACCORDANCE WITH MIAMI-DADE COUNTY TAS 106. L 1 r cerel _N* -1 TEST Alberto Cardona,P.E. Lie.No. 17138 1071i' ll-5- 10735 SW 216th St. Unit 416 Tel:305-256-4550 Miami FL 33170 Pale 1 of 1 Fax:305-256-6833 www.FloridaTEC.net P OD 247 Local Ruslne! s TAX eceipt . Miami—Dade Couny, State of Florida 7HIS,:IS:_.'NOT.A BILL„ 5 NOTPAY 24. LB­* 1:6014 C�+ BUSINESS{VAMFJLOCATION: RECEIPT NO. EXPIRES ANTHONY WILSONROOFING.ING aENEuuar_ SEPTEMBER 30,.2016.. ; ; 37919 . 120`NE 23;ST :,25Must be displayed at place oftiusfness, MIAMI(1•33137 Pursuant to County Code s'. Chapter 84—Art9&10 OWNER `:; SEC.TYPE OF BUSINESS PAYMENT RECEIVED ANTHONY WILSON ROOFING INC 196 SPECIALTY BUILDING CONTRACTOR BY TAX COLLECTOR. Woirker(s) 7 CCC05247D $45,00 08/24/2015 ECHECK-15-160390 This Local Business Taz`Receipt oniyimi firms payment of the Local Business Tax.The Receipt is not a license, permitora certification of the holder's:qualifications,to do business.Holder must comply with any governmental ormmt od'ernmental;regulatory lawsandrequirementswhichepplytothe business. The'RECEIPT N0.ab must be displayed on all commercial vehicles—Miami—DadeCode Sec Ba-276. For more infaimation,visit www miamidede.uov/faxcdllector EPew n0 -1614 Miami Shores Village Ty 'Rtx3f 10050 N.E.2nd Avenue NW :... .M :i/Yor, 0assificaWn.Repairftof Miami Shores,FL 33138-0000 `ti— p0 Phone: (305)795-2204 Perrrrit;Status,'APPRNED A RIDS` �-- � _ _ Expiration: 01 6/201 e Date }/201 Project Address Parcel Number Applicant 70 NW 105 Street 1121360131210 MIAMI SHORES, FL 33150-1242 Block: Lot: TRUSTED HOME BUYERS LLC Owner Information Address Phone Cell TRUSTED HOME BUYERS LLC 12864 BISCAYNE Boulevard (305)793-0002 NORTH MIAMI FL 33181- Contractor(s) Phone Cell Phone Valuation: $ 2,100.00 ANTHONY B WILSON ROOFING INC (305)251-9123 _..... . _ Total Sq Feet 70 Type of Work:Re Roof Available Inspections: Additional Info:REPAIR NE CORNER OF MAIN FRONT STRU Inspection Type: Classification:Residential Roof Repair Scanning:3 Final Roof Review Roof Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $1.80 DBPR Fee $2.00 InVOICe# RF-6-15-56151 DCA Fee $2.00 06/29/2015 Check#: 10660 $50.00 $67.80 Education Surcharge $0.60 08/10/2015 Check#:10947 $67.80 $0.00 Permit Fee-Repairs $100.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $117.80 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing informatio 's ac rate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-na co actor t o the work stated. ®/��✓,I/, August 10, 2015 Authorized Signature:Owner / Applicant / Con �^' '�gen; Date Building Department Copy August 10,2015 1 Miami Shores Village I JUN 26 2015 Building Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 INSPECTION'S PHONE NUMBER:(305)762.4949 FBC 20 10 BUILDING Permit No. PERMIT APPLICATION Master Permit No. � Permit Type: BUILDING ROOFING JOB ADDRESS: 70 A-Y W AOS _S-A2 City: Miami Shores County: Miami Dade Zip: 331 3 P Folio/Parcel#: • a - Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder):_�✓ TS e W YOA4 e- 13V ydrr[S It e—Phone#: Address: ✓aeGiF Q3,eCe,4,oA✓r- /1?&,0 471 City: I/Vd4y_L 14,0 AAA/ Or State: `Z zip: 33/XV Tenant/Lessee Name: Phone#: 30-S-- 79-.I-aOOQ- Email: CONTRACTOR:Company Name: Aped o�,,D40 lzov i0oo/ ,v( Phone#: Address: Azo Ile a 3 City: Mi&A-4 d �S"tate• r-A zip: Qualifier Name: N.L 0 ti (/11`J� . i Phone#: 3�eAT"`AS-6 State Certification or Registration#: &e 99 X_J 7 a U Certificate of Competency#: Contact Phone#:30r Qs/•9/13 Email Address: /1A9 to 2 d o/X%,N S • e o.*t re DESIGNER:Architect/Engineer: Phone#: u Value of Work for this Permit:$24/W Square/Linear Zepair/Replace e of Work: Type of Work: ❑Addition ❑Alteration ❑New ❑Demolition Description of Work: APe.7A 19— AM'- dc1e-NePL, 0!°=/��41s� Lo^A1SAOc e%4 A"464 71d- l• JN f--6rd ail Ile.411 le �! S® 14)11.le RX >� Ja���y Color thru tile: /-91,.-1 a- ef& l«rt"V L°®�i�� Submittal Fee$ 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$ d c 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be ed and a reinspection fee will be charged. Signature Signature Owner or Agent �p Contractor The foregoing instrument was acknowledged before me thisa/ The foregoing instrument was acknowledged/before me this�G day of�— 4 ,20 A' by-0D A)ALd &-dMAA1AJ day of—3—vw& ,20 L,by AV, who is personally known to me or who has produced Ad#,ere..ot C. who is personally known to me or who has produced L.r&e ws c- As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: OF; Sign: J o � Print: `Z JVJ S L- , t�,`VW q AA'UdW� FFA� Print:_�C N IS �.,,.Ti My Commission Expires: *44,60,1V My COMMISSION I EE 115440 My Commission Expires: * * My COMRSSION t EE 115440 EXPIRES:October24 2415EXPIRES:October 24,2015 BMW'RrU BMW t+lfty SEIYIm3 >k�kNsBaekga�kRaskXaaK�k�k�kaKsN�k�k�k�k+ksla8s�k%��k�ia�k�'R*kM�k 8s�k��k�kAse>ksksk�kBaAa%k�k�skxaXaBa%g�kaK�k�kS+��k$a�k�ksk�kBsM�sSsfla�k�k%��k�k��k�'F�k�ksk�K�h�H��ksk�kAaH��k�kskak�k�k�k�'Fsk�k#���Kak�k�ksNXa APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) i STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD (850)487-1395 1940 NORTH MONROE STREET TALLAHASSEE FL 32399-0783 ' F WILSON,ANTHONY BRADFORD ANTHONY B WILSON ROOFING INC 120 NE 23 STREET i MIAMI FL 33137 i Congratulations! With this license you become one of the nearly <a ;� � one million Floridians licensed by the Department of Business and �; r Professional Regulation. Our professionals and businesses range STATE OF FLORIDA from architects to yacht brokers,from boxers to barbeque restaurants, Y DEPARTMENT OF BUSINESS AND and they keep Florida's economy strong. PROFES 1 QULATION. L nr& k` 4 Every day we work to improve the way we do business in order to e CCC052470 cM= 09/1 D/ZOt4 serve you better. For information about our services,please log onto www.myfloridalleense.com. There you can find more information CERTIFIED RSL C N RA MT R about our divisions and the regulations that impact you,subscribe WJLSON,-ANTI-0 .. to department newsletters and learn more about the Department'sANTHONY B ® � Initiatives. Our mission at the Department is:License Efficiently,Regulate Fairly. We constantly strive to serve you better so that you can serve your - �' v customers. Thank you for doing business in Florida, -A is CE'FtTNF9EDwrmter the p7o�risions of Ch 4139 f$ and congratulations on your new license! pq'p°"` AIJ 2016 " 86 ' r I j DETACH HERE RICK SCOTT,GOVERNOR KEN IAWSON,SECRETARY STATE OF FLORIDA } DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 33 The ROOFING CONTRACTOR Named below IS CERTIFIED - Undef.the provisions of Chapter 489 fS. a Expiration date', AUG:31,2016 {_ ., Imu �. �, ❑ WILSON, RO ANTHONY BRADFORD INC .-ANTHONY B WILSON O�Il�G � �, t�•� ,'. :7.450 CH NPMAN�-FIELD DR rte ", j MIAMI L�331 645327 ' z� '�' ;ry,k `.. J6 L NJ ISSUED: 09/10/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1409100002286 — i I • I ' ijp 001722 L �.ocal �us��es� Tex Receipt C 6. M�arrli ilade CC�3untr, Mate a of ��lcrlda TH!A,2 NOTA 91LL Dp 11IOTPAY Z 2476014 '. I fR r � ; SUSIiVESS.NAMW,LOCAW0N- fiECEIOr t N0 E]tPIRES NTH NY'1ML5 RpOf,]NGJNc w �eNEv+r SEPTEMBER 30, X0' 5 2537979 T20,NE235rj� Atfustbed�spiayedatlaceofbusmess MUMMfl..333 �`e � } y',a- �i "'•'�..` f s, P�rsuarYtto o cO�& r eg jOWNER - '. c SEC.TYP OFhBUSINESS_ PAYMENT RECEIVED`, 4 _ANTHONY,WIISON ROOM GINC �196 SPACIAL BUILDING GDNTRACm- R gy rax t:OLLECTOR'F �1, 1N5.-CerES) 1 � 00005240 '$45.00 t1 /25/1614 T This;local BusinessTacReceipt oyoaGraa paymentofthe Local Business Tax,Iha Receipt is not a Gcanse pam, or cerffi*on of the hordors ualfficaddits,tD do business.HoldarmustcomQly with any governrleatal n or nongovenunertaraegnlamry lewsarequiremeMswhich epplym the husmess y,r'� -U=-w� Sec B 7de'-RECEIPTIf�'a6ove must belisplayed ortatl caetc�el vahtgle§ Mfamt-Dade oda a-276. Formoreyeiformahon v�srtwvwv'miamidade.'a`oSrRaxcollecmr _���_ mit._. _ .` w ..�.._.. _.....__..�..._.,�.._.,.. i i I i i • I I • I • I 1 • I. l ANTWO02 OP ID:KM CERTIFICATE OF LIABILITY INSURANCE 1 DATE(MYYY) 03/118/18/15 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pol)cy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 321-725-7000 CONTACT J.W.Edens&Company PHONE FAX Commercial Ins of Brevard,Inc 321-725-7856 A/c No): E-MA 325 Fifth Avenue,Suite 108 IL Indialantic,FL 32903 ADDRESS: Scott M.Steele,AAI INSURER(S)AFFORDING COVERAGE NAIC$ INSURER A:Axis Surplus Ins.Co. 26620 INSURED Anthony Wilson Roofing,Inc. INSURER B: 120 NE 23rd Street Miami,FL 33137-4827 INSURER C: INSURER D: INSURER E: INSURER F: 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 POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD MM/DD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A X COMMERCIAL GENERAL LIABILITY FLGLN01282AX 02/21/15 02/21/16 PREMISES Ea—mancel $ 50,00 CLAIMS-MADE FKOCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,00 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY PRO- LOC $ AUTOMOBILE LIABILITY Ea aBIdCOMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMIT R ANY PROPRIETORCPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? NIA (Mandatory In NH) E L DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION MIAMISH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Village of Miami Shores THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 N.E.2nd Avenue AUTHORIZED REPRESENTATIVE /� Miami Shores,FL 33138 �/ eoED ,�J` `b�.�!/� ©1•'9`88-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Date CERTIFICATE OF LIABILITY INSURANCE 6/26/2015 Producer: Plymouth Insurance Agency This Certificate Is Issued as a matter of information only and confers no 2739 U.S. Highway 19 N. rights upon the Certificate Holder. This Certificate does not amend,extend Holiday, FL 34691 or alter the coverage afforded by the policies below. (727)938-5562 Insurers Affording Coverage NAIC# Insured: South East Personnel Leasing, Inc.&Subsidiaries Insurer A: Lion Insurance Company 11075 2739 U.S.Highway 19 N. Insurers: Holiday, FL 34691 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 terms,exclusions,and conditions of such policies.Aggregate limits shown may have been reduced by paid claims. INSR ADDL Policy Effective Policy Expiration Limits LTR INSRD Type of Insurance Policy Number Date Date (MM/DD/YY) (MM/DD/YY) GENERAL LIABILITY Each Occurrence Commercial General Liability Damage to rented premises(EA Claims Made 13 Occur occurrence) Med Exp Personal Adv Injury General aggregate limit applies per. Policy 1:1 Project ❑ LOC General Aggregate Products-Comp/Op Agg AUTOMOBILE LIABILITY Combined Single Unit Any Auto (EAAc ident) $ All Owned Autos Bodily Injury Scheduled Autos (Per Person) Hired Autos Bodily Injury Non-Owned Autos (Per Accident) Property Damage (Per Accident) EXCESS/UMBRELLA LIABILITY Each Occurrence Occur ❑Claims Made Aggregate Deductible A Workers Compensation and WC 71949 01/01/2015 01/01/2016 X I WC Statu- OTH- Employers'Liability tory Limits ER Any pmprietor/partner/executive officer/member LE.L. Each Accident $1,000,000 excluded? NO Disease-Ea Employee $1,000,000 If Yes,describe under special provisions below. Disease-Policy Limits $1,000,000 Other Lion Insurance Company Is A.M.Best Company rated A-(Excellent). AMB#12616 Descriptions of Operations/Locadons/Vehicles/Exclusions added by Endorsement/Special Provisions: Client ID: 84-65-552 Coverage only applies to active employee(s)of South East Personnel Leasing,Inc.&Subsidiaries that are leased to the following"Client Company": Anthony Wilson Roofing,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 arty 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: ISSUE 03-24-15(MT)/REISSUE 06-26-15(TLD) in Date 5/21/2014 CERTIFICATE HOLDER CANCELLATION VILLAGE OF MIAMI SHORES Should any of the above described policies be cancelled before the expiration date thereof,the issuing BUILDING DEPARTMENT 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. 10050 N.E.2nd AVE. MIAMI SHORES, FL 33138 �/ J9 6/26/2015 12 : 27 PM FROM: 7276667636 TO: +13057568972 P. 2 Date CERTIFICATE OF LIABILITY INSURANCE 6/26/2015 Producer: Plymouth Insurance Agency This Certificate Is issued ars a matter of information only and confers no 2739 U.S. Highway 19 N. rights upon the certificate Holder. This Certificate does not amend,extend Holiday, FL 34691 or alter the coverage afforded by the policies below. (727)938-5562 Insurers Affording Coverage NAIC# Insured: South East Personnel Leasing, Inc. &Subsidiaries Insurer A: Lion Insurance Company 11075 2739 U.S. Highway 19 N. Insurer B: Holiday, FL 34691 Insurer C: Insurer D: Insurer E: Coverages The policiesof Insurance listed below have been issued to the insured namedabove a the policy period indicated. Notwithstanding any requirement,term w condition of any contract w 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. Aggregate limits shown may have been reduced by paid claims. INSR ADDL Policy Effective Policy Expiration LTR INSRD Type of Insurance Policy Number Date Date Limits GENERAL LIABILITY (MM/DD/YY) (MM/DD/YY) $ Commercial General Liability Each Occurrence Claims MadeOccur Damage to rented prern ses(EA occurrence) S Med Exp General aggregate limit applies per. Personal Adv Injury Policy ❑Project ❑ LOC General Aggregate $ Products-Comp/Op Agg $ AUTOMOBILE LIABILITY Combined Single Limit Any Auto (EA Accident) $ All Owned Autos Bodily Injury Scheduled Autos (Per Person) $ Hired Autos Bodily Injury Non-Owned Autos (Per Accident) Property Damage (Per Accident) $ EXCESS/UMBRELLA LIABILITY Each Occurrence Occur Claims Made AggregateDeductible A Workers Compensation and WC 71949 01/01/2015 01/01/2016 X WC Statu- OTH- Employers'Liability tory Limits I ER Any proprietor/partner/executive Officer/member E.L.Each Accident $1,000,000 excluded? NO If Yes,describe under special provisions below. E.L.Disease-Ea Employee $1,010,000 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/Locationshrehicles/Exclusions added by Endorsementispecial Provisions: Coverage only applies to active employee(s)of South East Personnel Leasing,Inc.&Subsidiaries that are leased to the following"Client Company"fent ID: 84-65-552 Anthony Wilson Roofing,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 contract0r(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: ISSUE 03-2415(MT)/REISSUE 06-26-15(TLD) CERTIFICATE HOLDERCANCELLATION Begin Date 5/2112014 VILLAGE OF MIAMI SHORES Should any of the above described policies be cancelled before the expiration date thereof,the Issuing BUILDING DEPARTMENT insurer will endeavor to mail 30 days written notice to the certificate holder named to the left,but failure to 10050 N.E.2nd AVE. do so shall impose no obligation orliabiiky of any kind upon the Insurer,Its agents or representatives. MIAMI SHORES, FL 33138 Detail by Entity Name http://searcb.sunbiz.org/Inquiry/CorporationSearcb/SearcbResultDetai... Home Contact Us E-Filing Services Document Searches Forms Help Detail by Entity Nam F AXIAMIted LiabffitwZomeany TRUSTED HOME BUYERS, LLC Filing Document Number L12000034482 FEI/EIN Number 30-0762710 Date Filed 03/12/2012 Effective Date 03/12/2012 State FL Status ACTIVE Principal Address 12864 BISCAYNE BLVD 271 NORTH MIAMI, FL 33181 Mailing Address 12864 BISCAYNE BLVD 271 NORTH MIAMI, FL 33181 Registered Agent Name & Address BAUMANN, DONALD AJR. 12864 BISCAYNE BLVD 271 NORTH MIAMI, FL 33181 "Authorize Per son(s) Name &Addres Title MGR BAUMANN, DON12864 BISCAYNNORTH MIAMI, Copyright ©and Privacy Policies State of Florida, Department of State 1 of 3 6/29/2015 10:09 AM Property Search Application-Miami-Dade County http://www.miamidade.gov/propertysearch/#/report/summary OFFICE OF THE PROPERTY APPRAISEf Summary Report Generated Property Information Folio: 11-2136-013-1210 � Property Address: 70 NW 105 ST Owner TRUSTED HOME BUYERS LLC 12864 BISCAYNE BLVD 271 ' Mailing Address 4 NORTH MIAMI, FL 33181 Primary Zone 0800 SGL FAMILY-1701-1900 SQ ` Primary Land Use 0101 RESIDENTIAL-SINGLE x FAMILY: 1 UNIT Beds/Baths l Half 2/2/0 Floors 1 ' Living Units 1 �� z , Actual Area Sq.Ft Living Area Sq.Ft a I Adjusted Area 1,578 Sq.Ft Lot Size 9,150 Sq.Ft Taxable Value Information Year Built 1939 2015 2014 Assessment Information County Year 2015 2014 2013Exemption Value $50,000 $50,000 $105,611 Land Value $164,440 $98,074 $44,981 Taxable Value 1 $106,855 Building Value $109,829 $106,988 $106,988 School Board XF Value $1,312 $1,327 $1,343 Exemption Value $25,000 $25,000 Taxable Value $131,855 $130,611 Market Value $275,581 $206,389 $153,312 Cfty Assessed Value $156,855 $155,611 $153,312 Exemption Value $50,000 $50,000 Benefits Information Taxable Value $106,855 $105,611 Benefit Type 2015 2014 2013 Regional Save Our Homes Assessment Exemption Value $50,000 $50,000 Cap Reduction $118,726 $50,778 Taxable Value 1 $106,855 $105,611 Homestead Exemption $25,000 $25,000 $25,000 Second Homestead Exemption $25,000 $25,000 $25,000 Sales Information Note: Not all benefits are applicable to all Taxable Values(i.e. County,School Previous Sale Price Price Bookk---Page Qualification Des. Board, City, Regional). 04/06/2015 $258,100 29574-3082 Qual by exam of deed Short Legal Description 01/01/2004 $269,000 22090-2395 2008 and prior year sale MIAMI SHORES SEC 5 PB 10-47 1 exam of deed LOT 12&E1/2 LOT 13 BLK 125 01/01/2004 $0 22090-2394 Qual by exam of deed LOT SIZE 75.000 X 122 01/01/2004 $0 22090-2393 Qual by exam of deed OR 15129-2203 07915 COC 22090-2393 012004 4 The Office of the Property Appraiser is continually editing and updating the tax roll.This website may not reflect the most current information on record.The Property. Mami-Dade County assumes no liability,see full disclaimer and User Agreement at http://www.miamidade.govrinfo/disclaimerasp 1 of 2 6/26/2015 11:45 AM _ I 1 1 � fes/ a I: • �, +: / I � 1 R■�[KK■■llf�lwi4wrrr.KwK■ )w KIIKK rr9llllrllN7[ ■w ■rrr rnr' [Kwrtr�rrr■w ILrw11■ ■wrw 1 RUN,* iw■■R■ rwr7I 111 taa[rrrs,�i *!::;:*I r�)•1R*"-,a��rarfr>r/r'::�W. w f![II�RIIIk� A ► o:q;.Zi�"!',),1►r■7K I�'lI+tk:111+,rr'A:rA6.lr'40ro#,ripj,.ri' i'� ,L,ilrf tr:lf` A'AI1iM►`k'i►�1Cri._7ii� 1 I�tr,w ..y.;.R� r� 1�1,�t#lily[ 'y�( J�ppr 00 w •rr{{■rwr■■r ti/rrH ■ ■r r 010 NKr ■KIR■■ IC�n4w CCU IRIRKr Kw111r1K rrxr ■MrrKKrMKr r■ errrrirr a 7f raKrrr r GaC' rC �Crn11■■ w "rw� Mr'ri� rwC 1 wr rr r r >R .r►w rrwas rK w r ■ wr Crwrw t i Cir rCi�i aaCe 0iwaa Mr �iC raian ii r afCffiffil t�aa a■r�i 1 IRK r p■pgqxrwMCrrr�wC rCr �1 ■ ■ ■r , CC ��MwwlM�[w■ qq■ �iwwC�ia�C■ All �� ■rlf■Illr� ��� r� � rM■■� w�►i�■ 1■ll�! 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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: Altusa Barrel Made in Honduras 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 wards 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. • • • • • • 00 • . INSPECTION; A'ct)p*V of"dilke INDA shall be provided to the user by the manufacturer or its distributors and shall be availagle fjr inspection at tie job site at the request of the Building Official. This renews%nd Levise$"07"11-Q812o.and consists of pages 1 through 6. The submitted do'curne$t'ation was rev3e3iel by Alex Tigera. . .. . . . . . . . CML"1-D�ECQUNTY NOANo.: 12-1203.03 ... Expiration Date: 12/16/17 • ••• • • Approval Date: 02/14/13 . . . . . . . . . . • •• •• •• •• Page 1 of ... . . . ... . . ROOFING ASSEMBLY APPROVAL Category: Roofing Sub Category: Roofing Tiles Material: Clay 1. SCOPE This approves a roofing system using Altusa `Barrel' Made in Honduras, as manufactured by Sulacer, SA. in Honduras and distributed by Sulacer USA,,Inc. as described in Section 2 of 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 section 4 herein. The attachment calculations shall be done as a moment based system. 2. PRODUCT DESCRIPTION Manufactured by Test Product Applicant Dimensions Specifications Description Altusa `Barrel' Made in 1= 18" TAS 112 High profile,two-piece,clay roof tile. For mortar Honduras w=8 %z" set or adhesive set applications with a nominal 2- %Z"thick nominal %2"headlap. Trim Pieces Length: varies TAS 112 Accessory trim,clay roof pieces for use at hips, Width: varies rakes,ridges and valley terminations. varying thickness Manufactured for each tile profile. 2.1 MANUFACTURING LOCATION 2.1.1. Pimienta Cortes,Honduras 2.2 EVIDENCE SUBMITTED: Test Aizencv Test Identifier Test Name/Revort Date American Test Lab of South RT0628.01-11 ASTM C 1167 07/12/11 Florida American Test Lab of South RT0718.01-11 TAS 101 07/21/11 Florida IBA Consultants,Inc. 2397-117 ASTM C 1167 06/28/07 The Center for Applied 94-083 Static Uplift Testing April 1994 Engineering,Inc. PA 101 (Adhesive Set) The Center for Applied 257869-1 Static Uplift Testing Jan. 1997 Engineering,hw, ... . . . . . .. PA 101 (Mortar Set) Redland Technejogiel ;•; ; ; ;•; ••• P0647-01 Wind Tunnel Testing Aug. 1994 •• 000 •• •• • • • •• PA 108 (Mortar Set) Walker Engiieerjiiag,Inc.•• ••• •Calculations Aerodynamic Multiplier March 1999 % Walker Engiflgeril:g,Lnc: ; 414tion Calculations 25-7183 March 1995 N�'�' NOA No.: 12-1203.03 MIAMI•DADE 14 COU TY • • ••• • • Expiration Date: 12/16/17 • • • • • • Approval Date: 02/14/13 .. •. . .•• •• •. ... .•• •• Page 2of6 . r 2.2 EVIDENCE SUBMITTED: Test Agency Test Identifier Test Name/Report Date Walker Engineering,Inc. Evaluation Calculations 25-7094 February 1996 Walker Engineering, Inc. Evaluation Calculations 25-7496 April 1996 Walker Engineering,Inc. Evaluation Calculations 25-7584 December 1996 25-7804b-8 25-78044&5 25-7848-6 3. LIMITATIONS 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile 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 underlayment shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.5 30/90 hot mopped underlayment applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayment material manufacturers published literature. 3.6 This acceptance is for wood deck applications. Minimum deck requirements shall be in compliance with applicable building code. 3.7 May be installed on slopes 7:12 and greater. .. ... . . . . . .. . .. . . . . ... . .. ... .. . . . .. . ••• •• •••.. . . . . • .. . . . . . . .. . . .. . . . . . . . NOA No.: 12-1203.03 WMIAMHD`°'D� lY • Expiration Date: 12/16/17 IIIIIIIIIIIIII�T • ••• • Approval Date: 02/14/13 . . . . . . . . . . • •• •' " Page 3 of 6 r 4. INSTALLATION 4.1 Altusa `Barrel' Made in Honduras tile and its components shall be installed in strict compliance with Roofing Application Standard RAS 120. 4.2 Data For Attachment Calculations Table 1: Average Weight (W)and Dimensions (I x w ) Tile Profile Weight-W(Ibf) Length-1 (ft) Width-w (ft) Altusa Barrel made in Honduras 4.5 11.5 0.71 Table 2: Aerodynamic Multipliers - (ft) Tile (ft) Profile Direct Deck Application Altusa Barrel made in Honduras 0.24 Table 3: Restoring Moments due to Gravity - M9 (ft-Ibf) Tile 211:12" 3":12" 411:12" 5":12" 6":12" 7":12" or Profile greater Altusa Battens Direct Battens Direct Battens Direct Battens Direct Battens Direct Battens Direct Barrel Deck Deck Deck Deck Deck Deck made in N/A 3.37 N/A 3.33 N/A 3.27 N/A 3.20 N/A 3.14 N/A 3.05 Honduras Table 7: Attachment Resistance Expressed as a Moment - Mf(ft-Ibf) for Single Patty Adhesive Set Systems Tile Tile Application Minimum Attachment Profile Resistance Altusa Barrel made in 3M 2-Component Foam Roof Tile Adhesive AH-160 177 (Clay tile) Honduras Flexible TileBond 115 (Cray tile) 3M 2-Component Foam Roof Tile Adhesive AH-160 91.85 (Clay tile) 1 Place 23 grams per pan and 23 grams per cap of AH-160. 2 Place 11.8 grams per pan and 11.6 grams per cap of TileBond. 3 Place 22.5 grams per pan and 14 grams per cap of AH-160. Table 8: Attachment Resistance Expressed as a Moment - Mf(ft-Ibf) •� �•• •• for Mortar Set Systems •• Tila .•: V: Tile Attachment ..Pr@f1;e••: - - Application Resistance Altusa Barrel made in Honduras Mortar Set 24.5 . ... .. ... . . . . . 213.8 4 Berm u a Roof Tree i e rrgortai-. •• • 5 Quickcuate R®of TilWortar#1#40. ••• NOA No.: 12-1203.03 MIAM4DADE • • Expiration Date: 12/16/17 • ••• Approval Date: 02/14/13 . . . . . . . . . . • •• •• •• .. Page4of6 ... . . . ... . . S. LABELING All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo, or following statement: "Miami-Dade County Product Control Approved". ALTUSA MADE IN HONDURAS IDENTIFICATION MARK FOR ALTUSA BARREL CLAY ROOF TILE 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. .. ... . . . . . .. .. . . .. . . . . ... . • . • . • .. ... .. . . . .. . •.• •• •.• . • .. . . . o 9 .. . . . . . . .. . . . •• . • see • • . NOA No.: 12-1203.03 MIAMI•DADECOU TY Expiration Date: 12/16/17 . . . 0 : :0: ; Approval Date: 02/14/13 ;• •; •.• 0:0 ;• •; Page 5of6 1 PROFILE DRAWINGS 18" 2 BARREL CLAY ROOF TILE END OF THIS ACCEPTANCE .. ... . . . . . .. . .. . . . . ... . .. ... .. . . . .. . ... .. ... . . .. . . . . . . .. . . . .. . . . . . . . NOANo.: 12-1203.03 MIAMIDADE COU TY •�• Expiration Date: 12/16/17 ;•; ; ; ; Approval Date: 02/14/13 • •• •• . .• • •' •• Page 6of6 ... . ... . . t MIAMI-DADE COUNTY MIAMFtAM PRODUCT CONTROL SECTION 11805 SW 26 Street,Room 208 DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES(RER) Miami,Florida 33175-2474 BOARD AND CODE ADMINISTRATION DIVISION T(786)315-2590 F(786)315-2599 NOTICE OF ACCEPTANCE (NOA) www.miamidade.gov/economy Somay Products,Inc. 4301 NW 35`"Street Miami,FL.33142-4382 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: Somay#842"Roof Mastic' Coating 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 NGA is displayed,then it shall be done in its entirety. INSPECTION A Qom*:)f't*:s$n=irt NOA shall be provided to the user by the manufacturer or its distributors and shall be availagle for inIpec4o;aileaob site at the request of the Building Official. .. ... . . . . . This NOA renews NOA No. 08-0717.04 consists of pages 1 through 3. . ... .. ... . . The submiled do&rumeJt-gtion,*Vas r:vLcte4 by Juan E.Collao,R.A. .. . . . . . . .. . . . .. . . . . . . . A4� i 'i . a • • • 6:0 • tai�aoe C'u ;.: NOA No.: 13-0627.09 ... : : �, Expiration Date: 09/25/18 ... . ... Approval Date: 09/12/13 Page 1 of 3 t ROOFING COMPONENT APPROVAL Category: Roofing Sub-Category: Cement-Adhesive-Coatings Materials: Elastomeric SCOPE: This approves"Somay#842"Roof Mastic' Coating"as a roof maintenance coatings manufactured by Somay Products Inc.,as described in this Notice of Acceptance.This product is designed to comply with the Florida Building Code and the High Velocity Hurricanes Zone of the Florida Building Code. MANUFACTURING LOCATION 1. Miami, FL EVIDENCE SUBMITTED: Test Agency/Identifier Name Re ort Date PRI Construction Materials Technologies SPIX-001-02-02 ASTM D 6083 06/25/08 Fed Spec TT-C-555B PHYSICAL PROPERTIES OF COMPONENTS Trade names: Somay#842"Roof Mastic' Coating Thickness: Apply a base coat at a minimum rate of Igal/100 ft2(10 dry mil thickness),and a top coat at a minimum rate of Igal/100 ft2(10 dry mil thickness). Total coating thickness for roof surfaces listed below shall be 20 dry mils. Specifications: ASTM D 6083 Description: An acrylic resin-based,water-borne coating applied to new and existing roof surfaces including: • Spray Applied Polyurethane Foam Roofs • Concrete Tile Roof • Clay Tile Roof • Galvanized Metal Roofs • SBS Granule Surfaced Modified Bituminous Membrane Roofs • PVC Single Ply Membranes Container Size: 1 and 5 gallons. Note all precautions on container. Systems Approvals: Methods of application and quantities shall comply with specific Roof Assembly, Product •. ••• •C ontjol DTgtice.pf Acceptance. .• •.. .. . . . .. . .. . . . • . . . • • • ••• • • NOA No.: 13-0627.09 MIAMI•DADE U i•i i i i �a; ,...� v���,. • � e � �•••� Expiration Date: 09/25/18 .a ••• • • • ••• Approval Date: 09/12/13 Page 2 of 3 q BUILDING PERMIT REQUIREMENTS: 1. This Notice of Acceptance 2. Any other documents required by the Building Official or applicable Building Code in order to properly evaluate the installation of this system. LIMITATIONS: 1. Fire classification is not part of this acceptance;refer to a current Approved Roofing Materials Directory for fire rating of this product. 2. Somay Products#842"Roof Mastic"shall not be applied in inclement weather conditions. 3. Somay Products#842"Roof Mastic"shall not be applied over asphaltic shingles. 4. Somay Products#842"Roof Mastic"used on Tiles shall be applied such that the headlaps are not `filled' or `clogged' with coating material,so as to maintain an air-permeable tile roof system. 5. The products listed herein are components of roof assemblies and are approved for use with roof assemblies that list any of the products listed herein as part of their roof assemblies Notice of Acceptance. For applications over existing single ply, smooth or granulated BUR systems.Refer applicable building code for requirements 6. 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.Follow up test results shall be made available to Miami- Dade Product Control Office upon request. 7. All approved products listed herein shall be labeled in compliance with TAS 121 and shall bear the imprint or identifiable marking of the manufacturer's name or logo and following statement: "Miami-Dade County Product Control Approved"or the Miami-Dade County Product Control Seal as shown below. MIAMI•DADE COUNTY �gA..l 7. Change in materials,use, or manufacture of any of the products listed herein shall be cause for termination of this Notice of Acceptance. 8. Somay Products#842"Roof Mastic"shall be applied in accordance with manufacturer's published application instructions. May not be applied on roofs with slope less than V4: 12. END OF THIS ACCEPTANCE • .+ . . . . . . .. . . . . ... . •• ••• •• • • • •• • ••• •• ••• • • •• • • • • • • •• • • • •• • • • • • • • 0. • ; ; `;• ; ; NOA No.: 13-0627.09 MIAMI•DADE C U ••• • • • .� � : : ••• Expiration Date: 09/25/18 ..• • • • ••• • • Approval Date: 09/12/13 Page 3 of 3