The URL can be used to link to this page

RF-15-3057 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-251508 Permit Number: RF-12-15-3057 Scheduled Inspection Date: January 26, 2016 Permit Type: Roof Inspector: Rodriguez,Jorge Inspection Type: Final Owner: MURILLO,SHIRLEY Work Classification: Tile/Flat Job Address: 147 NW 109 Street Miami Shores, FL 33168- Phone Number Parcel Number 1121360030200 Project: <NONE> Contractor: J&C ROOFING CORPORATION Phone: (305)219-0877 Building Department Comments INSTALL WHITE COLOR EAGLE BEL AIR CEMENT FLAT infractio Passed Comments TILE OVER NEW CONSTRUCTION ADDITION. INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid January 25,2016 For Inspections please call: (305)762-4949 Page 29 of 41 C I V I L Reileh Engineering Corp. (Consulting Engineer) 2370 Southwest 123rd Avenue Miami,Florida 33175-1174 RaTel:305-823-8008/305-397-6414 ENGINEER Fax:305-823-3300/305-884-8834 Website:www.reilehengineering.com January 5,2016 J and C Roofing Miami,Florida Project: ROOF TILE UPLIFT TEST REPORT Residential Home 147 Northwest 109 Street Miami Shores, Florida Information provided by client: Permit Number:Not Provided Date Completion: December 18, 2015 Roofing Contractor: J and C Roofing Project Number: 15.1056 (Testing Laboratory Certificate# 11-0715.04) Dear Sirs; In accordance with your request and authorization, a representative of Reileh Engineering Corporation completed the Roof Tile Uplift Test at the above referenced project. This testing was performed in general accordance with Roofing Application Standard TAS No.106 -- Standard procedure for field verification of the bonding of mortar or adhesive set tile system and mechanically attached,rigid, discontinuous roof systems. The total of the tested roof surface area was less than 10000 square feet,and the mean height of the roof is less than 40 feet above ground surface. The type of tile used for this project was reported to be Eagle Roof Tile. This tile was reported to have been foamed in place. At the time of our inspection,the entire area of the roof was examined for loose tiles. Not less than one(1)tile in ten(10)of all components in the field area and one(1)tile in five(5)of all tiles in the perimeter and comer areas were physically examined. A minimum of one(1)test per every two(2) squares in the field, one (1) test per square in the perimeter area, ridge caps and (1) in the comer areas were conducted. 13aced on our Zest results, we cone 4 e that the installation of the roof bleat the above 'referenced project meets the test requirement cbutlmed.in the above-mentioned protocol Attached please find cny o f our test report for your review. Reileh Engineering Corporation appreciates the opportunity of assisting you in this project. If you have any questions or if we may be of further assistance, please do not hesitate to contact the undersigned. Respectfully submitted; Reileh Engineering Corporation r koh nySalleh,P.E.49014 roject r TII.E UPLEff rEsr Residential Home 147 Northwest 109 Street Miami Shores,Florida Reileh Engineering Corporation—Project Number-15-1056—Page 2 of 4 Report of TILE UPLIFT TEST for Residential Home 147 Northwest 109 Street Miami Shores,Florida Project Number: 15-1056 Test Number Test Load b Test Status' 1 35 Pass 2 35 Pass 3 35 Pass 4 35 Pass 5 35 Pass 6 35 Pass 7 35 Pass 8 35 Pass 9 35 Pass 10 35 Pass 11 35 Pass 12 35 Pass 13 35 Pass 14 35 Pass 15 35 Pass 16 35 Pass 17 35 Pass 18 35 Pass 19 35 Pass 20 35 Pass 21 35 Pass 22 35 Pass 23 35 Pass 24 35 Pass Reileh Engineering Corporation—Project Number-15-1056—Page 3 of 4 b.9;. Test Number Test Load( b Test Status 25 35 Pass 26 35 Pass 27 35 Pass 28 35 Pass 29 35 Pass 30 35 Pass 31 35 Pass 32 35 Pass 33 35 Pass 34 35 Pass 35 35 Pass 36 35 Pass 37 35 Pass 38 35 Pass 39 35 Pass 40 35 Pass 41 35 Pass 42 35 Pass 43 35 Pass 44 35 Pass 45 35 Pass 46 35 Pass 47 35 Pass 48 35 Pass 49 35 Pass 50 35 Pass 51 35 Pass Test 1-10 Corner, 11-14 Ridge Caps, 15-32 Perimeter, 33-51 Field Reileh Engineering Corporation—Project Number-15-1056—Page 4 of 4 8 25 7 6 24 5 NO�TN 49 48 « 24 26 50 49 22 21S1 46 3 2 20 4 �o 4y 44 19 29 213 42 41 9 3 IO 2 'ab 31 shy 18 n 1 15 16 2V NLMMP 0r s51' 550 5F O 019a CAP lf5t LOCA11ON FEW = 19 COUP = 40 5F C OINM = 10 MMMMP r7MANa,a= 3' L MNM5 005 11.�1U I I O t;If7G�CAP = 4 C0M ASA= 513' ArwOX,Poor 1 5f LOCA110N5 ANb r71WN51ON5 7777 `yo!! s rpt Miami Shores Village IJTnlls Trpr '�2pofi, S� 10050 N.E.2nd Avenue NW . ... d» wofKclaufficallonjllelflat. Miami Shores,FL 33138-0000 Phone: (305)795-2204 :, Pef�i tat APPRC3VIft) LL "Uwe, Q"'S' Expiration: 0 107/201 Project Address Parcel Number Applicant 147 NW 109 Street 1121360030200 SHIRLEY MURILLO Miami Shores, FL 33168- Block: Lot: Owner Information Address Phone Cell SHIRLEY MURILLO 147 NW 109 Street MIAMI SHORES FL 33168-4316 Contractor(s) Phone Cell Phone Valuation: $ 5,900.00 J&C ROOFING CORPORATION (305)219-0877 Total Sq Feet: 770 Type of Work:Re Roof Available Inspections: Additional Info:INSTALL WHITE COLOR EAGLE BEL AIR C Inspection Type: Classification:Residential Scanning:3 Up Lift Report Tin Cap Final Roof Tile In Progress Roof in Progress Renailing Affidavit Review Roof Cap Sheet Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $3.60 DBPR Fee Invoice# RF-12-15-58007 $3.75 12/10/2015 Credit Card $276.10 $0.00 DCA Fee $3.75 Education Surcharge $1.20 Permit Fee-New Roof $250.00 Scanning Fee $9.00 Technology Fee $4.80 Total: $276.10 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��-done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING_.MEC ANICAL,W NDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I ce ' that all the fore inf d that all work will be done in compliance with all applicable laws regulating construction and zoning. thermore,I au c e work stated. December 10, 2015 Authorized Sign n / Contractor / Agent Date Building artment Copy December 10,2015 1 Miami Shores Village Building Department DEC ° 2015 10050 N.E.2nd Avenue, Miami Shores,Florida 33138 - Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20 a BUILDING Master Permit No.RC 314-450 PERMIT APPLICATION Sub Permit Nog 5—5® ❑BUILDING ❑ ELECTRIC M ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING [:] MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 147 NW 109 ST City: Miami Shores County: Miami Dade Zia: Folio/Parcel#:11-2136-003-0200 Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name(Fee Simple Titleholder):SHIRLEY MURILLO Phone#: Address: 147 NW 109 ST City: MIAMI SHORES State: FLORIDA Zip: 33168 Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: J & C ROOFING CORP Phone#: 305-219-0877 Address: 19351 SW 190 ST City: MIAMI State: FLORIDA Zip: 33187 Qualifier Name: SERGIO MUNOZ Phone#: 305-219-0877 State Certification or Registration#: CCC039764 Certificate of Competency#: DESIGNER:Architect/Engineer: NSA Phone#: Address: City: State: Zip: Value of Work for this Permit:$5900.00 Square/Linear Footage of Work: 770 Type of Work: ❑ Addition ❑ Alteration M New ❑ Repair/Replace ❑ Demolition Description of Work: INSTALL WHITE COLOR EAGLE BEL AIR CEMENT FLAT TILE OVER NEW CONSTRUCTION ADDITION Specify color of color thru tile: Submittal Fee$ 60 Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond TOTAL FEE NOW DUE$ a9r, In (Rev'sed02/24/2014) is L Bonding Coympany'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 commen nt must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issu . n the abs e ce of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature JII-A"' ��/ Signature JWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this ?)0 day of II 20 , by day of zn e 20��by who is pers f1.a1, who' rsonally known_to.> me o h roduced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLI • NOTARY PUBLIC: Sign- SignU•�I Print: 0. e Prin 0AEUMDES Seal: Seal. Notary Pulse-Stats of Florida My Comm.Expires Sep 29,2017 kV CLAUDIA NfEDWIADOW1EZ ''•: �' WWW"a FF SWI a 's MY COMMISSION#FF 15555 1 sii (407)398-0153 moridallotarq trvice.com APPROVED BY i s t r Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) SN�Rsqs G ..•. o•••t" Miami shores Village Building Department �ORIDp' 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. L"RACOPY OF QUALIFIER'S STATE LICENCES B. ,cam OPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF LIABILITY INSURANCE* D. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICATE OF COMPETENCY OF QUALIFIER B. COPY OF LOCAL BUSINESS TAX RECEIPT C. COPY OF STATE REGISTERED CONTRACTOR LICENSE OR MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT. D. COPY OF LIABILITY INSURACE* E. COPY OF WORKERS COMPENSATION INSURANCE* (Workers Compensation EXEMPTION must have NOTICE TO OWNER form and Contractor Affidavit) *YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE AS FOLLOW: Certificate Holder: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 Certificate must specify the description of operations or contractor license number. BUSINESS NAME: `f6s BUSINESS ADDRESS: qf) (--CITY ' STATEV ZIP BUSINESS PHONE: L�t` ) 2 f (� ®�7 FAX NUMBER r CELL PHONE QUALIFIER'S NAME: 6 QUALIFIER'S LIC NUMBER:.® � 7 ,"v,♦vvv, , vvv"�,w,� mizin 1../'\YVJVItl, JG�..I�G IAt\t STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CCCO39764 The ROOFING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31,2016 MUNOZ, SERGIO F - J 8r C ROOFING CORPORATION 19351 SW 190 ST MIAMI FL 33187 NMI ISSUED: 07/27/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1407270001982 Donau, Local Business Tax Receipt Miami—Dade- County, State of Florida THIS IS NOTA BILL. - DO NOT PAY LBT 1027960 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES 1&C Roo6CORPORATION RENEWAL SEPTEMBER 30, 2016 3285 NW 688 SS T 1027960 Must be displayed at place of business MIAMI FL 33147 Pursuant to County Code Chapter aA-Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED 1&C ROOFING CORPORATION 196 SPECIALTY BUILDING CONTRACTOR By TAX COLLECTOR Worker(s) 1 CCCO39764 $75.00 09/29/2015 ECHECK-15-165874 This Local Business Tax Receipt only confirm payment of the Local BusinessTax.The Receipt is not a license, permit or a certification of the holder's qualifications,to do business.Halder must comply with any governmental Of 1101190110111111190101 regulatory laws and requirements which apply to the business. The RECEIPT N0.above must be displayed on all commercial vehicles-Miami-Dade Code Sec 8a- rL For more information,visit www miamidade a wAucollector Oct. 21. 2015 4:42PM No. 1291 P. 1 J&CRO-1 OP 1D;GM CERTIFICATE OF LIABILITY INSURANCE PATR(MM110/21/120152015 , 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 13Y THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT 13ETWEEN THE ISSUING INSURP-R(S), AUTHORIZED REPRESE=NTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder Is an ADDITIONAL INSUREb,the policy(les)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 endorsernent(s). PRODUCER COMNEAOT GAYLE A 13AINBRIDGE Global Risk LLC 5959 Blue Lagoon Dr Suite 101 FHONE .306-456-7250 FAX-No N,I.-305465-7251 Miami FL 33IF26 F-MAIL 6,'Wil A BAINBRIDGE INSURER(S) AFFORDING COVERAGE "ON 1NSUr�A:Arch Specialty Insurance Co 21199 INSURED J&C Roofing Corp. 19351 S'W 190 Street INSURER E: Miami,FL 33187 INSURIMC: INSURER P INSURER 5: 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, NOTIMTHSTANDING 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, ILTR TYPR OF INSURANCEAPPLOUSIT POLICY EPP POLICY EXP WSO POLICY NUMBER mralnolYYYY MM1oo1YYYY LIMNS A X COMMERCIAL ENERAL LIABILITY EACH OCCURRENCE S 300,00 cLAIMs MaoE OCCUR AG L00300402 07/28/2015 07/28/2016 ,WA PR6mf8rz8 Mm o eez 100,00 MED EXP one eraon s 10,00 PERSONAL&ADV INJURY S 300,00 GENII.AGGREGAT6LIMIT APPLIESPER; GE NERAL AGGREGATE S 600100 POLICY M�T FILOC PRODUCTS•COMPIOPAGG S 600100 OTHER S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (5 acdcTentl ANVAUTO BODILY INJURY(Perperson) S ALLAUTOS�EO AAUUTE�DULED 80DILYINJuRY(Per aooldenO $ HIRED AUTOS q�VvNED OPERTY DAMAGE $ S UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESSLIAO CLAIMS-MADE AGGREGATE $ DED I I RETENTIONS $ wome R$COMpENumn AND RMPLOYERs•LIASIUTy ANY PROPRIETORIPARTNER/DCECUTIVE YIN $ OFFIC&VUEMBER EXCLUDED? NIA E L EACH ACCIDENT IMe descy OI un EJ..DISEASE-EA EMPLOYE $ Ifyes'dcmbe under DESCRIPTION OF OPERATIONS below FF--L DISEASE.POLICY OMIT $ bMCRlp,RCN OP OPERATIONS!LOCATIONS I VEHICLES(ACORO 104,Additional Remarks SohedW%may be aNachad if more syaes to(NuInd) Roofing residential 3 stories and under 98678,roofing commerical 98677 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OP THE AHOVE DOCRTBED POLICIES ISE CANCELLED BEFORE Miami Shores Village THE EXPIRATION PATI= TWWP-0F, NOTICE WILL BE DEUVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2nd Avenue Miami Shores Village,FL 33138 AUTHORIZED REPROgNTAYIVE ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/04) The ACORD name and logo are registered marks of ACORD 'om Purmort&Martin Insurance Agency Fax 9415524170 Thu Dec 10 09:23:37 2015 Page 3 of 3 Ae6 � CERTIFICATE OF LIABILITY IAByLITY piSURANCE DATT-.(MIWDDAfWY1 I 12!9/2C15 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLi,ER. THIS = CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES I BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESUNTATWE OR PRODUCER,AND THE OMRTIFiCATE HOLDER. I IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,'he policy()es)must be endorsed. If SUBROGATION 1S WAIVED,subject to the terms and conditions of the policy, certain policies may roquire an endorsement. A staternent on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PPODuuEe PURVIOR'T 2 MARTIN INSURANCE AGENCY LL'_ ia�CT RUSSELL.H eOEEITT ----------------------------- FAX --------------- 2301 RiNGLING BI_VG bn , 9413667070 1 (AJC,No': EMAIL RUSS(��PURMCIR'.00;91 ADDRESS: INSURFMI S AFFORDING COVERAGE NAILS SAR ASO—A FL 34237 INwRrx A: F AVCJUA ----------------------------------------------------------------------------------------------------=--------------------------------------------------------------------------------------------- INsvRm J. AND 0. ROOPING CORPORATION ANt� _@tea : - ---------------------------------------------------------------------------------------- 19351 SVV 190 TH ST AItsulz_Elt J�------------------------------------------------------------------------------------- INSURER D: P,11AM1 FL 33187 INSURER E. FFIN:Sa151C711 COVERAGES CERTIFICATE NUMBER:15120,90021 REVISION NUMBER: THIS IS TO CERTIFY THAT"MHE PWC..IES OF INSURANCE IES--60 BELOW HAVE SEEN ISSUED TO -HE' INSURED NAMED ASO'vE FOR THE POLICY PERIOD INDICATED. NOTWITI-I.4TANDING .ANY REQUIREMENT. TERM OR COI',IDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO'rl9-IICH THIS CER i'IFICA•rE MAY BE ISSUED OR MAY PERTAIN, 'i HE INSURANCE AFFORDED SY THE POLICIES DESCRIBED HEREIN IS SUSJEC-7 i'O ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLIO-IES.LIMITS SHOiNN MAY HAVE BEEN REDUCED BY PAID CLAIMS. !, LM. TYPE OF INSURANCE JN'R WV[ POLICY NUMBER MNNJDUIYYY fMMJDWyYY LIMITS GENEP.AL LIABILITY EACH GCCUc,,RENCE CCLM,MVRC;AL.GENERAL L.IAP.UTY 'v- -, ---- ----, --- I PREMIL==ES+E�vcwrrance� --J CLAIMS AiDF ---_ I _- ---------------- ______ MF.0 F-\P(Any one.person) I g -------------=----------------F-------------------------- ------------------------------- I PrERSGNAL&ADV INJUR'f ----------------------------'r------------------------- GENERAL AGGREGATE GEN'L AGGREGATE OMIT A0PUES PER: I PR:Y UCTs cow!oP A,3G s �:JLICY j I PRO c LOC I8 AUTOMOBILE LIABILITY COMANY ALITO c IN,3L S L.Ib11T )�a awidert person A_*WNEG SCHEOULEG P.OIJII_{IN�JUR'{(P- ) I$ ----------- -- At'1Us AUTOS I P.ODIL Y INJURY(P_r oor4dent)I g NON WINED ---------------�------------ 4iIRE0 ALTOS AUI Os I PRtW"RTY DADhA 35 'Prr aecide,rz� i� UMHRE-LA LIAU II F— I EACH C,CCL:wR.-NCE I g , nccuR "CES5LIAB CLAIMS MADE ----F-------�---- ------------ -------------- I AGi3RFCATL• 1$ ----- ------------------------------------- ----------- DEC � --- ---------------------------------------R-Earl-- -----i-------R- NSATI ------------------------------- NNORKFJs3 CONlP�1'SAl'ION --------------- --------------- ---r--7::�------r--- ----- -------------------------- X U �O-��L ANG f7Nl+LOYERS'I.IADILIIY YIN _--Lr�SiA�ac�J____�-�-.�-- ANV'^RC GRIu CYZlXLLUDEarXEPL1TVF N 171/'72:31^ ^9 2., i ' E.L.EACH ACCICE.NT 1CJ0 o0 ^Q CKFI_•E.4.f_?A_EREx.L'LUUED7 NIA�I - 1�/../201� 1_/_/20.6 i , (Manddeuvib and E.L.DISEAs6 6.ASGIPLOY6 s 1rJ0,000.00 IJI If Ices,dCfG'ILx Un{ICr r' ` G.L.I-ISEASE rll LICY L!?Arr; $5000,000.10 -- ----------------------- -- --- --------------------------- -------I— -------------------- `i:RIPTION OF OPERATIONS/L DrAT IONS f VEHSCLE4 (Atbrh ACOPD 101,Add-dinnal Remarks Schedule,if more spare.is required) Lia#CCC 033754 ---------------------------------------------------------------------------------------------------- CERTIFICATE HOLDER ----------------- CANCELLATION ------ ------------------------------------------------ Miarni Shores Villace SHOULD AMY OF THE ABOVE=DESCRIBED POLICIES BE CANOE--LED BEFORE 10450 N.G.2ncl A.ve T.iP- "FIRATION DATE THEREOF, NOTICE WILI. P.F DEI.R/EREr) IN 4d,L3uIItJinp p:p3r2rt:on[ ACCORDANCEVMT H THE POLICY PROVISIONS. Miami Shores FL 33138 AUTNORRED REPRESENTATNE , Phony Num;.ar: 305-795-22,07 �s_ � P ' 1 o b 1588-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ROOF ASSEMBLIES AND ROOFTOP STRUCTURES I Florida Building Code 5th Edition(2014) 2015 1 h DEC ® High-Velocity Hurricane Zone Uniform Permit A B ppiicatton Form. Section A(General Information) 1 C 1 Master Permit No. Process No. � . 1 Contractor's Name 0 • 119 •. • .• 6 6 • • 0.000• • •• 0660• Job Address s •••i•• • 60000 —i—O D 66.•6 ROOF CATEGORY � �-�� • 06:061 ..•••. 0..6 •0••01 O Low Slope ❑ Mechanically Fastened Tile Mortae+AiiMesive Set�i1850 000:q ❑ Asphaltic Shingles ❑ Metal Panel/Shingles ❑ Wood.=gles/Shakes 00 04664 ❑ Prescriptive BUR-RAS 150 :-0-00 0 . ••6661 ROOF TYPE •• • 0 -0' 0 /New roof ❑ Repair ❑ Maintenance ❑ Reroofing ❑ Recovering 1 ROOF SYSTEM INFORMATION Low Slope Roof Area(SF) Steep Sloped Roof AREA(SSF)—qr--)Q Total(SF)_�?20 1 1 1 Section B(Roof Plan) 1 Sketch Roof Plan:Illustrate all levels and sections,roof drains,scuppers,overflow scuppers and overflow drains.Include dimen- sions of sections and levels,clearly identify dimensions of elevated pressure zones and location of parapets. 1 Ipf, JA J f. 1 1 W < z 1 � G ❑ < w — 1 JI � Oft 134plr� ODE I L DING,DING,5th EDITION(2014) 15.37 to,or 6ceased by.[CC(ALL RIGHTS RESERVED);accessed by Elio=Palacio on Jun S.2015 10:32:12 AM pursuant to license Agreement.No futther tt:luodueftm and otized. t t` 7 1 ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code 5th Edition(2014) High-Velocity Hurricane Zone Uniform Permit Application Form t 6 Section D(Steep Sloped Roof System) 1 6 Roof System Manufacturer_ 1 Notice of Acceptance Number. 1 --------------------- Minimum Design Wind Pressures,If Applicable(From RAS 127 or Calculations): • • •tPl: . . P)' Deck Type: .•E•• • .eto:e Type Underiayment: 9 eat::* Roof Slope: ....a 6 ;: 12a 0 . B Insulation: •• • • • 1 • Fre Barrier: 1 1 1 Ridge Ve ation? Fastener Type&Spacing: I F F 1 Adhesive Type: 1 1 Type Cap Sheet; 1 Mean Roof Height: Roof Covering: 1 1 Type&Size Drip 1 Edge: 1 1 1 a FLORIDA BUILDING CODE—BUILDING,5th EDITION(2014) 15.39 Copyright to,or licensed by.CCC(ALL RIGHTS RESERVED);accessed by Elie=Palacio on Jun 8,2015 1032:12 AM pursuant to License se No further reproductions authtuized. ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code 5th Edition (2014) tf 1 High-Velocity Hurricane Zone uniform Permit Application Form. 1 1 Section E(Tile Calculations) For Moment based tile systems,choose either Method 1 or 2.Compare the values for M,with the values from Mc.If the M1 values are greater than or equal to the M,values,for each area of the roof,then the Ile attachment method is acceptable p . . .:0 1 0 6906.. Method 1 'Moment Based Tile Calculations Per RAS 12T' •• 0 •00 • Product Approval Mr • 6.6 990600 006'0 1 (P2'Ak xA _ ' 1 t -Nig: Md'U) Product Approval Mi 0 :0909: Et (P3 x71,?„Z=�Z. 311-Mg: j=M�,Z ,L Product Approval M, ....0. Method 2"Simplified Tile Calculations Per Table Belove0 0 0 .6"0. 6 Required Moment of Resistance(Mr)From Table Below Product Approval 0 0.6 0 s o 6 M, 6666.. Mean Roof Height "' required Moment Resistance' ; 0 00.0;0 9 Roof Slope 15' 20' 25' 30' : 6 0.40' 0 :6••0 '06 . 6 660 9 • 9 2:12 34.4 36.5 38.2 39.7 42.2 0 ' 6 3:12 32.2 34A 36.0 37.4 39.8 9 4.12 30.4 322 33.8 35.1 37.3 H 5:12 28A 30.1 31.6 32.8 34.9 9 6:12 26.4 28.0 29.4 30.5 32.4 712 24.4 25.9 27.1 282 30.0 `Must be used In conjunction with a list of moment based Ile systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based file systems use Method 3.Compared the values for F with the values for Fr. if the F'values are greater than or equal to the Fr values,for each area of the roof,then the Ile attachment method is acceptable. 1 Method 3'Uplift Based Tile Calculations Per RAS 127" (P1: x L = x w = )-W: x(os 0 =F,, Product Approval F' (P2 x L x w _�)-W: x ccs e =Fd Product Approval F' (P3: x L = x w:=��-W: x cos e =FA Product Approval F 6 1 Where to Obtain Information 1 Description Symbol Where to find Design Pressure P1 or P2 or P3 RAS 127 Table 1 or by an engineering analysis pre- pared by PE based on ASCE 7 Mean Roof Height H Job Site Roof Slope e Job Site Aerodynamic Multiplier h Product Approval Restoring Moment due to Gravity M Product Approval Attachment Resistance M, Product Approval Required Moment Resistance Me Calculated iI Minimum Attachment Resistance F Product Approval Required Uplift Resistance F, Calculated Average Tile Weight W Product Approval 1 Tile Dimensions L =length W=width Product Approval 6 All calculations must be submitted to the building official at the time of permit application. 9 B 15.40 FLORIDA BUILDING CODE--BUILDING,5th EDITION(2Q14) �r1�1a-h '1 by.ICC(ALL RIGHTS RESERVED),aid by Me=Palacio on dun 8.2015 10.32-12 AM pwsu=to license ngtecmrmt Nfunder rgn0&Cth=adhmized. t z MIAMI-DADE COUNTY 11 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) vvww.miamidade.gov/economy Eagle Roofing Products LLC 1575 East C.R.470 Sumterville,FL 33585 • 0000.. 0000.. .. .. . SCOPE: • ...0.. . .. 0000.. This NOA is being issued under the applicable rules and regulations governing the use of cum4mction materials. Tag••• documentation submitted has been reviewed and accepted by Miami-Dade County RER-P=dddL%ConbW.Waion td be used in Miami-Dade County and other areas where allowed by the Authority Having JurisdicHion(AHJf.0 0 •• 00. ...... 00 00.00 . . . 00000 0000 0000.. This NOA shall not be valid after the expiration date stated below. The Miami-Dade Count*Psoduct Control Section (in Miami-Dade County)and/or the AHJ(in areas other than Miami-Dade County)reserve6e njht to}tUi tis *000:0 product or material tested for quality assurance purposes.If this product or material fails tctpeVbimn in the accepte$....: manner,the manufacturer will incur the expense of such testing and the AHJ may immediate'l'y revoke,mogj,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",' ,Bel Air Double Eagle,Ponderosa,Ponderosa Double Eagle,Golden Eagle Low Profile Concrete Tiles 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 daze or if there has been a revision or change in the materials,use,and/or manufacture of the product or process. Misuse of this NOA as an endorsement of any product, for sales,advertising or any other purposes shall automatically terminate this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of NOA. ADVERTISEMENT: The NOA number preceded by the words Miami-Dade County, Florida, and followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is displayed,then it shall be done in its entirety. INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its distributors and shall be available for inspection at the job site at the request of the Building Official. This NOA revises NOA#12-0430.04 and consists of pages 1 through 10. The submitted documentation was reviewed by Gaspar J Rodriguez. \, NOA No.:15-0223.18 MInrn•�e Counmrrr _ Expiration Date: 10/05/16 �lLagyxlxfil , Approval Date: 09/24/15 Vit , Page 1of10 ROOFING ASSEMBLY APPROVAL Category: Roofing Sub Category: Roofing Tiles Material: Concrete 1. SCOPE: This approves a new roofing system using "Low Profile Concrete Tile" as manufactured by Eagle Roofing Products LLC in Sumterville, FL and described in Section 2 of this Notice of A%oeptanca. Vol locations;• where the pressure requirements, as determined by applicable Building Code &A hot e)Cftc?the desigfl. .. . . .. ... .. pressure values obtained by calculations in compliance with RAS 127 using tF '-jalues listed•m section 4 herein. The attachment calculations shall be done as a moment based system. %096: 0000 0 .000.0 0000 . 0000. 2.PRODUCT DESCRIPTION: 0000. .0000 • . 0000. 0. 00 0000 .U.... Manufactured by Test 8"Vct •• Applicant Dimensions Specifications Descriotion0000.0 :0...: Bel Air Concrete Tile L= 17" TAS 112 Flat profile concretd w6f tile equipped with Wd 0: W= 12 %4" nail holes. For adhesive set,direr ae®k or Thickness= %z" battened nail-on applications. Bel Air Double Eagle L= 17" TAS 112 Flat profile concrete roof tile equipped with two Concrete Tile W= 12 %4" nail holes. For adhesive set,direct deck or Thickness= %z" battened nail-on applications. Ponderosa Concrete Tile L= 17" TAS 112 Flat profile concrete roof tile with slate finish W= 12 %4" equipped with two nail holes. For adhesive set, Thickness= %2" direct deck or battened nail-on applications. Ponderosa Double Eagle L= 17" TAS 112 Flat profile concrete roof file with shake finish Concrete Tile W= 12 %4" equipped with two nail holes. For adhesive set, Thickness= %Z" direct deck or battened nail-on applications. Golden Eagle Concrete L= 17" TAS 112 Flat profile concrete roof file brushed finish Tile W= 12 %4" equipped with two nail holes. For adhesive set, Thickness= %2" direct deck or battened nail-on applications. Trim Pieces L=varies TAS 112 Accessory trim,clay roof pieces for use at hips, W=varies rakes, ridges and valley terminations. varying thickness Manufactured for each tile profile. rw►�anane counnY� NOA No.:15-0223.18 Expiration Date: 10/05/16 Approval Date: 09/24/15 Page 2 of 10 2A EVIDENCE SUBMITTED: Test Agenev Test Identifier Test Name/Renort Date PRI Asphalt Technologies ERPF-001-02-01 TAS 112 Aug. 2006 Redland Technologies 7161-03 Static Uplift Testing Dec. 1991 Appendix III TAS 102 Redland Technologies 7161-03 Static Uplift Testing Dec. 1991 Appendix III TAS 102(A) • Redland Technologies 7161-03 Wind Tunnel Testing +• ,„ Qec. 1991 Appendix 11 TAS 108 (Nail-On)...... : ' ....:. Redland Technologies P0402 Withdrawal Resistance Testing N:draw vs. 13ept. 19 3••• smooth shank nails •...., ;'•"' Redland Technologies Letter Dated Aug. 1, Wind Tunnel Testing';"; ."'Avg. 1994"' 1994 TAS 108 (Nail-On) '"' • .+.r.+ • • Redland Technologies P09647-01 Wind Tunnel Testing 1994-0-' TAS 108 (Mortar Setj . , ' :+...: The Center for Applied 94-084 Static Uplift Testing +1Vt'ay 1994 Engineering,Inc. TAS 101 (Mortar Set) The Center for Applied 25-7094-(2,5,&8) Static Uplift Testing Oct. 1994 Engineering,Inc. TAS 102 The Center for Applied 25-7183-(5 thru 6) Static Uplift Testing Feb. 1995 Engineering,Inc. TAS 102 The Center for Applied 25-7214-(1,5 ,&8) Static Uplift Testing March, 1995 Engineering,Inc. TAS 102 The Center for Applied 25-7487-2 Static Uplift Testing Dec. 1995 Engineering,Inc. TAS 102 The Center for Applied 25-7496-(1 &4) Static Uplift Testing Dec. 1995 Engineering,Inc. TAS 102 The Center for Applied 25-7804-6 Static Uplift Testing Sep. 1996 Engineering,Inc. TAS 102 Celotex Corporation Testing 520109-1 Static Uplift Testing Dec. 1998 Service 5201114 TAS 101 Celotex Corporation Testing 520191-1 Static Uplift Testing March 1999 Service TAS 101 Walker Engineering,Inc. Calculations Aerodynamic Multiplier Sep. 2006 Walker Engineering,Inc. Calculations Restoring Moments Due to Gravity Sep. 2006 NOA No.:15-0223.18 MIMI-DADE Cov" Expiration Date: 10/05/16 Approval Date: 09/24/15 Page 3 of 10 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 in accordance with TAS 106 shall be required,refer to applicable Building Code. 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 Miami-Dade County Product Control Section for review. 3.4 Minimum underlayment shall be in compliance with the applicable Roofing Applications Stand"Ubited section 4.1 herein. 3.5 30/90 hot mopped underlayment applications may be installed perpendicular to the roof Mope ur�fosas,*stated ••„• 0000 . otherwise by the underlayment material manufacturers published literature. ,••;,, , 3.6 This acceptance is for wood deck applications. Minimum deck requirements shall ba ita compliance with • applicable Building Code. •••o o 0000 . 0000. 0000.. 0000 0000. 4 INSTALLATION: •� :: ��•� •��s•• 000,0. so 0 0 0 4.1 Eagle Roofing Products LLC Bel Air, Bel Air Double Eagle, Ponderosa, Golden Eagle,Pondero;aQenble FFg1e*, Flat Concrete Roof Tiles and its components shall be installed in strict complianC�y tt Roofing,Applic4tM•; Standard RAS 118,RAS 119 and RAS 120. '..' 4.2 Data For Attachment Calculations Table 1: Average Weight (W) and Dimensions (I x w ) Tile Profile Weight-W (lbf) Length-1 (ft) Width-w (ft) Bel Air, Bel Air Double Eagle, 11.4 1.42 1.03 Ponderosa, Golden Eagle, Ponderosa Double Eagle Flat Tile Table 2: Aerodynamic Multipliers -A (ft ) Tile Profile A (ft3) Batten Application Directeck"Appi cation Bel Air, Bel Air Double Eagle, 0.301 0.278 Ponderosa, Golden Eagle, Ponderosa Double Eagle Flat Tile NOA No.:15-0223.18 MIAMI•DADE COUNTY ... 1 Expiration Date: 10/05/16 Approval Date: 09/24/15 Page 4 of 10 Table 3: Restoring Moments due to Gravity- M9 (ft-lbf) Tile 3":12" 4":12" 5":12" 611:12" Greater than Profile 7":12" Bel Air, Bel Air BattensBattens Direct Battens Direct Battens Direct Battens Direct Double Eagle, Deck Deck Deck Deck Deck Ponderosa, 7.48 7.71 7.37 7.59 7.22 7.44 7.05 7.27 6.86 7.07 Golden Eagle, Ponderosa Double Eagle Flat Tile Table 4: Attachment Resistance Expressed as a Moment - Mf(ft-lbf) for Nail-On Systems Tile Fastener Type Direct Deck Direct Deck Battens Profile (min 15/32" plywood) (min. 19/32" plywood) Bel Air, Bel 2-10d Ring Shank Nails 30.9 38.1 17.2 Air Double 1-10d Smooth or Screw 7.3 9.8 4.9 Eagle, Shank Nail Ponderosa, 2-10d Smooth or Screw 14.0 18.8 7.4 Golden Shank Nails Eagle, 1 #8 Screw 30.8 30.8 18.2 Ponderosa 2#8 Screw 51.7 51.7 24.4 Double 1-10d Smooth or Screw 24.3 24.3 24.2 Eagle Flat Shank Nail Field Clip) Tile 1-10d Smooth or Screw 19.0 19.0 22.1 Shank Nail Eave Clip) 2-10d Smooth or Screw 35.5 35.5 34.8 Shank Nails Field Clip) 2-10d Smooth or Screw 31.9 31.9. 0 32.2 6909:0 Shank Nails Eave Clip) '6 00 9 999999 6 66 999696 2-10d Rin Shank Nails' 50.3 65.5000 ' 48.3 ••••• 1. Installation with a 4"tile headlap and fasteners are located a min. of 2%" from -of til ••'66 6666 9 69966. 6099 6666. .. .. 6666 6666.. 6666.. • . . . 6 9669.. 6666.. 6 9 . . 666.. 00 0 NOA No.:15-0223.18 MIAMPDADECOUNT Y ..� Expiration Date: 10/05/16 Approval Date: 09/24/15 Page 5 of 10 r Table 5: Attachment Resistance Expressed as a Moment Mf(ft-lbf) for Two Patty Adhesive Set Systems Tile Tile Application Minimum Attachment Profile Resistance Bel Air, Bel Air Double Eagle, Adhesive' 31.32 Ponderosa, Golden Eagle, Ponderosa Double Eagle Flat Tile 1 See manufactures component approval for installation requirements. 2 Flexible Products Company TileBond Average weight per patty 13.9 grams. 3MTM 2-Component Foam Roof Tile Adhesive AH-160 Average weight per patty 8 grams. Table 6: Attachment Resistance Expressed as a Moment - Mf(ft-lbf) for Single Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Bel Air, Bel Air Double Eagle, 3MTM 2-Component Foam Roof Tile Adhesive AH-160 118.93 Ponderosa, Golden Eagle, 3MTm 2-Component Foam Roof Tile Adhesive AH-160 OR9q Ponderosa Double Eagle Flat Tile _.Z,::±fffl2:paddy placement of 45 grams of Po ProTm. 4 Mediumadd lacemen of 24 rams of of ProT"'. Table 7: Attachment Resistance Expressed as a Moment - Mf(ft-lbf) for Mortar Set Systems Tile Tile Attachment Profile Application Resistance Bel Air, Bel Air Double Eagle, Ponderosa, Golden Mortar Sets 43.9 Eagle, Ponderosa Double Eagle Flat Tile :009:0 5 Tile-Tite Roof Tile Mortar. • • 0 . ...... . . ...... .0000• 0 0 •00.0. .... . ..... 00.0000000 ..... 0 . 0 00000 .... ...... 0 0000.0 . 0 . . •0000• •000•• • • • • • 0 0 • •00.0• 00 • • 000 • 0 00 0 NOA No.:15-0223.18 MLAWDADecounrrr Expiration Date: 10/05/16 Approval Date: 09/24/15 Page 6 of 10 r 5. LABELING All tiles shall bear the imprint or identifiable marking of the manufacturer's name or logo (See Detail Below),or following statement: "Miami-Dade County Product Control Approved". EAGLE,, FLORIDA (LOCATED ON UNDERSIDE OF TILE) OR EAGLE FL (LOCATED ON FRONTSIDE OF TILE) BEL AIR,BEL AIR DOUBLE EAGLE,PONDEROSA,GOLDEN EAGLE,PONDEROSA DOUBLE EAGLE CONCRETE ROOF TILE LABEL,SUMTERVILLE PLANT :••••• • • • 0666•• 0 0 • • 00 0 60 6 ••9.99 • 69 666.66 099:0* • 9 • 90.00. 0000 . . 6 9 6. BUILDING PERMIT REQUIREMENTS: o 0 0.0 0 . 999999 99999 99.. 9999 9999. 6.1 Application for building permit shall be accompanied by copies of the following: ..' '9009999.0 6.1.1 This Notice of Acceptance. :09:0: • 6.1.2 Any other documents required by A1-IJ or applicable Building Code in order to ptoperlpAvAvate Me" installation of this system. 000 00 000 :9 9..: 00 9 NOA No.:15-0223.18 M�AMwLDAD,CouNTY Expiration Date: 10/05/16 JAPPRApproval Date: 09/24/15 Page 7 of 10 PROFILE DRAWING dF ti 17 12%11 P BEL AIR o� •... • •• ..•..• •••. • . • 17W 4 _- s • • • • • 00 0 'ems, r`" �`'c_� • • • ••.•.• .• • . :0: •• . • 00 0 BEL AIR DOUBLE EAGLE NOA No.:15-0223.18 MuuN•DADe cou Expiration Date: 10/05/16 Approval Date: 09/24/15 Page 8 of 10 " ~- a 1 PONDEROSA 17 rte. "� - �• • •••••• m� fir••• • ••�••• aero' � ••••• •••• ••••• ""gym � • • • • PONDEROSA DOUBLE EAGLE NOA No.:15-0223.18 MIAMFDADE COUNTY O Expiration Date: 10/05/16 Approval Date: 09/24/15 Page 9 of 10 R 17 1 ®, Rte. GOLDEN EAGLE END OF THIS ACCEPTANCE 0000.. 66666. .. .. 6 . . .. 04060. 606..6 . Lees: 4 .666 • 646 6 .• • • . • 6666 • •66.6 66066. 0660 06660 •• •• 4066 0606•• • •.466• • 4 • • • • • • • 6 •6406• •6066• i ••• 6 4640: •• • 6 666 • • 00 0 NOA No.:15-0223.18 M AMMADECo: Expiration Date: 10/05/16 Approval Date: 09/24/15 Page 10 of 10