RF-16-304 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-253593 Permit Number: RF-2-16-304
Scheduled Inspection Date: February 26,2016 Permit Type: Roof
Inspector: Rodriguez,Jorge Inspection Type: Final Roof
Owner: TAYLOR,WILLIE Work Classification: Tile
Job Address:9540 BISCAYNE Boulevard
Miami Shores, FL Phone Number (305)758-6878
Parcel Number 1132060142850
Project: <NONE>
Contractor: HORACIO UNZUETA Phone: 305-264-5444
Building Department Comments
RE- ROOF TILE Infractio Passed Comments
INSPECTOR COMMENTS False
EXPIRED PERMIT RF 15-947
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-252171. Ladder must extend
min 36"above roof line
Missing:
Uplift test
❑Failed Renailing affidavit
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid
February 25,2016 For Inspections please call: (305)762-4949 Page 28 of 33
,44 wmenma s, m.. A-1 CONSULTING ENGINEERS, INC
ROOF STRUCTURES CONSULTING
ON SITE CONCENTRATED UPLIFT LOAD TESTING ROOF TILE
. IN ACCORDANCE WITH METRO-DADE BUILDING CODE COMPLIANCE
TAS No. 106
UPLIFT TEST EXPERTS
SITE SPECIFIC INFORMATION
Owner's Name: Permit#:
Job Address: Y612
Roofing Contractor: 7`-
Type of Tile: T7 1667• 9P Date installed:
Approximate Roof Height: feet Roof Pitch: / 2
Type of Access to Roof: J�Scaff/olds Ladder Other
Approximate Square Footage of Roof: 1P20 ft 2
Required Testing Force: 35 lbs. Testing Equipment: F.G.E. 100
Date Tested:�_/9� o�
ST LOCATION UPLIFT PULL TEST rEST LOCATION UPLIFT PULL TEST TEST LOCATIOP UPLIFT PULL TEST TEST LOCATIOP UPLIFT PULL TEST rEST LOCATIOP UPLIFT PULL TEST TEST LOCATION UPLIFT PULL TEST
1 26 51 76 101 126
2 27 52 77 102 127
3 28 53 78 103 128
4 29 54 79 104 129 ,
5 30 55 80 105 130
6 31 56 81 106 131
7 32 57 82 107 132
8 33 58 83 108 133
9 34 59 84 109 134
10 1 35 60 85 110 135
36 61 86 111 136
1237 62 87 112 137
38 63 88 113 138
14 39 64 89 114 139
15 40 65 90 115 140
16 41 - 66 - - , 91 116 141
17 42 7 1 92 117 142
18 43 L 6 93 118 143
19 44 69 94 119 144
20 45 - 0 w ^ IN-1 I �5 120 145
21 46 �.^� 71 96 121 146
22 47 97 122 147
23 48 - � 98 123 148
24 49 74 99 124 149
25 50 75 1.00 125 150
IN ACCORDANCE WiTHTHE CRITERIA OF PROTOCOL PA 106,THIS ROOF ASSEMBLY HAS PASSED THE STATIC UPLIFT QUALITY CON-
TROL TEST. THIS TAS 106 TEST HAS BEEN PERFORMED IN FULL ACCORDANCE TO THE REQUIREMENTS OF DADE COUNTY, WITH NO
DEVIATIONS.
THIS REPORJENE
JoseA.MartinP.E.#031509A-1 CONSULTI C.Lab. Certificatenews:01-1224.05
383 S.W. 70th Ct, Miami, Florida 33155 - Telephone(305)740-9550 • Fax (305) 740-9550
ENGLISH: Cell (305) 609-6388 •SPANISH: Cell (305) 498-9804
A-1 CONSUTTING ENTGE\TIEE-RS E\TC.
ROOF STUCTUTIES CONSULTING UPLIFT TEST UCPERTS
LAB. CERTIFICATION No.01-1224-5
4383 SW 70 CTS MANE FL 33155
TE-1.3,05-740-9550 F_X305-74th-955{
Ommer's name: Perm it#:
job address: 9540 BIS:r.4YNE BLVD MIAMI FL.
Roof ing, contractor: H',0RACI0A. UNZUETA.
Type of tile: F-,�, T TILE 9". Date ins-stalled:
,kpproximate roof height- 12 feet Roof pitch: 3./12
Tipe of access to roof: Scaffold: Ladder: otlien
Approxmimate sqtiare footage of roof. 6,20 f U
Required testing force: 35 Ibs
Date tested- Number of tests:. 12
SKETCH OF ROOF
12
7
Revicect- JMM
Date.- 6/19/2015
�5R Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
rORTel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit# DATE:
INSPECTION AFFIDAVIT
I Nzi&hcl® A ` Gjzoe-,-7' licensed as a(n)Contractor/Engineer/Architect,
,
(Print name and circle Ucense Type) FS 468 Building Inspector
License#:
On or about � �-f
I did personally inspect the roof deck nailing
(Date&time) • ••
work at C?54-0 -tSC#NyeSC 13Lti'i'). '0000' 0000.0
.. 0000
•••..• ..:o •.•.:•
(Complete Job Site Address) •
Based upon that examination I have determined the installation was done according to the OHtxweqne Miggtiog Retrdfit0.0'
0000
Manual(Based on 553.844 F-S) . .. 00:00•
0 0 0 0 0 0 0 0 0 0 0 0 0
00000.
0000 . 0000.6
L0000.. 0
. . 0
0.....
Signature '..' : 0 000
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.
Sworn to and subscribed before me this -Z-L-day of u(
Notary Public, Sate of Florida at Large
AUNA R.UNZUETA
MY COMMISSION#EE 154272
'General,Building,Residential,or Roofing contractors or any Ind nrFX WoOkARRIgm on.Include photographs of each plane of the roof with
permit#and address#clearly shown marked on the deck for each BOe�Tkm Notary f'b0a undenxritera
Revised on(7/10014)5/21=9
Pettit NO - - 6-
yxs y,` Miami Shores Village Permit Type R�lof
10050 N.E.2nd Avenue Vb�trJCCtassoafcJn T &b
Miami Shores,FL 33138-0000
xe � Phone: (305)795-2204
F'etrrliliVattrs AP'PROVM
cowlu� 08/14/201
Issue Date.2116/2016FExpiration:
Project Address Parcel Number Applicant
9540 BISCAYNE Boulevard 1132060142850
Miami Shores, FL Block: Lot: WILLIE TAYLOR
Owner Information Address Phone Cell
WILLIE TAYLOR 9540 BISCAYNE BLVD (305)758-6878
MIAMI SHORES FL 33138-2537
Contractor(s) Phone Cell Phone Valuation: $ 7,000.00
HORACIO UNZUETA 305-264-5444
Total Sq Feet: 624
Type of Work:Re Roof Available Inspections:
Additional Info: Inspection Type:
Classification:Residential Up Lift Report
Scanning:3
Tin Cap
Final Roof
Tile In Progress
Renailing Affidavit
Review Roof
Cap Sheet
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $4.20
DBPR Fee Invoice# RF-2-16-58555
$3.75 02/16/2016 Credit Card $227.70 $50.00
DCA Fee $3.75
Education Surcharge $1.40 02/03/2016 Cash $50.00 $0.00
Permit Fee-New Roof $250.00
Scanning Fee $9.00
Technology Fee $5.60
Total; $277.70
In consider,ation 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 at all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zonin . Futhe ore,I authorize the above-named contractor to do the work stated.
February 16,2016
Autho ¢ed Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
February 16,2016 1
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Section D Tile Roof System
Roof System Manufacturer:VENTEGRA ROOF TILE INC
Notice of Acceptance Number(NOA): 11-0414.09 7
Minimum Design Wind Pressures,If Applicable(from RAS 127 or Calculations): ••"
P 1• -39.1 P 2: -68.1 P 3• .... •
...... .... ......
Maximum Design Wind Pressures,(From the NOA Specific system): 40 psf .. •
Fill In the specfflc roof assembly components.If a component is not required,Insert not applicable(hWA the Atobm •••••
...... . . .....
—6/BPI dtld--" ••••••
Deck Type: " yW
. •
Optional Insulation:
NA .. ...
Optional Nailable Substrate:
NA
Optional Nailable Substrate Attachment:
Roof Slope: "112"
NA
Roof Mean Height: 16 ft. Basesheet Type:
Method of The Attachment: ASTM FELT D226 30#
Adhesive,Medium Paddy Polyfoam Polypro—
Fastener Type for Basesheet Attachment:
Alternate Method of Tile Attachment per NOA 1-1/4"RS NAIL AND TIN CAP
NA
Tile Underiayment(Cap Sheet)Type:
�-3"face 26 a POLYGLASS TU PLUS
Drip Edge Size&Gauge: 9
Tile Underiayment Attachment Method:
Drip Edge Material Type: —Gatvinized Metal-- SELF ADHESIVE
Drip Edge Fastener Type: 1-1/4°RS NAIL 4"OC Tile Profile:
BERMUDA CONCRETE 9"FLAT TILE
Hook Strip/Cleat gauge or weight: --Select Hook Strip--
Section E(Tile Calculations)
Method 1 "Moment Based Tile Calculations Per RAS 127"
For Moment based Ute systems,use Method 1. Compare the values for Mr with the values from Mt:If the Mf values arl •
greater than or equal to the Mr values,for each area of the roof,then the file attachment method is acjept%ft "" • 0
• •
P 1: 39.1 x 0.206 = 8.01 _Mg; 8.88 Mr1; 1.15 S 13-1.37NOAtillf"
P 268.1 X 0.205 = 13.95 _Mg 6.86 =Mr2: 7.09 5 31.3 NOA Mf• • " 0:' .
® � ® F-86 � F ....•
P3: 100.7 x 0.205 = 20.64 _Mg; =Mr3: 13.78 5 31.3 N4+�ITAt.' :•••:• ••••••
•••••• • •
•
•
Method 3"Uplift Based Tile Calculations Per RAS 127" 00000. :0 00••
0.0
For Uplift based the systems use Method 3.Compare the values for P with the values for Fr.If the F values are greater than or equal to`tbij Fr blues,for
each area of the roof,then the the attachment method is acceptable.
P1:® x1:®=®xw:===-W=== xcoo 0:�=Fr1:Q5=NOA F
P2®xr===xw.==®-W®=® xc0s0:a=Fr2:=5=NOAF
P3:=xl:==®xw;®=®-W:®== x00s6-F1=Fr3:=5=NOAP
Where to Obtain Information to complete the calculations
Description Symbol Where to Find
Design Pressure P1 or P2 or P3 Table 1 RAS 127,or by an engineer analysis prepared,signed and sealed by a professional
engineer based on ASCE 7.
Mean Roof Height H Job Site
Roof Slope 6 Job Site
Aerodynamic Multiplier X Product Approval(NOA)
Restoring Moment due to Gravity Mg Product Approval(NOA)
Attachment Resistance Mf Product Approval(NOA)
Required Moment Resistance Mr Calculated
Minimum Attachment Resistance F Product Approval(NOA)
Required Uplift Resistance Fr Calculated
Average Tile Weight W Product Approval(NOA)
Tile Dimensions
I=length Product Approval(NOA)
w=width
SECTION R440113
HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING
CONSIDERATIONS
R4402.13.1 Scope. As it pertains to this section,it is the responsibility of the roofing contractor to provide the
ownerwith the required roofing permit,and to explain to the owner the content of this 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 and the
contrac or.The owner's initial in the adjacent box indicates that the item has been explained.
1.Aesthetics-Workmanship:The workmanship provisions of Section R4402 are for the purpose of
providing that the roofing system meets the wind resistance and water intrusion performancg startiards.Atrthetics see*:*
(appearance)are not a consideration with respect to workmanship provisions.Aesthetie j4dUe s such as,"or •o
or architectural appearance,that are not part of a zoning code,should be addressed as&-"gflhe agreUent ......
between the owner and the contractor.
2.Renailing Wood Decks:When replacing roofing,the existing wood roof Aay have tete ••;••.
ren iled in accordance with the current provisions of Section R4403.(The roof deck is u%L"1y%wnceaieddr yr •••••
to removing the existing roof system.) •••••• ;•
_ 3. Common Roofs: Common roofs are those which have no visible dellrteation beXg1g ••••••
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 workleSe;erforrgedy•; •
r' SIL •• •
4.Exposed Ceilings: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 penetrations of the underside of the decking may not be acceptable.This provides the option of maintaining
this appearance.
` 5. 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. Ponding can be an indication of
structural distress and may require the review of a professional structural engineer. Ponding may shorten
the life expectancy and performance of the new roofing system. Ponding conditions may not be evident
until the original roofing system is removed. Ponding conditions should be corrected.
6.Overflow scuppers(wall outlets): It is required that rainwater flow off so that the roof is not
overloaded from a build up of water.Perimeter/edge walls or other roof extensions 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.
1 7.Ventilation:Most roof structures should have some ability to vent natural airflow through the
interior of the structural 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.
Exception:Attic spaces,designed by a Florida licensed engineer or registered architect to eliminate the attic
venting,venting shall not be required.
1
lA/Nl_ i l /�
Owner's/Agent's Signature Date Con or's Si e
Property Address Permit Number
M1tA►M
MIAMI-DADE COUNTY
0MIS PRODUCT CONTROL SECTION
DEPARTMENT OF REGULATORY AND ECONOMIC RESOURCES(RER) l 1805 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.minmidade.eov/economy
Polyglass USA Inc.
150 Lyon Drive •
)Fernley,NV 89408 i •'• •��•' •�••�•
...... .... ......
SCOPE: ...:.• • • •
This NOA is being issued under the applicable rules and regulations governing the use of construstiei!materils..The• •
documentation submitted has been reviewed and accepted by Miami-Dade County RER-ProductelFelttrol Seddon"be
used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction f4N'l
...... ......
•• •• • •
This NOA shall not be valid after the expiration date stated below.The Miami-Dade County Prodwsi:Eentrol Section '.
'(In Miami Dade County)and/or the AHJ(in areas other than Miami Dade County)reserve the right to have tht...;. """
product or material tested for quality assurance purposes.If this product or material fails to perf lm Urtbe acc6pted *90000
manner,the manufacturer will incur the expense of such testing and the AHJ may immediately re*ke,modify.br:': '
suspend the use of such product or material within their jurisdiction. RER reserves the right to revoke this acceDrance,
if it is determined by Miami-Dade County Product Control Section that this product or material fails to meet the
requirements of the applicable building code.
This product is approved as described herein,and has been designed to comply with the Florida Building Code
including the High Velocity Hurricane Zone of the Florida Building Code.
DESCRIPTION:Polyglass Polystick Underlayments
LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo,city,state and following
statement:"Miami-Dade County Product Control Approved",unless otherwise noted herein.
RENEWAL of this NOA shall be considered after a renewal application has been filed and there has been no change
in the applicable building code negatively affecting the performance of this product.
TERMINATION of this NOA will occur after the expiration date or if there has been a revision or change in the
materials,use,and/or manufacture of the product or process.Misuse of this NOA as an endorsement of any product,
for sales,advertising or any other purposes shall automatically terminate this NOA.Failure to comply with any section
of this NOA shall be cause for termination and removal of NOA.
ADVERTISEMENT: The NOA number preceded by the words Miami-Dade County, Florida, and followed
by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then
it shall be done in its entirety.
INSPECTION:A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and
shall be available for inspection at the job site at the request of the Building Official.
This revises NOA#12-0713.02 and consists of pages 1 through 9.
The submitted documentation was reviewed by Alex Tigera.
NOA No.: 14-0717.08
MIAMI•DADECOUNTY Expiration Date: 09/13/16
Approval Date: 01/22115
Page 1 of 9
ROOFING COMPONENT APPROVAL
Category Roofing
Sub-Category: Underlayment
Mate 1 : SBS,APP Self-Adhering Modified Bitumen
PRODUCTS DESCRIPTION:
Test Product
Product Dimensions Specification Description
Polystick MTS Roll: TAS 103 A homogeneous,rubberized asphalt waterproofing
Manufacturing Location 65'8"x TV/s" membrane,glass fiber reinforced with polyolefinic
02 60 mils thick film on the upper surface for use as an
underlayment for metal roofing,roof tile,slate
tiles and shingle underlayment.
Polystick MTS Plus Roll: TAS 103 A homogeneous,rubberized asphalt waterproofing
Manufacturing Location 65'8"x 3'3 3/s" membrane,glass fiber reinforced with polyolefinic
#2 60 mils thick film on the upper surface for use as an
underlayment for metal roofing,roof tile,slate
tiles and shingle underlayment.
Polystick IR-Xe Roil: ASTM D 1970 A fine granular/sand top surface self-adhering,
Manufacturing Location 65'x 3'3 3/s" APP polymer modified,fiberglass reinforced,
#1  Or 65' x 3' bituminous sheet material for use as an
60 mils thick underlayment in sloped roof assemblies.
Designed as an ice&rain shield.
Polystick TU Plus Roll: TAS 103 and ASTM A rubberized asphalt self-adhering,glass.•
(Surface Printing) 65'x 3'3 3/s" D 1970 fiber/polyester reinforcgd waterproofm�•.. ......
Manufacturing Location 80 mils thick membrane.Designed as a tnet9d roofingaftd4roof •
file underlayment. •••:•• *see ••••••
.....•
Polystick TU P Rall: TAS 103 and ASTM A rubberized asphalt waUWbfing x4e4& Me, •....
32'l 0"x 3'3'/s" D 1970 glass-fiber/polyester reinforced,with�a.gragular 6 6:6*•
Manufacturing Location 130 mils thick surface designed for uscasatle roof:
#2 •�����
underlayment. •••••• •
. . . . ......
ass-
Polystick Tile Pro Roll: TAS 103 and ASTM A rubberized asphalt sof-a0h%ring, •
......
Manufacturing Location 6 P x 3'3 3/s" D 1970 fiber/polyester reinforced 4,vatZrproo�ng;•; •
#2 60 mils thick membrane.Designed as a metal roof iVan&roof
tile underlayment.
Polystick Dual Pro Roll: TAS 103 and ASTM A rubberized asphalt self-adhering,glass-
Manufacturing Location 61' x 3'3}/s" D 1970 fiber/polyester reinforced waterproofing
#2 60 mils thick membrane. Designed as a metal roofing and roof
tile underlayment.
NOA No.: 14-0717.08
MIAMMADECOUNTY Expiration Date: 09/13/16
Approval Date: 01/22/15
Page 2 of 9
PRODUCTS DESCRIPTION:
Test Product
Product Dimensions Specification Description
Polystick TU Max Roll: TAS 103 and ASTM A rubberized asphalt self-adhering,polyester
ManufacturingLocalion 65'8"x 3'3-3/8" D 1970 reinforced waterproofing membrane. Designed as
42 60 mils thick a a roof tile underlayment.
Elastoflex S6 G Roll: TAS 103 and ASTM Polyester reinforced,SBS modified bitumen
32' 10"x3'3-3/8" D6164 membrane with a burn off polyethylene or sanded
back face and a granule top surface. For use in
roof tile underlayment systems.
MANUFACTURING PLANTS:
1.Hazelton,PA
2.Winter Haven,FL
EVIDENCE SUBMITTED:
Test A¢ency, Test Identifier Test Name/Report Date
Trinity)ERD P10870.09.08-R1 TAS 103 12/04/08
P10870.04.09 TAS 103/ASTM D4798&G 15 5 04/13/09
P33360.06.10 ASTM D1970 07/01/10
P33370.03.11 TAS 103 03/02/11
P33370.04.11 ASTM D 1623 04/26/11
P36900.09.11 TAS 103/ASTM D4798&G155 09/01/11
P37300.10.11 TAS 110/ASTM D4798&D1970 10/19/11
P40390.08.12-1 TAS 103&TAS 110 080.6112
P40390.08.12-2 ASTM D 1623 08WIV 6000:6
P40390.10.12 ASTM D 1970 •••0 0 10/01Ul2
P37590.07.13-1 ASTM D6164 •••�•• OW4J13 000000
P45270.05.14 TAS 103,TAS 110&ASPM•••• 05/12V14
.66666
D1623 ••some i•• •• • •
P46520.10.14 ASTM D1623 •••• 10/031'44 ••;•••
P44360.10.14 TAS 103&TAS 110 •0: •. 1p(QVjg •••••
P43290.10.14 ASTM D 1970&TAS I IV 6• It/17/14 ••••;•
000000
PRI Asphalt Technologies PUSA-035-02-01 TAS 103 • 0 03JJ25 6 6 6••••
PUSA-055-02-02 TAS 103 00.0• 12/10/07 •..•
PUSA-089-02-01 TAS 103/ASTM D4798&G155 4070i
0i
Momentum Technologies,Inc. JX20H7A TAS 103/ASTM D4798&G155 04/01/08
RX14138A TAS 103/ASTM D4798&G155 11/09/09
DX23D8B TAS 103/ASTM D4798&G155 02/18/LO
DX23D8A TAS 103/ASTM D4798&G 155 02/18/10
NOA No.: 14-0717.08
MIAMMADECOLum Expiration Date: 09/13/16
�Wg...gqxlq t
Approval Date: 01/72/15
Page 3 of 9
INSTALLATION PROCEDURES:
Deck Type 1: Wood,non-insulated
Deck Description: Min. 19/32"plywood or wood plank
System Type E(1) Anchor sheet mechanically fastened to deck,membrane adhered
Anchor/Base Sheet: One or more plies of ASTM D 226 Type II or ASTM D 2626.
Fastening: Per FBC 1518.2& 1518.4 Nails and tin caps 12"grid,6"o.c.at a minimum 4"head lap.(for
base sheet only)
Membrane: Polystick membranes self-adhered.
Surfacing: See General Limitations Below.
Deck Type 1: Wood,non-insulated
Deck Description: Min. 19/32"plywood or wood plank
System Type E(2) Anchor sheet mechanically fastened to deck,membrane adhered
Anchor/Base Sheet: One or more plies of ASTM D 226 Type II or ASTM D 2626.
Fastening: Per FBC 1518.2& 1518.4 Nails and tin caps 12"grid,6"o.c.at a minimum 4"head lap.(for
base sheet only)
Membrane: Elastoflex S6 G,hot asphalt applied.
Surfacing: See General Limitations Below.
Deck Type 1: Wood,non-insulated
Deck Description: Min. 19/32"plywood or wood plank
System Type E(3) Base sheet mechanically fastened deck,subsequent cap membrane self-adhered.
Anchor/Base Sheet: One or more plies of ASTM D 226 Type II or ASTM D 2626. ••••
Fastening: Per FBC 1518.2&1518.4 Nails and tin caps 12"grid,6"o.c.at a Ainialm 4"held Up.(for "
. 8888
base sheet only) •
0:0.
88i.min. 8888 8888..
Ply Sheet: Polystick MTS Plus,self-adhered with minimum 3"horizontal laps,a imum 6':vertical .
•....•
(Optional) laps. •••• •• •
Membrane: Polystick TU Plus,self-adhered. ..:9
96
Surfacing: See General Limitations Below. •• •• 8888..
8888..
. . . . •....•
8888..
. . .80000
o 0
. .
NOA No.: 14-0717.08
MIAMI•DADECOUNW Expiration Date: 09/13/16
�Fa...v
Approval Date: 01l22/15
Page 4 of 9
INSTALLATION REQUIREMENTS:
1. All nails in the deck shall be carefully checked for protruding heads. Re-fasten any loose decking panels,and
sweep the deck thoroughly to remove any dust and debris prior to application.
2. Place the underlayment over metal drip edge in accordance with RAS 111.
3. Place the first course of membrane parallel to the eave,rolling the membrane to obtain maximum contact.
Remove the release film as the membrane is applied. All side laps shall be a minimum of 3-1/2"and end laps
shall be a minimum of 6". Roll the membrane into place after removing the release strip. Vertical strapping of
the roof with Polystick is acceptable. Membrane shall be back nailed in accordance with applicable building
code.
4. When applying the membrane in the valley,start at the low point and work to the high point,rolling the
membrane from the center outward in both directions.
5. For ridge applications,center the membrane and roll from the center outward in both directions.
6. Roll or broom the entire membrane surface so as to have full contact with the surface,giving special attention
to lap areas.
7. Flash vent pipes,stacks,chimneys and penetrations in compliance with Roof Assembly current Product Control
Notice of Acceptance.
8. All protrusions or drains shall be initially taped with a 6"piece of underlayment. The flashing tape shall be
pressed in place and formed around the protrusion to ensure a tight fit. A second layer of Polystick shall be
applied over the underlayment.
GENERAL LIMITATIONS:
1. Fire classification is not part of this acceptance.
2. Polystick MTS,Polystick MTS Plus,Polystick TU Plus,Polystick Tile Pro and Polystick Dual Pro may be used
in asphaltic shingles,wood shakes and shingles,non-structural metal roofing,roof tile systems and quarry slate
roof assemblies.Polystick TU P may be used in all the previous assemblies listed except metal roofing.
Polystick IR-Xe may be used in all the previous assemblies listed except metal roofing and roof tile systLMs.
Polystick TU Max maybe used in non-structural metal roofing and roof tile systems. lylaslp Vx S6 Gfilty be 0000:0
.
used in roof tile systems only. 0 0 0 e
00. 0
4:00 0000 000000
3. Deck requirements shall be in compliance with applicable building code. Gooses e
0000..
4. Polyglass Polystick membranes shall be applied to a smooth,clean and dry surface. T1tB&K shall t#�•f�ee 9f •
0000 a es Goose
irregularities. e G e G ...
e e G
e e 0 '
5. Polyglass Polystick membranes and underlayments shall not be adhered directly over aeprwlsting bf••• 0066:6
membrane as a recover system. :00:0: e
6. Polyglass Polystick membranes shall not be left exposed as a temporary roof for longef than the am*A pt days ••e•••
listed in the table below after application. Polyglass reserves the right to revise or alteii erocfuct exposure times; :sees:
0 000
not to exceed the preceeding maximum time limitations. •
ss
Expasure Limitations(days)
MTS IR-Xe I Elastollex TU Plus TU P Tile Pro Dual Pro TU Max MTS Plus
S6 G
Winter Haven, 180 90 180 180 180 180 180 90 180
FL.
Hazelton,PA. N/A 90 NIA 180 N/A N/A NIA N/A N/A
7. All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code and
Rule 9N-3 of the Florida Administrative Code.
NOA No.: 14-0717.08
MuuaMannne cauw rr
...� Expiration Date: 09/13/16
�lraApproval Date: 01/22/15
Page 5 of 9
8. In roof tile application,data for the attachment resistance of roof tiles shall be as set forth in the roof the
manufacturer's Notice of Acceptance.Polystick TU PIus,Polystick Tile Pro,Polystick TU Max or Elastoflex S6
G may be used in both adhesive set and mechanically fastened roof the applications.Polystick Dual Pro is
limited to mechanically fastened roof the applications.Polystick MTS and Polystick MTS Plus are limited to
mechanically fastened with the limitations outlined in Section 9.Polystick TU P may be used in mechanically
fastened roof tile applications with the exception of mortar set tile applications.
9a. The maximum roof slope for use as roof tile underlayment for(direct-to-deck)tile assemblies shall be as
follows:(See Table Below)
Tile Profile Polystick MTS Elastoflex S6 G Polystick TU Plus, Polystick TU Polystick MTS
TU P,Tile Pro, Max Plus'
Dual Pro
Flat Tile Prohibited 4:12 No limitation No limitation 5:12
without battens
Profiled Tile Prohibited 4:12 No limitation No limitation
without battens
The above slope limitations can be exceeded only by using battens and counter battens in accordance with the
Approved Tile System Notice of Acceptance and applicable Florida Building Code requirements. Battens are
required for both loading and installation of tiles at all times.
'The following limitations shall be apply when using Polystick MTS Plus:
• Slopes up to those shown in the table above will require stagging of tiles—two tiles laid perpendicular to
slope followed by a maximum four tile stack parallel to the slope,for a total of 6 tiles. (See Figure 1
below)
• Battens shall be used for stagging of lugged tiles above 4:12
• Battens shall be used for stagging of flat tiles above 5:12
1 /Slope sees
.
I` ilI . . .o.. Goes..
.. e...
00
600060 boo. .0000.
0000..
.Gose.
.... .. .
.... . .. .....
...... . . .....
. Gee...
.. .. . ......
s
GG.O.. G .
. . G . ...Gee
000...
0 000 .
Figure 1:Stagging Method 0 a
"' '
9b. There shall be no roof slope limitation for the Polystick MTS Plus/Polystick TU Plus two-ply underl"medt
system when a applied using the stagging method outlined above.
NOA No.: 14-0717.08
MIAMI•DADECOUNTY Expiration Date: 09/13/16
M/ Approval Date: 01/22/15
Page 6 of 9
10. Care should be taken during the loading procedure to keep foot traffic to a minimum and to avoid dropping of
tile directly on the underlayment.Refer to PolygIass'Tile loading detail below for loading procedure for all
underlayments except Polystick MTS which shall be loaded onto battens.
j Roofing Tiles
to Max.Per Stack)
m 12 «
N 6
N
tp
" POLWRCK Rl Rus Y
11. Refer to prepared roofing system Product Control Notice of Acceptance for listed approval of this product with
specific prepared roofing products.Polystick MTS,Polystick MTS Plus,Polystick IR-Xe,Polystick TU Plus,
Polystick TU P,Polystick TU Max,Polystick Dual Pro,Polystick Tile Pro or Elastoflex S6 G may be used with
any approved roof covering Notice of Acceptance listing Polystick MTS,Polystick MTS Plus,Polystick IR-Xe,
Polystick TU Plus,Polystick TU P,Polystick TU Max,Polystick Dual Pro,Polystick Tile Pro or Elastoflex S6 G
as a component part of an assembly in the Notice of Acceptance. If Polystick MTS,Polystick MTS Plus,
Polystick IR-Xe,Polystick TU Plus,Polystick TU P,Polystick TU Max,Polystick Dual Pro,Polystick Tile Pro
or Elastoflex S6 G are not listed,a request may be made to the Authority Having Jurisdiction(AHJ)or the
Miami-Dade County Product Control Department for approval provided that appropriate documentation is
provided to detail compatibility of the products,wind uplift resistance,and fire testing results.
LABELING: Goes
1. All membranes or packaging shall bear the imprint or identifiable marking of the manufs" tureris name or U jo,city •
and state of manufacturing facility and the following statement: "Miami-Dade County P°rp�lyl&ontrpi 0pproved,°•„:
or the Miami-Dade County Product Control Seal as shown below. 000:0* 0 :0*00•
MIAMI•DADE COUNTY •00000 •0 •• • •
• •
BUILDING PERMIT REQUIREMENTS: °° °°°':°
•••••• • •
Application for building permit shall be accompanied by copies of the following: ••••••
1.This Notice of Acceptance. ••••••
2.Any other documents required by the Building Official or applicable building code in order to properly e'Aludte the
installation of this materials.
NOA No.: 140717.08
Expiration iration Date: 09/13/16
...� �ICY
Approval Date: 01/22/15
Page 7 of 9
POLYGLASS GENERAL APPLICATION GUIDELINES FOR POLYSTICK MEMBRANES:
1. Polyglass does accept the direct application of Polystick underlayment membranes to wood decks. Installers are
cautioned to refer to applicable local building codes prior to direct deck installation to ensure this is acceptable.
Please also refer to applicable Product Data Sheets of the corresponding products.
2. All rolls,with the exception of Polystick TU Plus should be back-nailed in selvage edge seam as per Polyglass
Back Nailing Guide. Nails shall be, 1 I gauge ring shank type,applied with a minimum 1"metal disk as required
in Dade County or simplex type nail as otherwise allowable in other regions,at a minimum rate of 12"o.c.
Polystick TU Plus should be back nailed in designated area marked"nail area,area para clavar"on the face of
membrane,with the above stated nails and/or disks.The head lap membrane is to cover the area being back-
nailed.(Please refer to applicable local building codes prior to installation.)
3. All seal lap seams(selvage laps)must be rolled with a hand roller to ensure full contact.
4. All fabric over fabric;and granule over granule end laps,shall have a 6"wide,uniform layer of Polyglass
Polyplus 55 Premium Modified Flashing Cement,Polyglass Polyplus 50 Premium MB Flashing Cement,
XtraFlex 50 Premium Modified Wet/Dry Cement,Polyglass PG500 MB Flashing Cement,applied in between
the application of the lap.The use of mastic between the laps does not apply to Polystick MTS.
5. A maximum of 6 tiles per stack are allowed when loading tile on the underlayments.Refer to the Polyglass Tile
Loading Guidelines.See General Limitations#9 and#10.
6. Battens and/or Counter-battens,as required by the tile manufacturers NOA's,must be used on all projects for
pitch/slopes of T712"or greater. It is suggested that on pitch/slopes in excess of 6'/V112",precautions should
be taken,such as the use of battens to prevent tile sliding during the loading process.
7. Minimum cure time after membrane installation&before loading of roofing tiles is Forty-Eight(48)Hours.
8. Polystick membranes may not be used in any exposed application such as crickets,exposed valleys,or exposed
roof to wall details.
9. Repair of Polystick membranes is to be accomplished by applying Polyglass Polyplus 55 Premium Modified
Flashing Cement,Polyglass Polyplus 50 Premium MB Flashing Cement,XtraFlex 50 Premium ModTJF4
Wet/Dry Cement,Polyglass PG500 MB Flashing Cement to the area in need of repair,folloyved by 4WOof the......
Polystick material of like kind should be set and hand rolled in place over the area neeftk4s4ch repair.Patching .'
membrane shall be a minimum of 6 inches in either direction. The repair should be installed in such Byway so ••••:•
that water will run parallel to or over the top of all laps of the patch. & •
10. All self-adhered membranes must be rolled to ensure full contact with approved substrn*leis+,Aolygleps rggtrires a.....•
minimum of 40 lbs for a weighted roller for the rolling of the field membrane. Hand rgUVV qre accgptable for 40:600
rolling of patches or small areas of the roof. Brooming may be used where slope prohiWA r0ling. ;""' ......
11. All approved substrates should be dry,clean and properly prepared,before any applic0lid8tPolystick' '.
membranes commences. An approved substrate technical bulletin can be furnished upon request. Itir••:•
recommended to refer to applicable building codes prior to installation to verify accepLblo sabstratel. ••••
12. The Polyglass Miami-Dade Notice of Acceptance(NOA)approval for Polystick membranes can be famished
upon request by our Technical Services Department by calling 1 (800)894-4563.
td1AMl•DADE COUNTY
NOA No.: 14-0717.08
�ffnazxlrml Expiration Date: 09/13/16
Approval Date: 01/22/15
Page 8 of 9
13. Questions in regards to the application of Polyglass products should be directed to our Technical Services
Department at 1 (800)894-4563.
14. Polyglass recommends that applicators follow good roofing practices and applicable procedures as outlined by
the National Roofing Contractors Association(NRCA).
PLEASE CHECK WITH LOCAL BUILDING CODES REGARDING LIMITATIONS OF SPECIFIC
APPLICATIONS. LOCAL CODES MAY SUPERSEDE POLYGLASS REQUIREMENTS AND
RECOMMENDATIONS.
END OF THIS ACCEPTANCE
0000
4,
0000..
0 0 0
00 0 0000 0
000000 0000 0000..
000000 0
0000 00 . :0000:
0000 0 00 00000
0000.. . . 0000.
.6000.
0000 . 0000..
:00:0:
. . . 0 000000
0000..
. . 0000..
.. 0 000
00 0
NOA No.: 14-0717.08
CMIAMIOMM5aaoej-111 r Expiration Date: 09/13/16
Approval Date: 01/22/15
Page 9 of 9
MMIAMI- MIAMI-DADS COUNTY
rMW
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.eovteconomy
3M Company
3M Center Building 0220-05-E-06
SU 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 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.
. . 0000 0000..
DESCRIPTION:3M'D1 Foam Roof Tile Adhesive AH-160 00 0000 0•
000.99 0090 000000
LABELING: Each.unit shall bear a permanent label with the manufacturer's name or logo,cottv.,tate an�.follQwing ;••••;
statement: "Miami-Dade County Product Control Approved",unless otherwise noted herein. • •
0900 . .0 00000
0000.. 00:00'
RENEWAL of this NOA shall be considered after a renewal application has been filed and t ;is beeih8'cii0ange .996:9
in the applicable building code negatively affecting the performance of this product. . 9 •• ' :9999.
0:6.,,6.
TERMINATION of this NOA will occur after the expiration date or if there has been a ruvisiont or change to the ;06,0 00.00.;
materials,use,and/or manufacture of the product or process.Misuse of this NOA as an endorsetrant of any gtodVPC for •
sales, advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any Sectidh 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 13-0502.02 and consists of pages 1 through 11.
The submitted documentation was reviewed by Alex Tigera.
MtAMt•DADEOUNT
C1f
NOA No.: 14-0805.01
•••. � Expiration Date: 05/10/17
Approval Date:09/04/14
Page t of 11
ROOFING COMPONENT APPROVAL:
Category: Roofing
Sub Category: Roof tile adhesive
Materials: Polyurethane
SCOPE:
This approves 3MTM 2-Component Foam Roof Tile Adhesive AH-160 as manufactured by 3M Company as
described in this Notice of Acceptance.For the locations where the design pressure requirements,as determined by
applicable building code,do 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 tile systems using 2-Component
Foam Roof Tile Adhesive AH-160.
PRODUCTS MANUFACTURED BY APPLICANT:
Product Dimensions Test Product Descrintion
Specifications
3MTrt 2-Component N/A TAS 101 Two component polyurethane foam adhesive
Foam Roof Tile Adhesive
AH-160
Foam Dispenser NIA Dispensing Equipment
RTF1000
ProPaek®30& 100 NIA Dispensing Equipment
0000
6
0.00.0
PRODUCTS MANUFACTURED BY OTHERS: " ' 0•
0000.. 0000 0000..
Any Miami-Dade County Product Control Accepted Roof Tile Assembly having a current NOAavgifk fist attachment :0096;
resistance values with the use of 2-Component Foam Roof Tile Adhesive AH-160 roof tile adhesive 0 •• •
0000
MANUFACTURING 0000.. :606:9 LOCATION. 6 00
•
. 00.
.. .. . 0000..
1. Tomball,TX. .....9 9 •
. •
. 0 . . 609960
0000..
PHYSICAL PROPERTIES: ; .6 0 '0 000 :*Soo
Property Test Results '9 6•
Density ASTM D 1622 1.6 lbs./ft.'
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./Ft'
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 @158°F., 100%Humidity,2
weeks
Closed Cell Content ASTM D 2856 86%
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.
NOA No.: 14-0805.01.
MIAMFD®ullmr llllllllllllllir Expiration Date: 05/10/17
Approval Date:09/04/14
Page 2 of I 1
EVIDENCE SUBMITTED:
Test Aaencv 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[l] ASTM E 84 01/16/95
Trinity Engineering 7050.02.96-1 TAS 114 03/14/96
P36700.04.12 ASTM D 1623 04/18/12
P39740.02.12 TAS 101 02/21/12
TAS 123
Celotex Corp.Testing Services 528454-2-1 TAS 101 10/231 !''.
528454-9-1
528454-10-1 •• •••• •
520109-1 TAS 101 : 12/2§798
520109-2 •••••• •
520109-3 •••• •• •
.... . .. .....
520109-6 •
...... . . .....
520109-7
.. .. . ......
5201.91-1 TAS 101 ......03/02!99. •�
520109-2-1 '
. . :foe:*
......
0 :0606:
LIMITATIONS: " '
..
1. Fire classification is not part of this acceptance. Refer to the Prepared Roof Tile Assembly for fire rating.
2. 3MT"2-Component Foam Roof Tile Adhesive Al-I-160 shall solely be used with flat,low,8r,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 3W 2-Component Foam Roof Tile Adhesive AH-
160 roof tile adhesive with their tile assemblies shall test in accordance with TAS 101.
5. All products listed herein shall have a quality assurance audit in accordance with the Florida Building Code and
Rule 61 G20-3 of the Florida Administrative Code.
NOA No.: 14-0805.01.
MIAM6DADE COUN77
•••� � Expiration Date: 05/10/17
Approval Date:09/04/14
Page 3 of 1 t
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 attachment 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 to meet or exceed the resistance value determined in compliance with Miami-Dade County
Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA.
3. 3MTM 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 RTF 1000 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).
6. 3MTM 2-Component Foam Roof Tile Adhesive AH-160 shall be applied with Foam Dispenser RTF 1000 or
ProPack@ 30& 100 dispensing equipment only.
7. 3MTM 2-Component Foam Roof Tile Adhesive AH-160 shall not be exposed permanently to sunlight.
S. Tiles must be adhered in freshly applied adhesive.Tile must be set within 1 to 2 minutes atter MTM 29:**"- ......
Component Foam Roof Tile Adhesive AH-160 has been dispensed. • ' •
9. 3MTM 2-Component Foam Roof Tile Adhesive AH-160 placement and minimum patty wlrtgljt%lhall be sir• 000000
accordance with the'Placement Details'herein. Each generic tile profile requires the speeifit*tftement ndted :....:
herein. •••• •• '
.... . .. .....
...... . . .....
.. .. . ......
. . . . ......
NOA No.: 14-0805.01
MIAM4DAt7E COUNTY
Expiration Date: 05/10/17
Approval Date:09/04/14
Page 4 of 11
Table 1: Adhesive Placement For Each Generic Tile Profile
Tile Profile Placement Detail Minimum Paddy Contact Minimum Paddy Gram
Area Weight
Eave Course-Flat,Low,High All Eave Course 17-23 sq.inches 45-65
Profiles
Flat,Low,High Profiles #1 17-23 sq. inches 45-65
Flat Profile #2 10-12 sq. inches 30
Low Profile #2 12-14 sq. inches 30
High Profile #2 17-19 sq. inches 30
Flat,Low,High Profiles #3 Two Paddys: 8-9 sq. inches at 12 grams per paddy
head of tile 9-11 sq. inches at
overlap
Two-Piece Barrel(Cap Tile) Two Piece 2 Beads(I each longitudinal 17 grams per bead
edge)20-25 sq. inches each
bead
Two Piece Barrel(Pan Tile) Two Piece 65-70 sq. inches 34 grams under pan
LABELING: ••••
All approved products listed herein shall be labeled and shall bear the imprint or identifiable m$rkirg 9f the •••ie
.
manufacturer's name or logo and following statement:"Miami-Dade County Product Control Ap�fove'd"or thea hemi-
000:0• '•
.... •.....
Dade County Product Control Seal as shown below. •
ilii•• • 0000••
MIAMFDADE COUNTY .... •• • • •
.... . .. .....
0001•• • • •1000
BUILDING PERMIT REQUIREMENTS: 0000.0 :•ll•• 0 0 0 0:0
As required by the Building Official or applicable building code in order to properly evaluate theinatailation Qf Ai Soso**
system. :00000
0.00•
000
00 0 • l i
so a
DADIENOA No.: 14-0805.01
COUNTY Expiration Date: 05/10/17
Approval Date:09/04/14
Page 5 of I I
ADHESIVE PLACEMENT DETAIL# 1
man NUOuphWauker •oc WdySmooth Irks) Flat/Low Profile Tile
1. Starting at the cave course,apply a minimum 2"
(50.8 mm)x 10"(254 mm)x 1"(25.4 mm)foam
paddy onto the underlayment positioned as shown,
under the strengthening rib closest to the Overlock
' poi. of the the being set.
�b�7ti1) ..•'� a �� a tea: "•„-. •.
2. Continue in same manner. Insure approximately 17
(109.7 cm)—23(148.4 cm2)square inch adhesive
contact with the underside of the tile.
w. ' r
taauo,r• hp� m Medium Profile/ Double Pan Tile
iwh*n rewired)
Paddy 18""OthW el 1. Starting at the cave course,apply a minimum 2"
(50.8 mm)x 10"(254 mm)x 1"(25.4 mm)foam
paddy onto the underlayment positioned as shown
-, :�•>�
under the pan portion of the file closest to the
Overlock of the tile being set. ••••••
battens 01"W"01 tf y ';.^ 2. Continue in same manner. Imre epproxi�teiy 17 ••
r � �rt j ` *' Fu4 (109.7 cm2)-23 (148.4 cntZ %§there inchWiftesive ••••••
`mac w e• z�•'}" a •
contact with the underside Dftiic'llle. ..•...
r°CuuPce-' ' Fends •••••• i••••• ••••••
•
• • • • ••••••
elrou�h pl.ak r ••••••
(a49�®nrayua,•at f �t .-P+�r�jt$sn.dh3ilaf High Profile/Single Pan Tile. • • i••••i
„ .y„ ie •, � '»tee rr 1. Starting at the cave course,apply a minifiv,j;:*
(50.8 mm)x 1.0"(254 mm)x 1"(25.4 mm)foam
iPll
paddy onto the underlayment positioned as shown
»sa.k under the pan portion of the tile closest to the
°n "d
" ° { Overlock of the tile being set.
Bartans . Y '�. 2. Continue in same manner. Insure approximately 17
� �`, (109.7 cm2)-23(148.4 cm2)square inch adhesive
rs.
.+, ,,� ,��°''j contact with the underside of the tile.
a"€"de�a
Drip edge
s=-
NOA No.: 14-0805.01
Mu►Mt•DADE CouNTY
AD P Expiration Date: 05110117
�ZnkaApproval Date:09/04/14
Page 6 of 11
ADHESIVE PLACEMENT DETAIL#2
kARthrough F"aieeemene � �dy,�„eAthTd1D� Flat/Low Profile Tile
Othm rDpu}red9, s `'v
1. Starting at the cave course,apply a minimum 2"(50.8
rry, mm)x 10"(254 mm)x l"(25.4 mm)foam paddy
* , t onto the underlayment positioned as shown under the
strengthening rib of the tile closest to the overlock of
the tile beingset.Insure approximately 17 109.7 cm2
—23(148.4 cin2)square inch adhesive contactwith the
Buis e�rY�nflal �,' ,
Eavmcan„m• underside of the tile.
2. At the second course apply a minimum 2" 50.8mm
Ida x 7" 177.8 mm x I" 25.4 mm foam paddy onto the
..
underlayment positioned as shown under the
strengthening rib closest to the overlock of the the
EDteChjama,
being set.
3. Continue in same manner.Insure approximately 10"
(64.5 cm)- 12(77.4 cm)square inch adhesive
contact with the underside of the tile.
NO Medium Profile/Double Pan Tile
4when requiredl
PeddyWaaevAtile) 1. Starting at the cave course,apply a minimum 2"(50.8
uedellep�n,1 a� mm)x 10"(254 mm)x 1"(25.4 mm)foam paddy
onto the underlayment positioned as shown under the
pan portion of the tile closest to the overlock of the
'w r �n. _ the beingapproximately Insure a roximatel 17 109aarn —
a i '� '` ~ 23(148.4 cm)square inch alheslvt�c ntactowkk the 9999:9
underside of the tile.
Does** Goo* 0 0.0 0•
2. At the second course,apply a itfi;Klm 2"(50-8mm)
x 7"(177.8 mm)x 1"(25.4 nuhl Edam padlf onto the
ravo .. .0000
o.t.r. underlayment positioned as showneee under the pan
EDy®Ceweee- " V r _Fe+de portion of the tile closest to the ever;ock ot:6 wAo •••••
Y
being set. •• •• D 000000
. . ......
3. Continue in same manner. Iniurc a,pproxin.lely.l2" D
(77.4 cm2)- 14(90.3 cm2)sgt#gei*h adhesives D :00 e
contact with the underside of the tile, '..•
(Instructions continued on next page)
M"DADE COUN—TY-
NOA No.: 14-0805.01
• r 11111
Expiration Date: 0.5/10/17
Approval Date:09/04/14
Page 7 of I 1
ADHESIVE PLACEMENT DETAIL#2(CONTINUED)
MAR IhMU911PIAJuac twntt•,,,�`Y ae�ari�a. «,�ni.a High Profile I Single Pan Tile
8whenta"lttvla
1. Starting at the eave course,apply a minimum 2"(50.8
mm)x 10"(254 mm)x 1"(25.4 mm)foam paddy
onto the underlayment positioned as shown under the
pan portion of the file closest to the overlock.of the
tile being set. Insure approximately 17(109.7 cm)–
�"' 23(148.4 cm')square inch adhesive contact with the
underside of the tile.
2. At the second course,apply a minimum 2"(50.8mm)
r Eave c° Fascia x 7"(177.8 mm)x I"(25.4 mm)foam paddy onto the
y
�``-`Y " lv"P e& underlayment positioned as shown under the pan
s 6�veclo�wsre
to«a:''.. _2 6h. - ,,�°' Vtipadg® portion of the lite closest to the overlock of the file
being set.
3. Continue in same manner.Insure approximately 17"
(109.7 cm)- 19(122.6 cm)square inch adhesive
contact with the underside of the tile.
eeee
. . .... ......
e e
..eeee ..0 .eel%
000000
.... . .. .....
...... . . .....
.. .. . ......
. . . . ......
.. . e •ee . e
. e
NOA No.: 14-0805.01
MlAMFDADE CCIUNTY
A - Expiration Date: 05/10/17
Approval Date:09/04/14
Page 8 of 11
ADHESIVE PLACEMENT DETAIL#3
Nei1t3exc gia$mCCORWt Paddyibetweestaesl
Whm tet 1. On the eave course only,apply a minimum 2"(50.8
�,$„ „� • mm)x 10"(254 mm)x V(25.4 mm)foam paddy
w° +hl Anel onto the underlayment positioned as shown,under
t the strengthening rib for flat the or under the an
antaPadle ' g g P
portion of the the for low or high profile tile closest
�� Rei to the overlock of the tile being set.Leave
s - approximately 4"(10 1.6 mm)up from the save
sd►yieP�day ,� " % ^^ edge free of foam to prevent the expanded adhesive
2xaIn. from blocking the weep holes. insure
• h ' approximately 17-23 int(109.7-148.4 cm)of
�ot>b-`max adhesive contact with the underside of the tie
ra"El°w`e 2. Apply a 4"(101.6 mm)x 4"(101.6 mm)x 1"(25.4
mm)foam paddy onto the underlayment just below
Flat/LowProtileTile the second course line positioned foam paddy
under the strengthening rib for flat tile,or under the
NAduwAo plasac°ama SWOepaftundwtfle pan portion of the tile,closest to the underlock for
twly6tete�eieaA
PaWyibetwew me,) the second course tile to be installed. Insure
approximately 8-9 int(51.6-58.1 cm2)of adhesive
I Pa*y(u dowel contact with the underside of the tile.
(Instructions continued on next page)
Si to X �• 2s4ut
�f 4.v
tMemI.`..'•. ',n,# '\
b
lin. ••• 0000 ••••�•
•• • 0000 •
Fame Owv
dt6 • •
00 .060 0.0•6 0000••
•
Eaite Conrse Fa ed�
*00000
• •
0000 •• • :000*:
Medium ProflieTtle 0.6.6• 1 0 0 0 0 ••6 6•
•
•6666• • • 0000•
• • 0000••
•• •• • 0000••
•
•60069 • •
• • • • 0000••
96606•
• • • •0696•
• • •
t41AMFOADE COUNTY
�Y NOA No.: 14-0805.01
...... ,- Expiration Date: 05/10/17
Approval Date:09/04/14
Page 9 of 11
ADHESIVE.PLACEMENT DETAIL#3(CONTINUED)
Nam#H"ghomdcae S1ngiepa*WWrWV
twhr►re Ire4 3. Also apply a 2"(50.8 mm)x 4"(101.6 mm)x 3/4"
Paddyere:i (19 mm)paddy on top of the eave course the
satcens surface as shown,on top of the strengthening rib
"donai • ,, iiW+aetWet for flat tile or on top of he pan portion of the tile,
gip{
closest to the underlock of the first course of tile.
rshweung J Install second course of tile.Insure approximately
t
x4in. l 9(58.1 cm2)- l 1 (71cm2)square inch adhesive
2s41n `Y , *, contact with the underside of the tile at the overlap
Simon " and 7(45.2 cm2)-9(58.1 cm2)
paddyon inch
adhesive contact with the underside of the tile at
i the head of the tile.Continue in same manner.
Fare C.. k t fasda
Weephde
loin. tin Earedowre
v► OHP edge
High Profile Ttlo
6666
• • 6666 6990•0
.6 . 9... •
96999• •96. 9696%
•
6666.6 6 • 0
9••9.9
660• .9 0 • •
99.6 . •. 666••
6 .
. •..96.
060000 . 9..69•
•06.69 • 6
6
.0.0.9
• •0 00 6 6 •
6.6 6
NOA No.: 14-0805.01
MAMMADBCOUN Expiration Date: 05/10/17
Approval Date:09/04/14
Page 10 of i I
ADHESIVE PLACEMENT DETAIL
TWO PIECE BARREL
Two Piece Barrel(Cap and Pan)Tile
1. Starting at the eave course,apply a minimum 2"
with
tt ponce et Adhesive to adhkeve 68 to 70�.in Steep pitch Dons 25.4 mm foam
In contact with the pen tile. an required)red) (50.8 mm)x 10"(254 min)x 1"( )
2)Tum covers upside down.place adhesive In paddy onto the underlayment positioned as
tot In.from outshleedge ofcover tile. shown under two adjacent pan tiles.Support eave
then Install the tile.Ensure 20 to
25 sq.In.contact area. `° tiles from rocking until adhesive has a chance to
Underoayment �-�,, " cure.
2. Continue in same manner bringing two pan
r't o
courses up toward the ridge. Insure 2
approximately 65(419.4 em )–70(451.6 cm )
square inch adhesive contact with the underside
,may +sem .yr Sheathing of the pan tile.
Eaver.,'
lmolarshovml 3. Turn covers upside down exposing the underside
weephole Fascia Board of the tile.Apply a minimum 1"(25.4 mm)x 10"
(254 mm)bead of adhesive directly on the inner
It move top portion ofthese"course cover tile.Abuttosecond course of edge of each side of the cover tile. Leave
pan tile&Enwre as"and of pen and cover tiles are flush at eave line.
approximately 3/4„(19 mm)to 1„(25.4 mm)
Two Piece Barrel-High Profile Tile from the outside edge of the tile,inward,free of
foam to allow for expansion.
4. Turn cover tile over after foam is applied and
place onto pan tile course.Insure a minimum of
20(129 cm2)-25(161.3 cm)square inch
contact area on each side of the cover lite to the
pan tile.Continue in sante mAger.Trift odWay ••••••
any cured exposed foam adhesive.Pointft f •,
AAA. eee
......
longitudinal edges of th�.�.oA�er iles A? • • •
considered optional. ::::a •• e ....
A ; • eeeee
5. When additional nailing jrgAgAt;ired,21(568 ••t•*.
min)x4"(101.6 min)nalftsitthe ti;tiaire• eeeeee
system using galvanized.;Wgless steel,or e•
copper wire and compattbleha>as may.be used. •0•e;
000 :00000 e
.. . e eee e e
e .
END OF THIS ACCEPTANCE
MIAMFDME COUNTY NOA No.: 14-0805.01
t- Expiration Date: 05/10/17
Approval Date:09/04/14
Page 11 of 11
OR ti Miami Shores Village
Budding Department
10050 N.E.2nd Avenue
R 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, FI 3313,,8®® '' _
Re: Owner's Name: W it LL°(t f eQlz
Property Address: 9 540 & ` AJC V®.
Roofing Permit Number:
Dear Building Official:
I U)(c."4E 1,gQi UO K.— 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 alUb proof of ad
00
valorem taxation. .'. •.•• ••••••
.. . ....
GO
❑The building was constructed in compliance with the provisions of the Florida Building CodboT.W)or wTtWe provisFdYfs"'
.. ... .
of 1994 edition of the South Florida Building Code(1994 SFBC) •••• •• • •
.... . .. .....
lelJ L..t E ( A .....• • • .•...
I A/aJ
• ••
Signature Print NameGO ...... •00,00:
. . ......
.
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 day -of
. .,,.
�.•..*""+•;•.,� ALEJANORA BDFlodda
Notary Public, Sate of Florida at Large •¢ Notary Public-stat- y Commission N FF
• When the just valuations of the structure for p of a los on a not constructed with FBC nor a 1994
SFBC.Then you must provide a building lication from a General Con ctor for the Roof to Wall connection Hurricane Mitigation.
Revised on 5)21P2009
SS R Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
IORIDA Tel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit# DATE:
INSPECTION AFFIDAVIT
U,,,jztt-j-&�I�&�1® , licensed as a(n)Contractor/Engineer/Architect,
(Print name and circle Ucense Type) FS 468 Building Inspector
License#: `C,6;c- 00&J 3 CO
On or about `.�
I did personally inspect the roof deck nailing
(Date&time)
work at 854-0 &-SC-A-yJ&- 1gLv'0'>
(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) ....
...... •••• ......
......
Signature �`.•so �•••••
...... . . .....
....%
.. .. . ......
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 '� day of
//Z
V.
Notary Public, Sate of Florida at Large
=oaf>Y c AUNA R.UNZUETA
S MY COMMISSION#EE 154272
'General,Building,Residential,or Roofing Contractors or any indiv nc6s)WftJ w&&A Allon.Include photographs of each plane of the roof with
permit#and address#clearly shown marked on the deck for each • ' Bonded Thru Notary Public undervaders
Revised on(7/1012014)5/2112008
Miami Shores village
�won anal" Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
AFFIDAVIT OF COMPLIANCE WITH ROOF TO WALL CONNECTION HURRICANE MITIGATION
RETROFIT FOR EXISTING SITE-BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PURSUANT
TO SECTION 553.844 F.S.
To: Miami Shores village Building Department
10050 NE 2nd Ave Date: /_5
Miami Shores, FI 33138
Re: Owner's Name:
Property Address: .
s � � v
Roofing Permit Number:
Dear Building Official: _
I � ` r/ ` / 2L_ certify that I have improved the roof to wall
Property as required by the Manual of Hurricane Mitigation Retrofits for Existing Site-Built Single Family
of the referenced
Structures as adopted by the Florida Building Commission by Rule 9B-3.047 F.A.C. g IY sees*0 Goof fees:*
esldentlal
. .
�� l ...... ..•. .Goes.
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 day of 20
aamq, "
Notary Public,Sate of Florida at ge ��• F- ALEJANORA BRITO
No PON c-State 01 Florida
My Comm.Exprres dun 10,2018
(SEAL)
�its CommlSSion&FF 101837
_.
Revised on 521PM FINAL COMPLIANCE
Miami Shores Village
—C VED
Building Department 7FE8 � � 816
I
10050 N.E.2nd Avenue, Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 -
INSPECTION LINE PHONE NUMBER:(305)762-4949 501
FBC 201 {
BUILDING Master Permit No. 300 .
PERMIT APPLICATION Sub Permit No.
❑BUILDING ❑ ELECTRIC 0 ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL
❑PLUMBING ❑ MECHANICAL [:]PUBLICWORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
,� CONTRACTOR DRAWINGS
JOB ADDRESS: C1 5�'0 '� �c7a ,"`�a- 6"
City: Miami Shores Countv: Miami Dade -Zip:-
1
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: G FFE:
OWNER:Name(Fee Simple Titleholder): 0 t.& Phone#:
Address: C154.0
City: ca-eZ E6,0101 V State: Zi
X.
Tenant/Lessee Name: Phone#: 3O Sl 6�?
Email: �.r►�—
CONTRACTOR:Company Name: e U0 Z�)t�� Phone#: 9—go 2-3
Address: XZ SCZ)
City: / 1-v State: Zip:
Qualifier Name: C l c:l 41 io r_t) Fn Phone#: rey 2® z,3
State Certification or Registration#: 00&93(, Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Zip:
Value of Wawk Mr-this Permit•-$ �i uare/6rneac' e of-Work-
Type
f-WorkType bf Work:- 'E]'Ad-dit)on r ❑ Iteration ❑ Nelace Re
p ❑ Demolition
l � gv
Specify color of color thru tile: rzeb
Submittal Fee$ /�^� Permit Fee$ C
CF$ T•�� CO/CC$ '�
Scanning Fee$ o) Radon Fee$ DBPR$3 Notary$
Technology Fee$.-a Training/Education Fee$ I q® Double Fee$ c '
Structural Reviews$ Bond$12FI
TOTAL FEE NOW DUE$ 0 —1 `
(Revised02/24/2014)
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS, HEATERS,TANKS,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—J—/ / Signature s
OWNER or AGENT CO CTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of 20 /-C- , by 3 day of F4 t-Kot ir y ,20 1& ,by
Wf�r� w fd�,who is personally known to /�Op-atc-re� G/Ar_"ewho is personally known to
me or o as oduce / Lr .; as me or who has ed rls as
i ntifi and o t c` hath. b L1101 9A ON" identificat' a ho dir,�4 a° ALLIMRA BRIT0
r• 'p4 •o .y
NOT Notary Pelta.State of FWWNOTA P C: Notary Punk•State o1 Florida
My Conon.Ex"Jun 10.20181Commissft
•� My Comm.Expkes Jun 10.2018
'•.;;E aF•• I FF 101887 �•.:E��♦`- � 0 FF 101837
y4tttM"
Sign: ` Sign:
Print: �(` L� Prin
Seal: Seal:
APPROVED BY ans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
t
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c'1/LU10 7:1U:Vt1 AM F5.1. It{Y1•- ) L.-R im: 1UUUU5-T0: 13052649964 Page: 2 of 2
CCM ® CO.RTI ICATE OF LIABILITY INSURANCE FA2/ M1M"
'
THIS CERTIFICATE IS ISSUED A EOF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRATNELY �R NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OFF INSURANC DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATNE OR PRODUCE:I ID THE ERTIFICATE HOLDER.
IMPORTANT: N the certificate holder son ITIONAL INSURED,the polh;y(les)must be endorsed. N SUBROGATION IS WANED,subject to
the tanno and conditions of thepol�icy,certain ay cies mrequire an endorsement. A statonent on this certificate doss not confer rights to the
cwdflea%holder In lieu of such 9r
PRODIH:ER SUNZ Insurance Soluflons,LLC. ID: LR
c/o TLR of Bonita Inc Aimee Gray
700 Central Ave ISuite 500 iaw ER& 727-520-7676 x 222 727-525-3862
St.Petersburg, L 337 1
S AFFORDING COVERAGE MAIC t
rrs A: SUNZ Insurance Company 34762
r (
TLR of Bonita, Inc w
stmm s: Aspen Re-London-Best Rating"A+"
�
Enter
nseHR e+aurmt c: Chaucer Syndicate-Uoyds-Best Rab "A+"
700 Central Avenue Suite 500 i wouRER D: Faraday Syndicate-Uo -Bee Rahn "A+"
St. Petersburg FL 33701 INSE;
COVERAGES E FICA NUMBER: 28 2255 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLUi;IESFERTAIN�
IN NCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING AW'r REREME TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR AWAYHE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDMONS OF SliCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
am li--Rma SOUPPOLICY Mae
LTR TYPE OF @TRANCE POUIREFF
LIAliB
OowAote N.e8ma LLA8l1ry EACH OCCURRENCE $
CLAIMS-MADE OCCUR
I— MED EXP(Anyone ) $
PERSONAL&ADV INJURY $
GEHL AGGREGATE LIMIT APPLIES PER: rl GENERAL AGGREGATE $
POLICY
P
,IER& LOC
{ PRODUCTS COMPIOP AGO $
oTHER: I I $
AUTOMOBILE LIAHL"
JJ $
ANY AUTO BODILY INJURY(Per person) $
ALL OWNED SCHEDULED
AUTOS AUTOS BODILY INJURY(Per seddard) $
NOWOHIRED AUTOS 0� i GE
$
p $
UMBRELLA LIABOCCUR i EACH OCCURRENCE $
EXCESS UAB
HCLAHWS-M AGGREGATE $
A woRKMcod LJAUI I WCPE0000000111 6/112015 6H12016 a R
AND EAIPLOYERB'UABBlTI �!N T TF
ANY PROPRIETORMARTNER40MCUTNE y E.L.EACH ACCIDENT $ 1,000,000
OFFICERIMEMBEREXCLUDED? /A
{Mandatary In
esoribs �r and El.DISEASE-EA EMPLOY $ 1,000,000
Ar
d '
DES(dtOPERATIONS bebw EL.DISEASE-POLICY LIMIT 1,000,000
Workers Compensation 18 is Or I Ore
C Excess Coverage and nothing shall create any night
D under such reinsurance.
OESCR9+TION OF OPERATIONS I LOCATIONS I ViI 181,Adito m1 Remarks SGIMMe,ray be attached N n we space is requlred)
Coverage Provided for an leases ertllrtoy but not a Liboontractors;of:Horado A Unzuets
Client Effective:1012312W7
General Contracting Ucense#1CGC006�36 i
GG
i
CERTIFICATE HOLDER CANCELLATION
4820
Miami Snores Village SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
10050 NE 2nd Ave THE EXPIRATION DATE THEREOF, NOTICE WALL BE DELIVERED IN
Miami
Shores FL 33138 ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
• i-
Glen J Distefano
! ®1888.2014 ACORD CORPORATION. All rights reserved.
ACORD 25(2014101) i The A CCIRD name and Ingo are registered marks of ACORD
28382255 Maetez Ceztificate tathleea KJ Lke� 2/1/ ,16 12:06:02 PM (EST) Page 1 of 1
Feb 01 16 06:15p Assu*'Ce�ssoCioies 5 3052272263 p.1
L DATEIM IOnTY1YY1 l
C�RTIFIOATE OF LIABILITY INSURANCE
_ 02/01/16
THS CERTIFICATE IS ISSUED AS MATTER OCT INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFI TlYELY OR:
A>,AEND.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES i
BELOW. THIS CHRTIFlCATE OF t UF�J0.NICF: ES NOT CONSTITUTE A CONTRACT BETVirEEN THE ISSUING INSURER(S),AUTHORIZED
l REPRESENTATIVE OR PROD ,AND THE JRTIFICATE HOLDER.
NPORTAtd- If the aeffiftete holder IsI DITTO INSURED,1he polIcAles)must be endorsed. E SUBROGATION iS WAIVED,subject to
the farms and conditlons of the pottcy,V potiotes I may require an eadorsemerd. A stmt on this cerUfftaft does not oo*r rights to the
cwtwdmw holder In Beu Of such endajrlt
PRODUM9ahrador Garda
AssuranceAssociates 5,tux NE (346)22?-1121 Oraj227-2283
8743 SW 9 Terrace B7
FL ;� p�DD salvadorgarcia79D®yatao Com —_..
Miami, MO� ( MUR9M AFFORCOVERAGE NAICA •-_._
Phone 305)227-1121 !Fax! 7-2265 -_ �s��A: Gr ands Insurance Insurance - 96$70
INSURED _.. .. -
1 INBURBRH:• _. — .. ..
Hormb Unameta { ' INSUMM C: --
1422 8XV.82 Ct -
MIAMI.FL 33144 ! 989-5023 ;_ffip e: -- •-
_ MUREiR F
COVERAGES~ C WfT FICA NUMBER: REVISION NUMBER
THIS IS TO CERTIFY THAT THE POLICIES KWRA CE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PE 6-• ----
INDMATED. NOTWITHSTANDING ANY I E TERMOR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY 13E ISSUED OR MAYi';PERT AIN,THI INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM
E)ICLUSIONSAND CONDITIONS OF SU{, PQQ??LtCIES.I.NITS SHOVMN MAY HAVE BEEN REDUCEO_BY PAID CLAIMS.
LLr[R! TVFOF INSURANCEE 16L1� POUGYN _. umrm —
GHNERAtLU7�UTY G I EACHocT RRENCE 76 1,000A00-00
® C06iMERCIA GMERALL1ABalTY , E0wools 100,000.00
❑ ❑
CLOJ1484SWE ❑ OCCUR { �0185FL000Mi71-3 1aEDEacPu+nY� g 5,000.00
A [N N 11120)2015:1112012016 - —" -
EJ — PERSONAL&AsVINJURY_ S 1,000,000.00 -
❑ GEIERALAGGREGATE $ 2,000,001).00 _
GF_N'LAOOfC-GATELIMRAPPLIESPER: ( PRODUCTS-COMPIOPAGG i Z,O4O,400.00
W POLICY El 79- t_I LOC
AUTOS UA&uTYLARI'r
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U WREDAUTOS I.� AUTOS ter°. rra�toAnapr - -°a
UMBRELLA UM ❑OCCUR ; EACH OCCURRENCE S
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'V@ORxL'li8 OOMPfiT18A710ri ! ._1 AT n ER
AND EMPLOYE=RS'LJABI 1T1' YI AI _..
ANY PROPRETORIPARTNER1EXECUTIVE I £.L EACH ACCIDENT $
OrFICER E ERMUJO C? 01A
(Mpp:esln��g�sdyNH) EL DISEASE-EA EMPLOYE
widw
DESCRIPTION OF Ol'ERAT ONS bdow it E.L WSr�-POLICY umrrl S
DESCR1PTtONor-OPERATiWRe/LOCAiIONe!' RCORD907.Ad:egarfalRemarka9ensawe,irmmreapa�elBrBqulBdl
GENERAL CONTRACTING LICENSE;
CERTIFICATE HOLDER — --_—— CANCELLATION
S14OUL13 ANY OF THE ABOVE DESCR93ED POLICIES BE CANCELLED BEFORE
Mbrrd Share Village ( THE
EXPIR EON DATE DHT THEREOF NOE POLICY TICE WILL
BE DELIVERED IN
10450 N.E 2 AVE
MIAMI SHOREFL 331J _ —.._......
�� � � � AUTtIDR�:DREPREBEHTATIVB_
- -- `i Salvador Garc]a
61988-201 ACORD CORPORATION. AN rights reserved.
ACORD.26(21I10106j QF i The ACORD name and logo are registemd marks of AC'ORD
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PROPOSAL - CONTRACT
HORACIO A. UNZUETA
STATE GENERAL CONTRACTOR
COUNTY ENGINEERING CONTRACTOR
Id6 1422 S.W.82nd Ct Miami,FL 33144 Gustavo Ballestas
License Number CGC-006936 PH-(786)223-1222
Ph(305)2645444 Cell(305)989-8023 March 20th.,2015
SUBMITTED TO JOB NAME
Willie Taylor Tile Re-roof
STREET E-mail JOB ADDRESS
9540 Biscayne Blvd same
CITY,STATE&ZIP CODE PHONE LEGAL DESCRIPTION JOB PHONE
Miami,FL.33138
WE HEREBY SUBMIT SPECIFICATIONS AND ESTIMATE FOR:
Tile Re-roof
[ S FFII?' ------------
10
SCOPE OF WORK:
.... ..........................................................................................................
TILE ROOF RE-ROOF 6.24 SQ
Remove existing roofing materials
Re-nail existing sheathing as per Code
Replace up to 3 sheets of damaged plywood sheathing
Disposal of all trash
Install one layer of#30 asphalt paper,tin capped
Install one layer of Pol stick TU PLUS self adhere sheet
Install 3 x 3-26 galvanized eave drips
Install flat red cement tile using foam adhesive
PRICE $7,000.00
EXCLUSIONS:
Any other work not enumerated above.
Temporary water and power during construction.
SCHEDULE OF PAYMENTS:
1 40% Upon signature of Contract
2 40% Upon tin cap inspection
2 20% Upon completion
TOTAL PRICE FOR ABOVE WORK $7,000.00
We propose hereby to fumish material and labor-complete in accordance with above specifications,for the sum of:
SEVEN THOUSAND DOLLARS
Payment and Work Completion to be made as follows:
See above schedule
Work completed in approx..3 weeks from permit
All materials are guaranteed to be as specified.All work to be completed in a workmanlike manner
according to standard practices. Any alteration or deviation from the above specifications involving Authorized
extra costs will be executed only upon written orders,and will become an extra charge over the Signature
estimate.All agreements contingent upon strikes,availability of materials,accidents or delays
beyond our control.Owner to carry fire,tomado,builders risk and any other insurance requirements Note:Void if not
by his mortgage carrier or others. Our workers are fully covered by Workmen's Compensation& accepted by Us within 15 days
General Liability Insurance. Upgrades to new code requirements,if needed will become extra charge.
ACCEPTANCE OF PROPOSAL- The above price,specifications&conditions are satisfactory Signatures:
and are hereby accepted.You are authorized to do the work as specified Payment will be made as OwneNs:
outlined above. _
Date of Acceptance: Contractor: