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RF-15-2761 Petal' 4 - � 51W $i,� Miami Shores Village 4, elf T} Ja'.1, � 10050 N.E.2nd Avenue NE wt'* 14 �)r, s �•• Miami Shores,FL 33138-0000 � a tatr :AP"PRC 1 . f4 Phone: (305)795-2204 2015 :' Expiration: 04/26/2016 Project Address Parcel Number Applicant 1080 NE 105 Street 1122320280090 Miami Shores, FL 33138- Block: Lot: VERONIQUE LESTRADE SFARA I Owner Information Address Phone Cell VERONIQUE LESTRADE SFARA 1080 NE 105 Street (305)799-2006 MIAMI SHORES FL 33138-2106 Contractor(s) Phone Cell Phone $ 11,300.00 Valuation: TRADE PRODUCTIONS INC (954)822-1943 -_ Total Sq Feet: 600 Type of Work:Repair Available Inspections: Additional Info:WATER PROOFING CONCRETE DECK Inspection Type: Classification:Residential Roof Repair Scanning:3 Final Roof Review Roof Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $7.20 Invoice# RF-10-15-57596 DBPR Fee $5.09 10/29/2015 Credit Card $377.38 $0.00 DCA Fee $5.09 Education Surcharge $2.40 Permit Fee-Repairs $339.00 Scanning Fee $9.00 Technology Fee $9.60 Total: $377.38 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by eit myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS O RS,ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing informatio(,iacc ate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore,I authorize the above-namo ctor to do the work stated. October 29, 2015 Authorized Signature:Owner / Applicant / Co ractor / Agent ate Building Department Copy October 29,2015 1 Miami Shores Village1-kk 4- Building Department 291015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 �OCT Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20N BUILDING Master Permit No. -� PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC r.A ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION FISHOP �l CONTRACTOR DRAWINGS JOB ADDRESS: `° tlS fh S t City: Miami Shores County: Miami Dade zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO Occupancy Type: Load: Construction Type: Flood Zone: SFE: FFE: OWNER: Name(Fee Simple Titleholder): h ilec�thcLje_ ne Z©S 74q q4W16 Address: +M City: State: Zip: Tenant/Lessee Name: Phone#: Email: %C. lestrae a# to QL r" CONTRACTOR:Company Name:�11 �IC,, CCAJCDV5 Phone#: Z �� Address: 3 ��-` City: V_AJ q�� n r A LO State: Zip: Qualifier Name: Phone#: State Certification or Registration#: ac& �Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ << �(�� Square/Linear Footage of Work:4D Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: ,` __ _ ��''�"'� P• - ^ _ Specify color of calor t �r�l Submittal Fee$Scanning Fee Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond TOTAL FEE NOW DUE$ (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. a;4�1Signature Signature OWNER or AG T C RAC OR The foregoing instrument was acknowledged before me this The fore oing instrument was acknowledged before me this cA`l day of b e r 20 byn2`t day of O �-�- C ,20 \ ,by &Vx KA PL , n 1FX,who is personally known to 1+}tgT%A c,ra t -%c Z ,who is personally known to me or who has produced �s�.r e� L.r_ as me or who has produced � (,q)&,, L_ as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: ?` Seal: N"y public-State of Florida Seal: ys Notary Public-State of Florida FF 904368 • Whvi fesion#�FF 904358 8p colm,Esus did 28,2019 Ary►Comm.Expires Jul 28,2019 �at�Nmrli tgtiongl NoWyAssn. L� APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) STATE:OF FL:ORmA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION OONSTRUCTION-INbUSTRY L ICENStN BOARQ 1W NORTH MONROJESITREET (80)48743' TALL-"'_SSEE FL-32;W"1783 DYER;Tkl J> SDE PaCl)4{ TIONS IN G, 55A7 $INf 1.6�R0 SOUTHt�T GHES fL33334 Co'§raeiaianmtht k*� orWoftheoae rbORFOrdRcdSed --.•-t1ti Prdftwonw R@gl flat Our- SiGRa�atfd tt199IFf irmn arsttite s ,ofcers.from�bxets tottarte STATE 1 FLORIDA E and ks eco taurar>is; stteng. DEPAR�'MENT 0 BUSINES$-AND Evesy try we t ;faproteft y we dp'busiess.ra order't ROMS$ppt�lLRI f Uk�iE3N seems You lieu For inform aon about oar, pMps 9=328a4t ^' •;D 11�t9 4 out.titN d fans arui th�r fiiirts t at.impact Yctr,:subscribe CSMFIED RGQ �p to departrt e . arttl lea rt more abouC the 6�eParlme s DYERS T HQR $ TRADE PRODU(3 OuF R deparlitierit#sr Icon Ertl ,Regeiat we strive to Y' of y, �- yQII,'YCNQI SQ;-�Wlcoo .•. D •.-+ .%t Y4U. isov ][O�Ir V s � �. f0 ch*q�v_*wl%FrOiida. _ y0Ur-R Wften ,k` IS:t3El rIFtLD;tirtdst .qte pro1►43iane 9f GIe4H$,F5. BcTM AUG3s two, cttoetytkoais�a DETACH HERE- RICK-SCOTT RPfOR KEN LAWSON.SECRETAFIY` STATE.OF FLORIDA DEPARTMENT OF BUSINESS AND-PROFESSIONAL REGULATION CONWRUDTIOKI`INWSTRk UCEPO Nt�' - - C Ct32824t The ROOFIN CONTiiAC70Ft Nart*d.below IS EE ED Under ft. of Chap�r489 F&. Ezpiratiar date: A1 ;3'1,2016 DYER,1146 lAS a _p TRSDUCTIONs 5509_SW 69RGAVE SOUTHWESrl £HES FL s 1 i DBA: Receipt#:185-236441 Business Name'TRADE PRODUCTIONS INC Business T e•ROOFING/SHEET METAL CONTRA OR (CERTIFIED ROOFING CONTRAC R) i i Owner Name:THOMAS J. DYER Business Opened:l0i/06/2010 Business Location:5501 SW 163RD State/County/Cert/Reg:CCC1328241 DAVIE Exemption Code: Business Phone:954-822-1943 i Roonnti seats Employees Machhm Professionals 1 3 ` 4 For Vendig Business Only Number of Machines: Vending Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collecdon Cost Total Paid I j 27.00 0.001 4.00 .1 040. 0:00. 0.00 27.00 i i I I THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature.You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements.This Business Tax Receipt ust be transferred whe ; i the business is sold, business name has changed. r you have moved the j business location.This receipt does not indicate that th business is legal or that i it is in compliance with State or local laws and regulations. I j j Mailing Address: j f � f THOMAS J. DYER Receipt #01C-14-00003071 5501 SW 163RD Paid 09/11/2015 27.00 DAVIE, FL 33331 i i { ! � 2015 - 2016 FRI Ire !up a ri. i z . AC4C>v® CERTIFICATE OF LIABILITY INSURANCE DATE(MMMDMM `.►/ 10/27/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUB OGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER COONT CT TriGen Insurance Solutions, Inc. 315 BE Mizner Blvd, Suite 213 PHONE (877) 987-4436 FAX AIC No:(561) 952-2625 E-MAIL Boca Raton FL 33432 ADDRESS: certs@trigengroupino.com INSURER 8 AFFORDING COVERAGE NAIC# INSURER A:Guarantee Insurance Company 11398 INSURED (248) 971-1030 Trion Solutions, Inc. at al L/C/F INSURERS: AmeriTemps Employment II INSURERC: 340 E Big Beaver Road I Suite 160 INSURER D: Troy MI 48083 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 7674 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I ADDL SUBR LTR TYPE OF INSURANCEim POLICY NUMBER Myo EFF POLICY N01/ LDI O YYYl EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH CURRENCE $ D TO RENTED CLAIMS-MADE OCCUR PREMIS S Ea occurrence $ MED EXP(Any one person) $ PERSONAL$ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY F-1JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accid m ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accident) ccident $ UMBRELLALUIB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATIONPER OTH- A AND EMPLOYERS'LIABILITY Y/N WCP500002702GIC 1/1/2015 1/1/2016 R STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEd$ 1,000,000 Wsdescribe under RIP71ONOFOPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached N more space is required) Coverage provided to leased employees and not subcontractors of AmeriTemps Employment II. Location coverage effective 1/1/2015 Ref: Trade Productions, Inc. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBE 3 POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, 140TICE WILL BE DELIVERED IN Trade Productions ACCORDANCE WITH THE POLICY PROVISIONS. Building Department 10050 NE 2 Ave. AUTHORIZED REPRESENTATIVE Miami Shores Vlllage FL 33138 ©1988-2013 ACORD CORPORATION. All rights reserved. ACORD 25(2013/04) The ACORD name and logo are registered marks of ACORD Page 1 of 1 ® DATE(MMMD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE 10/29/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. It SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Holl Yager Plymouth Insurance Agency PHONE727_682-4040 FAX 2739 US Hwy 19 North EMAIL Holiday, FL 34691 �` AIC N,:727-682-0239 ADDRESS:h•Yager@plymouthinsuranceagency.com INSURER(S) AFFORDING COVERAGE NAIC9 INSURER A:WESTERN WORLD INSURANCE CO. INSURED Trade Productions, Inc. INSURER B: 5501 SW 163rd Ave. INSURER C: SW Ranches, FL 33331 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WV0 POLICY NUMBER MWDD/YYYY MWDD LIMITS $ COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000 000 CLAIMS-MADE CI OCCUR PREMISE Ea occurrence $ 100, 000 PGP0789602 12/20/2014 12/20/2015 MED EXP(Any one person) $ 5, 000 A PERSONAL BADV INJURY $ 1, 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2, 000,000 X I PRC CI POLICY C JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE L177— $ Ea accident ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPER DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OT - AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? 71N!A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) THOMAS J. DYER / CCC1328241 CERTIFICATE HOLDER CANCELLATION BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 10050 NE 2 AVE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. MIAMI SHORES VILLAGE, FL 33138 FAX: 305-756-8972 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD25(2014/01) The ACORD name and logo are registered marks of ACORD A-0 DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 2/4/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT TriGen Insurance Solutions, Inc. NAME: Chris Rhoden 315 SB Mizner Blvd, Suite 213 aON o Ext: (877) 987-4436 aC No:(561) 952-2625 E-MAIL Boca Raton FL 33432 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC q INSURERA:Guarantee Insurance Company 11398 INSURED (248) 971-1030 INSURER B: Trion Solutions, Inc. et al L/C/F Ameritemps Employment II INSURERC: 340 E Big Beaver Road INSURERD: Troy MI 48083 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:cart ID 13226 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE �OCCUR DAMAGE-TO( RENTED PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY 1:1 PROJECT ❑ LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPER TY DAMAGE $ Peracci ent HIREDAUTOS I AUTOS UMBRELLA LIAB OCCUR EACH O CURRENCE $ EXCESSLIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PE )TH- A ANDEMPLOYERS'LIABILITY YIN WCPS00079301GIC 12/31/2015 12/31/2016 % STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached K more space Is required) Coverage is provided to leased employees and not subcontractors or non-leased employees of Ameritemps Employment II. Location coverage effective 12/31/2015. Ref: Trade Productions Inc, License Number DCC1328241 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Village of Miami Shores ACCORDANCE WITH THE POLICY PROVISIONS. 10050 North East AUTHORIZED REPRESENTATIVE 2nd Ave Miami Shores FL 33138 CO�� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Page 1 of 1 I Olt OCT 22��5 ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Code 5th Edition(2014) 1 High-Velocity Hurricane Zone Uniform Permit Application Form. 1 1 Section A(General Information) 1 1 Master Permit No. Process No. 1 Contractor's Name 1 Job Address 1 1 ROOF CATEGORY 1 ow Sloe 1 �'1- P ❑ Mechanically Fastened Tile ❑ Mortar/Adhesive Set Tiles 1 ❑ Asphaltic Shingles ❑ Metal Panel/Shingles ❑ Woodhingles/Shakes 1 El Prescriptive BUR-RAS 150 1 ROOF TYPE 1 ❑ New roof ❑ Repair ❑ Maintenance ooflng ❑ Recovering 1 /,�,1 ROOF SYSTEM INFORMATION 1 Low Slope Roof Area(SF� Steep Sloped Roof AREA(SSF) Total(SF) 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,dearly identify dimensions of elevated pressure zones and location of parapets. 1 1 1 1 - 1 �r � 1 Q 1 C 1 Lu Q 1 L LL LL' 1 c Q 1 4 1 U L 1 z — 1 J C I o ? 1 .. ... .. �. C) c 1 1 C c •0 0 • • • c, 1 F- 0 I FLORIDA BUILDING CODE—BUILDING.5thEDI4Iy:3;4)0 ; 0 15.37 A0mr�lt o k j":Y����IGHnMjjRVED),accessed by Eliczcr Palacio on Jung,2015 10:32:12 AM pursuant to License ROOF ASSEMBLIES AND ROOFTOP STRUCTURES ® Florida Building Code 5th Edition(2014) 1 High-Velocity Hurricane Zone Uniform Permit Application Form. 1 1 1 Section C(Low Slope Application) Top Ply Fastener/Bonding Material: 1 Fill In specific roof assembly components and identify 1 1 manufacturer 1 (If a component is not used,identify as"NN') Surfacing: Fastener SpiftAior(�izp3� 1 System Manufacturer. � ��// 1�f 1 Field: oc @ Lap,#Rows _@—^oc , 1 Product Approval No.: l 5r /��2"7 o OL Perimeter:t/--"oc @ Lap,#Rows_@ ^oc 1 1 1 Design Wind Pressures, From RAS 128 or Calculations: Corner ^oc @Lap,#Rows @ "oc , 1 Number of Fasteners Per Insulation 1 1 P1: P2: P3: 1 1 duct Field Perimeter Ii Comer 1 Max.Design Pressure,from the specific ro 1 approval system:._ ^�3� 3 Illustrate Components Noted and Details as Applicable: 1 I 1 , Deck: / Woodblocking,Gutter, Edge Termination,Stripping, Flashing, Type: (�i(1 C� Continuous Cleat,Cant Strip,Base!Flashing,Counterflashing, 1 Coping, Etc. 1 Indicate: Mean Roof Height, Parapet Height, Height of Base 1 Gauge/Thickness: Flashing, Component Material, Material Thickness, Fastener 1 Type, Fastener Spacing or Submit Manufacturers Details that 1 Slope: Ili Comply with RAS 111 and Chapter 16. 1 1 Anchor/Base Sheet&No.of Ply(s): A/,# 1 1 1 1 Anchor/Base Sheet Fastener/Bonding Material: 1 1 I 1 FT. Insulation Base Layer. 1 1 1 1 Base Insulation Size and Thickness: Parapet I Height 1 Base Insulation Fastener/Bonding Material: 1 1 1 1 Top Insulation Layer:_ ly FT. , Top Insulation Size and Thickness: 1 Mean , 1 Top Insulation Fastener/Bonding Material: Roof 1 Height 1 Base Sheet(s)&No.of Ply(s): 4&� 1 1 1 Base Sheet Fastener/Bonding Material: 1 .. ... . . . . . .• • . Ply Sheet(s)&No.of Ply(s):_ k!�/� 0 0 1 1 1 Ply Sheet Fastener/Bonding Material: , 1 • ••• •• ••• • ••• Top Ply:_ � �1 • % • . • • . • •. I 1 15'38 .•• . . . 0 •0 . 1 i i i 000 i 0 FL0;lDA BUILDING CODE—BUILDING,5th EDITION(2014) llgl t I ' j 1 1 ' Copyright to*or li IGS(.�nsLLeees ,=RRESPVED);ascd by EHem Palacio on luta,B.2015 10:32:12 AM pursuant to license im AgrcemenL afiu�cr roprQduc4pa .i MIAMI- MIAMI-DADE COUNTY • ., 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)31525-99 NOTICE OF ACCEPTANCE (NOA) www.miamidade.eov/economy Tremco,Inc. 23150 Commerce Park Dr. Beachwood,OH 44122 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials.The documentation submitted has been reviewed and accepted by Miami-Dade County RER-Product Control Section to be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction(AHJ). This NOA shall not be valid after the expiration date stated below. The Miami-Dade County Product Control Section (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County) reserve the right to have this product or material tested for quality assurance purposes. If this product or material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing and the AHJ may immediately revoke, modify, or suspend the use of such product or material within their jurisdiction. RER reserves the right to revoke this acceptance, if it is determined by Miami-Dade County Product Control Section that this product or material fails to meet the requirements of the applicable building code. This product is approved as described herein, and has been designed to comply with the Florida Building Code including the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION: Vulkem® Liquid Applied Roof(LAR) Systems 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 NCJA sQEbeFrovtdeitatle user by the manufacturer orits distributors and shall be available for inspection at the job Ne al:A rdgdesl oI''tQe Building Official. so 000 This NOA consists of pages I through 8. The submitted documentation was revietwe gy Aleac"ig•et�. .. .. . . y- a ••� •. L NOA No.: 15-0127.02 MIAMI•DADE COUNTY ••• • • • • ••• • • ...� � • . • • • . . . Expiration Date: 07/16/20 • : :': : : • : Approval Date: 07/14/15 •:• :• ': 000 •:• :' : Page I of 8 ROOFING SYSTEM APPROVAL Category: Roofing Sub-Category: Liquid Applied Roof System Material Polyurethane Deck Type: Concrete Maximum Design Pressure -850 psf TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT: Test Product Product Dimensions Specification Description Vulkem®350NF-SL Available in 5 & 55 ASTM C 836 One part, Low VOC polyurethane base coat gallons ASTM C 957 waterproofing membrane. Do Not Apply to Vertical Surfaces. Vulkem®350NF-R Available in 5 & 55 ASTM C 836 One part, Low VOC polyurethane base coat gallons ASTM C 957 waterproofing membrane. Vulkem®351 Available in 5 & 55 ASTM C 957 One part, sand filled, too coat aliphatic gallon pails polyurethane coating to provide chemical and UV resistance. Vulkem®951NF Available in 4.2 ASTM C 957 Two part, sand filled, top coat aliphatic gallon kit polyurethane coating to provide additional chemical and UV resistance. Vulkem®346 Available in 5 & 55 ASTM C 957 One part, sand tilled, intermediate/top coat gallon pails aliphatic polyurethane coating to provide chemical and UV resistance PRODUCTS MANUFACTURED BY OTHERS: Test Product Product Dimensions Specification Description Manufacturer Unimin Aggregate N/A N/A 2040 (20/30 mesh size) Silicone Dioxide Generic (silica)aggregate which imparts non-slip texture and wear resistance. .{ • . %: { •• ••• •• • • • •• •• • • • • • • • • • • •• • • • • • • •• WAWED"AD COUNTY NOA No.: 15-0127.02 ••• • • • • ••• • • Expiration Date: 07/16/20 :•: ; ; • ; Approval Date: 07/16/15 ••• • •• •• • • • •• •• Page 2of8 • • • ••• • • EVIDENCE SUBMITTED: Test Test Agency Test Identifier Specification Date Underwriters Laboratories, Inc. TGFU.R10845 UL 790 06/07/13 PRI Construction Materials TRE-102-02-01 ASTM C 957 12/11/12 Technologies LLC TRE-103-02-01 TAS 114 D 11/10/12 TRE-042-02-01 ASTM C 836 02/04/11 TRE-043-02-01 ASTM C836 02/04/11 TRE-099-02-01 ASTM C 957 12/11/12 TRE-041-02-01 TAS 114 D 01/20/12 TRE-100-02-01 ASTM C 957 12/17/12 TRE-101-02-01 TAS 114 D 11/10/12 • . .. . . . . MIAMI•DADE COUNTY NOA No.. 15-0127.02 �Fuameynlj� ••• • • • • •.• • • Expiration Date: 07/16/20 :•: Approval Date: 07/16/15 i i.�.i i i i i.�.i Page 3 of 8 APPROVED APPLICATIONS: Deck Type 1 Concrete Deck Description: Min. 2500 psi, structural concrete System Types F(1): Vulkem© 350NF/351 Liquid Applied Roof(LAR) System Substrate Preparation: All surfaces must be dry and clean, free of depressions, spalled areas, honeycombs, or voids. Clean and free of any non-compatible curing compounds, release agents and other surface contaminants. Substrate shall be smooth with a hair broom finish. Preferably water cured. Primer: Primer not required. Refer to manufacturer's recommendation or code requirements. Base Coat: Apply 40 vet mils of Vulkem® 350NF-R or 350NF-SL to the entire area to be coated, including all detail coats, but excluding expansion joints. Use a V-notched squeegee, followed by back rolling to evenly distribute coating and eliminate pinholes. Base coat shall be allowed to cure in accordance with manufacturer's instructions to a firm but tacky rubber. For control joints or cracks, refer to the manufacturer's instructions. Do Not Apply 350NF-SL to Vertical Surfaces. Top Coat: Apply one or more coats of Vulkem® 351 with a solvent resistant roller sleeve at a rate of 100 sq. ft. /gal to a minirnum thickness of 15 wet mils. Broadcast 20/30 mesh size aggregate into wet coating at a rate of 12 — 18 pounds per 100 square feet and backroll into membrane. Maximum Design -850 psf (See General Limitation#9) Pressure: .• •.. . . . . . .. • .. . . . . ... . •. ..• .. . . . .. . .•• .. ... . ... .• . • • • • • • • • . .• . • . . . . .. CM1AM1j-3D0ALDE=couN1Y NOA No.: 15-0127.02 "'• ' ••• • • • • ••• • • Expiration Date: 07/16/20 . . . . • . . • • • Approval Date: 07/16/15 • •• •• • • • •• .. Page 4of8 ••• • • • ••• • • MANUFACTURER'S REQUIREMENTS: 1. All work shall be performed by a Contractor licensed to do roofing/waterproofing work in Miami-Dade County. Contractor shall be familiar with the details and shall be approved by Tremco, Inc., Tremco, Ine.'s Liquid Applied Roof(LAR) Systems shall be installed solely by approved applicators and only with installation equipment approved by Tremco, Inc. 2. Contractor shall submit to the Building Official for review the system specifications and details. Submission of these documents, as well as the proper application and installation of al l materials shall be the sole responsibility of the contractor. 3. Flashings shall be installed according to the manufacturers published standard details, slpecific details,approved by Tremco, Inc.,shall be submitted to the Building Official for review. 4. Tremco, Inc.,Vulkem® Liquid Applied Roof(LAR) Systems shall not be installed without consultation with Tremco, Inc., if ambient or surface temperature is below 407. Do not apply to wet or frozen concrete surface. 5. Tremco, Inc.,Vulkem® Liquid Applied Roof(LAR) Systems shall not be installed over lightweight insulating concrete or plywood decking. 6. All attachment and sizing of perimeter nailers, metal profile, and/or flashing termination designs shall conform to Roofing Application Standard RAS 1 11 and the wind load requirements of applicable Building Code. CONCRETE DECK SYSTEM LIMITATIONS: 1. If mechanical attachment to the structural deck through the lightweight insulating concrete is proposed, a field withdrawal resistance testing shall be performed to determine fastener patterns and density. All testing and fastening design shall be in compliance with Testing Application Standard TAS 105 and Roofing Application Standard RAS 117,calculations shall be signed and sealed by a Florida registered Professional Engineer, Registered Architect,or Registered Roof Consultant. .• ••• . . • . . •• II' • . .. . • .. ... .. . . . .. • . . . . • 00 •. 0 00 0 MIAM-DADE counnY 1NOA No.: 15-0127.02 • •:• •:• Expiration Date: 07/16/20 : i • i :•: : i • i Approval nate! owm/15 •:• :• •: ••• •:• :• •: Page 7 of 8 GENERAL LIMITATIONS: 1. Fire classification is not part of this acceptance, refer to a current Approved Roofing Materials Directory for fire ratings of this product. 2. Insulation may be installed in multiple layers. The first layer shall be attached in compliance with Product Control Approval guidelines. All other layers shall be adhered in a full mopping of approved asphalt applied within the EVT range and at a rate of 20-40 lbs./sq.,or mechanically attached using the fastening pattern of the top layer. 3. All standard panel sizes are acceptable for mechanical attachment. When applied in approved asphalt and/or adhesives panel size shall be 4'x 4'maximum. 4. An overlay and/or recovery board insulation panel is required on all applications over closed cell foam insulations when the base sheet is fully mopped. If no recovery board is used the base sheet shall be applied using spot mopping with approved asphalt, 12" diameter circles, 24" o.c.; or strip mopped 8" ribbons in three rows, one at each sidelap and one down the center of the sheet allowing a continuous area of ventilation. Encircling of the strips is not acceptable. A 6" break shall be placed every 12' in each ribbon to allow cross ventilation. Asphalt application of either system shall be at a minimum rate of 12 lbs./sq. Note: Spot attached systems shall be limited to a maximum design pressure of-45 psf. 5. Fastener spacing for insulation attachment is based on a Minimum Characteristic Force(F')value of 275 lbf.,as tested in compliance with Testing Application Standard TAS 105. If the fastener value,as field-tested,are below 275 lbf. insulation attachment shall not be acceptable. 6. Fastener spacing for mechanical attachment of anchor/base sheet or membrane attachment is based on a minimum fastener resistance value in conjunction with the maximum design value listed within a specific system. Should the fastener resistance be less than that required,as determined by the Building Official,a revised fastener spacing, prepared,signed and sealed by a Florida registered Professional Engineer,Registered Architect,or Registered Roof Consultant may be submitted. Said revised fastener spacing shall utilize the withdrawal resistance value taken from Testing Application Standards TAS 105 and calculations in compliance with Roofing Application Standard RAS 117. 7. Perimeter and corner areas shall comply with the enhanced uplift pressure requirements of these areas. Fastener densities shall be increased for both insulation and base sheet as calculated in compliance with Roofing Application Standard RAS 117. Calculations prepared, signed and sealed by a Florida registered Professional Engineer, Registered Architect,or Registered Roof Consultant (When this limitation is specifically referred within this NOA,General Limitation#9 will not be applicable.) 8. All attachment and sizing of perimeter nailers,metal profile,and/or flashing termination designs shall conform with Roofing Application Standard RAS 111 and applicable wind load requirements. 9. The maximum designed pressure limitation listed shall be applicable to all roof pressure zones(i.e.field, perimeters,and corners).Neither rational analysis,nor extrapolation shall be permitted for enhanced fastening at enhanced pressure zones(i.e. perimeters,extended corners and corners). (When this limitation is specifically referred within this NOA,General Limitation#7 will not be applicable.) 10. 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. •• •••4ND•0JF•TIAIS ACCEPTANCE . .. . . . . ... . . ... .. ... . ... NOA No.: 15-0127.02 MIAMFDADECOUNTY Expiration Date: 07/16/20 ;•; ; Approval Date: 07/16/15 ;•••; ; ; ; ;••„ Page 8of8