RF-15-756 (2) 0 Miami Shores Village
allot" Building Department
10050 N.E.2nd Avenue
h
two Miami Shores, Florida 33138
�EpR�pA Tel: (305) 795.2204
Fax: (305) 756.8972
RE: Permit# R F- y-15- 15 6 DATE: Sa i/i S
INSPECTION AFFIDAVIT
I L o v )s I o I Q 4 0 licensed as a(n)Contractor/Engineer/Architect,
(Prtnt name and&de License Type) FS 468 Building Inspector
License#: CCC 0 2 b 0 3 2
On or about A p r I I I Lt Z 01 s , 1 did personally inspect the roof deck nailing
(Date&time)
work at 0111 NE 100 ST, Miami Shoxirs, R 3213%
(Complete Jolstte 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)
Sigture
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 y of
t :.. 1-1.4 Affloriz
Notary Public, Sate of Florida at Large 0.` CMWAb 5 M#FF0s7913
� � EgAm&J1.30,2019
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'General,24uildmg,Roftnrnl,or Roofing Contraclars or any Indtriduat cer&A under 488 F.S.to make such an Irmpectlon.Include photographs of each plane of the roof with
permit 9 and address d claaify stern ffeend en 0a deck for each Inion
FtevW on(7110014,11PM
ACB2 Engineering Inc.
Testing & Engineering Services
Certification of Authorization#8131 Roof Tile Uplift Test Report
Tel: 954-245.8976; Fax: 954.301.7776
5230 NE 18 Avenue
Fort Lauderdale, FL 33334
Attention: Miami Shores Village, Building Division,
10050 NE 2nd Avenue, Miami Shores, FL 33138
Client: T& S Roofing Systems, Inc
Test Date:5/18/2015 Permit#RF-4-15-756
Property Address: Kohen Residence
1177 NE 100 Street,Miami Shores, FI
Roof Pitch: Type of Tile: Roof Area:
3 in 12 Bora)Roof Tile 45.00 squares
Tile Attachment Method: Two Component Polyurethane Foam Adhesive-Poly Pro H 160
field instrument : IMADA Force Gauge 0-100 Serial number:243454
Test Location Total Number of Tests Field Uplift Pull Test Test results
Perimeter Area: 20.00 sq 20 As per FBC 2010 Passed
Field Area: 25.00 sq 25 As per FBC 2010 Passed
No.of Corner: 9 9 As per FBC 2010 Passed
Ridge Areas: 190 PCs 17 As per FBC 2010 Passed
Important.
These laboratory results can change due to future weather impacts and/or unavoidable roof
traffic.Therefore,this report represents the TAS 106 results at the time of the test.
Please see att2ched a Roof Sketch for this project.
Cordiall
ACB a ring Inc. (NOA 09-1005.01)
Antoni Acevedo, PE
Fla. Reg. No: 36466
1? 2DIS-