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RF-16-1184 C Inspection Worksheet Miami Shores Village Ec 16— cl 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax:(305)756-8972 Inspection Number: INSP-258004 Permit Number: RF-5-16-1184 Scheduled Inspection Date:June 28,2016 Permit Type: Roof Inspector: Mesa,Michel Inspection Type: Final Roof Owner: WATSON,LEONARD Work Classification: Tile Job Address:165 NW 99 Street Miami Shores,FL 331504742 Phone Number Parcel Number 1131010230390 Project <NONE> Contractor: KAMEL'S PLACE Phone:(305)206-1566 Building Department Comments ADDITION ROOF TILE. Infracdo Passed Comments INSPECTOR COMMENTS False TO REPLACE PERMIT#RF14-2706 Inspector Comments Passed ® '�o C10 Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid q June 27,2016 For Inspections please call:(305)7624949 Page 9 of 32 AC62 Engineering Inc. �d 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: Kamel's Place Test Date: 03/30/2016 Permit#RF-12-14-2706 Watson Residence Property Address: 165 NW 99 Street, Miami Shores,FI Roof Pitch: Type of Tile: Roof Area: 4 in 12 Boral Roof Tile 10.00 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: 4.00 sq 4 As per FBC 2014 Passed Field Area: 6.00 sq 6 As per FBC 2014 Passed No.of Corner: 5 5 As per FBC 2014 Passed Ridge Areas: 38 4 As per FBC 2014 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 attached a Roof Sketch for this project. Cordiei ACB ing Inc. (NOA 09-1005.01) Antondo, PE Fla. Reg. (Vo: 36466 C 5I3O�7f�i� 1. . . ACE2 Engineering Inc. Engineering and Laboratory Services 5230 NE 18*Avenue Fort Lauderdale, Florida 33334 Phone: (954)245-8976 Fax: (954) 301-7776 C • s • F k Mu 04 Miami Shores Village 10050 N.E.2nd Avenue NW Miami Shores,FL 33138-0000 i o- x Phone: (305)795-2204 i Ilk Expiration: 1 14/201 Project Address Parcel Number Applicant 165 NW 99 Street 1131010230390 Miami Shores, FL 33150-1742 Block: Lot: LEONARD WATSON Owner Information Address Phone cell LEONARD WATSON 165 NW 99 Street MIAMI SHORES FL 33150-1742 Contractor(s) Phone Cell Phone Valuation: $ 2,500.00 KAMEL'S PLACE (305)206-1566 Total Sq Feet: 110 Type of Work:Re Roof Available Inspections: Additional Info:ADDITION ROOF TILE. Inspection Type: Classification:Residential Scanning:3 Up Lift Report 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 $1.80 DBPR Fee Invoice# RF-5-16-59620 $3.75 06/17/2016 Cash $226.30 $50.00 DCA Fee $3.75 Education Surcharge $0.60 05/02/2016 Cash $50.00 $0.00 Notary Fee $5.00 Permit Fee-New Roof $250.00 Scanning Fee $9.00 Technology Fee $2.40 Total: $276.30 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS AFFI IT: I cert' thet all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction a d zoning. Futh rendre,I a e ove-named contractor to do the work stated. June 17, 2016 Aut gnature:Ornep, / App icant / Contractor / Agent Date Building Department Copy June 17,2016 1 �rF t�•t I ' r x: �� _ice • ,._ 1, • Yll�.L ` r Ml ■ ■ ■ :+ ■ c ■ Z. • • ■ in •T• a • • I :i.l •II r .� .,. .r . :16: NOUN asBuon M/CrMM'�7M Ypi�rMMamammon NaMMM/CCCMMMM/MMMM� aMMMMMMMMMMMnMMMCC IM■f!M ■m■/!!�/�M7T!4�►i1•M#i■//fatal■ // /■Mi///■■■m■mann/ata///!/#/aa■f//mf■ of/■f ■////f►7r11/liana aan-: ,■rm■a■ f■ aft Tn�ia/f■mala■/a////■!■n//ff/fa�mai /inti///fat/aa/a/Mann/#fV!�'lmla/f/!/amm�►T9 JoseM/Mnn//Mani/nslfainmon ■ ■ff//afrf/f/■ M■■ M/#/l�a/f warMaafrrrrr►.ar.r r��••t•#flan/ of ■ f / / ## I ■l:M�aaa ■/�aaf#fiOaiamfr �� •• :■a■ alar■■Aa■�Man�I�rafaff/aMiMaaaMlaMi/■ Iaaae'Taal/braaft•+_-'..•.�aalisirG■aa;faa/■a/aa1■■ana■r; aCanaaan#■■anMa a■ ifaafll■\r': �. .■I•flaiA�■/ff■■tiff■f■f■'l/■/fffffflf/fffllf■f i■af■fff■a/ff !l■■ 10Nl:Mf:MK PA-'IMM:M:■:MMMMMM:f'.'fM/a/MMRlMMa/%��/MMMMMall�taM/!■an■■a////flan 1 ■ fff■l�aia■##f/A RnMafnlldM/■M■■Mania■ ■ata/Ma■afMMnM#afaMaa■ai/a/■/allmMfaMfMn■■{•"_ . 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(PEXaI.Mai::NN Nn M� IiMMN;C/�'l #QCs iiiii E_m a�MM /MMMfrr C-='='-"- iiLMCiM/M�Mr's 'fir�"� irk{I'�arfi'■iI li ! Mia �IMMi:MMC:MC ■MMM�MIa aMlnfk a ommoomma■aa■ Mta11 as■ MME IM:IY mail!III ■ / ■a/ 11111160 1010.■ /mala/!ff/ aMa/ n Nl■■M !11■fn .11---=: is MI NII ti*■�■i■sMas AMaMrN: aaM:M 11 a MrMMMaM%� 'C'M:M:M' 'MCS nNIF�1NMi(v llmwwIx f E mf# MII MA'aal a aaallaaaaaMMaaa�alf#m/aMMaM/ M11MfMaaaM■ Mm1�11 211/Mlatlllllak A■ I aCl1 M 'In �MMMM:NMNirMM s I rMMNMMSam ■ II i� iw1 M aa��IN ;NrM(biit a, • iiiiG�iiliCii t�ii iiiCC xi a offoon Munrua ' ' iM a ■a ■ ►'ti allnal'r�11i a=■ i . +��ta � aMastanraalrar.11�i�_a swum Florida Building Code 2010 Edition High Velocity Hurricane Zone Uniform Permit Application Foran Section D (Steep Sloped Roof SVstem) :.•.:• Roof System Manufacturer: Notice of Acceptance Number. C4 . Minimum Design Wind Pressures,If Applicable(From RAS 1v ar baicu jatiops): •.•; • Maximum Design Pressure From the NOA Specific stem : b 6 • 55 3 Method of the attachment: t` -------------- Steep Sloped Roof System Description Deck Type: 154 LAA 010 Roof Slope: YPe Un nt: �� nsulation: Fire SAMTEW. Ridge Ventilation? astener Type S Spacing: iv T �/ 'S N .S 4- � i^ .s dhes a Type: ype cap sheet: oof Covering: �,d I A o 0 Mean Roof Height-.-I � ��°►�,�s r-► �� '� Type SSize Drip Edge: X3 a,6 CD c Florida Building Code 2010 Edition High Velocity Hurricane Zone Uniform Permit Application Form Section E ¢idle Calculations) •.. :••• • ,,,, , For Moment based tile systema,choose either Method 1 or 2.Compared flteWhtes •• •••• • for M,wlth the values from ME.lithe Mivahm are greater than or egaal td 1"Mr ;... values,for each area of the roof,thea the tile attachment method is accepia !c. ...:. .... • q Method i"Moment CkatoPer RS i '' •••o .... . NOA NOA�• -�' • _ .... • (P3: 'LW' X;L�sd31 -Mg:. �e i NOA ..... . . .... . Method 2"SimpMed Tile Calculation Per Table Belewo• ••• • Required Moment of Resistance(Mr)From Table Below NOA b* M,Required Moment Resistance* Roof Siope 15' 20' 26' 3W40' M2 34A &12 X4 3U 5:12 26A 32.8 34.9 29A .12 219 - *Must be used in e*unedon with a list of moment based the systems endorsed by the Broward County Board of Rales and Appeals. For Uplift based the systems use Method 3.Compared the values for F'with the values for F,.H the F'vah m are greater than or equal to the F,values,for each area-of the roo4 then the the attachment method Is aeceptehle. Method 3"Uplift Based Tile Cakulahtons Per RAS 127" Fn: NOAF (P2:—z L• -—z w:®_)-W: a cos 8:_= Frz: NOA F` (P3: zl: =,z w:=_)-W:_zeos8:_= Fa: NOAF' When to Obtain Information Descripikion Sj bol Where to find Dedpftsmv for orORAS IVTable I orbyancnSh=InSansIyWspmparedby MbawdonASCE z Mean Roof HeW H Job Site Roof Sbpa Job Sio A Redodu Moment to M NOA A#wJm ant RedB=w Mt NOA Moment Resishm M: CalcuMed MkAmomAftband$esietWn F NOA RoquWUAMRensx FrCalcubded &VCWTft W NOA Too ons ROA a-vM moons mast eta the � time :000:0 SECTION 114402.13 .•. *see.:• HIGH VELOCITY HURRICANE ZONES—REQUIRED OWNERS NOTIE'11�10N FOR ROOFING•• • CONSIDERATIONS 000:00 0 0000.0 R4402.13A Scope.As it pertains to the section,it is the responsibility of roofing co "'•• '•• 0• • :000 with the required roofing permit,and to explain to the owner the content of the s A p provide the ownep 0 0. 114402 govern the minimum requirements and standards of the indust for roofing provlkfol�$'o Seco°A•;0• Additionally,the following items should be addressed as part of the agreement beton V6 owns tthe • contractor.The owner's initial in the designated space indicates that the item has bben eS1lained.000 •••••• 0000.. 0 Aesthetics-Workmanship:the workmanship provisions of Section R4402 are for the0 purpose of • 1. ?� 00 providing that the roof system meets the wind resistance and water instruction performance standards. Aesthetics(appearance)are not a consideration with respect to workmanship provisions.Aesthetic issues such as coloror architectural appearance,that are not part of a zoning code,should be addressed as part of the agreement between the owner and the contractor. 2. lcRenalling wood decks:When replacing roofing,the existing wood roof deck renalled in accordance with the current provisions of Section R4403. roof deck is may have to be r to removing the existing roof system). usually concealed prior 3. '— ____Common roofs:Common roofs are those which have no visible delineation between 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 to be performed. 4. f _� Exposed Ceiling:Exposed,open beam ceilings are where the underside be viewed from below.The owner may wish to maintain the architectural a e;therefore, of the roof decking can penetration f appearance. the underside of the decking may not be acceptable.This provides the option of maintainingtaining the 5. 7—Ponding water:The current roof system and/or deck of the build' l and cause water to pond(accumulate)in low-lying areas of the roof. Pounding can be an indication ofmay not drain estruc ural y distress and may require the review of a professional structural engineer.Pounding may shorten the life expectancy and performance of the new roofing system.Pounding conditions may not be evident until the original roofing system is removed.Pounding conditions should be corrected. 6. Overflow scuppers(wall outlets):It is required th ) at rainwater flows off so that the roof is not overloaded from a buildup of water.Perimeter/edge wall or other roof extension 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. 7. Ventilation:Most roof structures should have some ability to vent mural airflow through the interior of the structure assembly(the building itself).The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting whi res ending the service life of the Owner/Agent's Signature Date Contractor Signat Date Revised on 7/9/2009 LD M IAM =6 ��/�,,� MIAMI-DADE COUNTY PRODUCT CONTROL S9CTION DEPARTMENT OF PERMITTING,ENVIRONMENT,AND REGULATORY AFFAIRS(PERA) J 1805.SW 26 SttetItMn 208 •••••• BOARD AND CODE ADMINISTRATION DIVISION ••.Mial i,FloriA 331 5-2474 .• T(7%115,;1590 F C780)419-2599 •••• • NOTICE OF ACCEPTANCE (NOA) ..XtwmiamidadUoy/yera , Boral Roofing LLC. ...... .... . ..... 7575 Irvine Center Drive,Suite 100 ...... . . ..... Irvine CA.92618 •••••• SCOPE: •••••• This NOA is being issued under the applicable rules and regulations governing the use of construction matelials.The ;....; documentation submitted has been reviewed and accepted by Miami-Dade County PERA-Product Control S&INn to ' be used in Miami Dade County and other areas where allowed by the Authority Having Jurisdiction(AHJ).•*00 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. PERA 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: Spanish`S'Nuevo Concrete Roof Tile 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# 10-0701.01 and consists of pages I through 6. The submitted documentation was reviewed by Alex Tigera. NOA No.: 12-0308.19 rIu►r�i nAwe cotnvrr Expiration Date: 05/20/14 Approval Date: 06/21/12 Page 1 of 6 ROOFING ASSEMBLY APPROVAL Category: Roofing •.• :""' ...... Sub-Category: Roofing Tiles •• • •• • •' Material: Concrete ...... . .. ...... 1. SCOPE .... ..... This approves a system using Spanish S Nuevo Concrete Roof Tile,as manufactured Bora�*6R®efing IsI�Ci n Lake ..:..' Wales, FL., and described this Notice of Acceptance. For locations where the pit9sdrt requirements, as •••••• determined by applicable Building Code does not exceed the design pressure values ob2fttd:by calculations in •, compliance with RAS 127 using the values listed in the installation section herein. The attacAment 1"ations shall be done as a moment based system. •••• • •• •••• 2. PRODUCT DESCRIPTION Manufactured by Test Product Applicant Dimensions Specifications Description Monier Lifetile Spanish 1= 17" TAS 112 High profile,interlocking,one-piece,'S'shaped, 'S'Tile w=9-3/4" high-pressure extruded concrete roof tile equipped min. .63"thick with three nail holes. For direct deck nail-on, mortar set or adhesive set applications. Trim Pieces 1=varies TAS 112 Accessory trim,concrete roof pieces for use at hips, w=varies rakes,ridges and valley terminations. varying thickness Manufactured for each tile profile. 2. 1 PRODUCT DESCRIPTION 1. Lake Wales,FL. 2.2 SUBMITTED EVIDENCE: Test Agency Test Identifier Test Name/Report Date Redland Technologies 7161-03 Static Uplift Testing Dec. 1991 Appendix III PA 102&PA 102(A) Redland Technologies 7161-03 Wind Tunnel Testing Dec. 1991 Appendix II PA 108(Nail-On) Redland Technologies P0647-01 Wind Tunnel Testing Aug. 1994 PA 108(Mortar Set) Redland Technologies P0402 Withdrawal Resistance Testing of Sept. 1993 screw vs.smooth shank nails The Center for Applied 94-084 Static Uplift Testing May 1994 Engineering,Inc. PA 101 (Mortar Set) The Center for Applied 94-083 Static Uplift Testing April 1994 Engineering,Inc. PA 101 (Adhesive Set) The Center for Applied 25-7183-4 Static Uplift Testing Feb. 1995 Engineering,Inc. PA 102(2 Quik-Drive Screws, Direct Deck) NOA No.: 12-0308.19 ruartPDADE CouNTY Expiration Date: 05/20/14 Approval Date: 06/21/12 Page 2 of 6 2.2 SUBMITTED EVIDENCE: Test Agency Test Identifier Test Name/Revort .Date 006..0 The Center for Applied 25-7214-3 Static Uplift Testing: .•. March, 1995 .... • Engineering,Inc. PA 102(1 Quik-Drive Screv6, :'. •. 00.00. 0 Direct Deck) • Redland Technologies Letter Dated Aug. 1, 1994 Wind Tunnel Testing.. .. 4ug.*L994 �••••� PA 108(Nail-On) '0000• :0.00• ••••0 The Center for Applied Project No.307025 Wind Driven Rain 000000 Oct. 1994 ..:..• Engineering,Inc. Test#MDC-78 PA 100 •• •• • 660900 Nutting Engineering 13343.1 Physical Properties:••;•; Feb 2009 •0 TAS 112 :...:. 0.0f0• Celotex Corporation Testing 520111-3 Static Uplift Testing: 00 15ec. 1998 :....: Service 520191-2-1 PA 101 �� Ma�rc�i�1�99 ' Walker Engineering,Inc. Calculations Aerodynamic Multiplier Jan 2009 Walker Engineering,Inc. Evaluation Calculations 25-7094 February 1996 Walker Engineering,Inc. Evaluation Calculations 25-7496 April 1996 Walker Engineering,Inc. Evaluation Calculations 25-7584 December 1996 25-7804b-8 25-7804-4&5 25-7848-6 Walker Engineering,Inc. Evaluation Calculations 25-7183 March 1995 Walker Engineering,Inc. Evaluation Calculations Restoring Moment Due to Gravity Jan 2009 Walker Engineering,Inc. Calculations Two Patty Adhesive Set System April 1999 3. LIMITATIONS 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile applications, a static field uplift test shall be performed in accordance with TAS 106. 3.3 Applicant shall retain the services of a Miami-Dade County Certified Laboratory to perform quarterly test in accordance with TAS 112, appendix `A'. Such testing shall be submitted to the Building Code Compliance Office for review. 3.4 Minimum underlayment shall be in compliance with the applicable Roofing Applications Standards listed section 4.1 herein. 3.5 30/90 hot mopped underlayment applications may be installed perpendicular to the roof slope unless stated otherwise by the underlayment material manufacturers published literature. 3.6 This acceptance is for wood deck applications. Minimum deck requirements shall be in compliance with applicable building code. 3.7 May be installed on slopes 7:12 and greater NOA No.: 12-0308.19 MLINKMane couNTtr Expiration Date: 05/20/14 Approval Date: 06/21/12 Page 3 of 6 ...... . .. ...... 4. INSTALLATION •••••• • 4.1 Spanish `S' Nuevo Concrete Roof Tile and its components shall be installed in•Stftt compliance with••;••• Roofing Application Standard RAS 118,RAS 119,and RAS 120. •': :...:. ••••• 4.2 Data For Attachment Calculations •• •• •••••• ••••• Table 1: Average Weight(VI) and Dimensions (I x w) :"'•• Tile Profile Weight-W(lbf) Length-1 (ft) •• OVidth-4(ft 000 • Spanish `S' Nuevo Tile 8.95 1.417 0.8125 Table 2: Aerodynamic Multipliers -X(fe) Tile ).(ft) (ft) Profile Batten Application Direct Deck Application ,Spanish `S' Nuevo Tile 0.215 0.233 Table 3: Restoring Moments due to Gravity-Mg(ft-lbf) Tile 2":12" 3":12" 4":12" 5":12" 6":12" 7":12" or Profile greater Spanish Battens Direct Battens Direct Battensirect attens Direct Battens Direct Battens Direct 'S' Nuevo Deck Deck Deck Deck Deck Deck Tile 1 5.36 6.00 1 5.33 5.93F 5.21 ' 5.83 5.09 5.70 4.96 1 5.56 1 4.82 5.39 Table 4: Attachment Resistance pressed as a Moment-Mf(ft-lbf) For Nail-On Systems Direct Deck Direct Deck Tile Fastener Type (min 15/32" (min. 19/32" Battens Profile plywood) plywood) Spanish `S' 2-10d Ring Shank Nails 28.6 41.2 19.4 Nuevo Tile 1-10d Smooth or Screw Shank Nail 5.1 6.8 2.8 2-10d Smooth or Screw Shank Nails 6.9 9.2 7.3 1 .#8 Screw 20.7 20.7 18.1 2 48 Screws 43.2 43.2 29.8 1-10d Smooth or Screw Shank Nail 23.1 23.1 19.0 Field Clip) 1-10d Smooth or Screw Shank Nail 29.3 29.3 24.0 Eave Clip) 2-10d Smooth or Screw Shank Nails Field Clip) 27.6 27.6 38.6 2-10d Smooth or Screw Shank Nails Eave Clip) 38.1 38.1 41.8 2-10d Ring Shank Nails 33.1 48.1 45.2 1 Installation with a 4"tile headlap and fasteners are located a min. of 2Y2"from head of tile. NOA No.: 12-0308.19 CMIUALADE=NT Expiration Date: -0308.14 Approval Date: 06/21/12 Page 4 of 6 0000.. 0000.. .. :0 . . . .0 000000 Table 6: Attachment Resistance Expressed as a Moment Mf(ft-HAI•• 0 • 000 for Two Patty Adhesive Set Systems ease 0. • 0000.. 0000 Tile Tile Application Micliautrn Attachment 0000' Profile •• lce lResistar • ••••• Spanish 'S' Nuevo Tile Adhesive • • • 9.3"_ •,; 2 See manufactures component approval for installation re uirements. •••••• 3 Flexible Products Company TileBond Average weight per patty 10.7 grams. .. ••••. 0000 3M TM 2-Component Foam Roof Tile Adhesive AH-160 Average weight per a 8 rams. • Table 7: Attachment Resistance Expressed as a Moment-Mf(ft-lbf) for Single Patty Adhesive Set Systems Tile Tile Application Minimum Attachment Profile Resistance Spanish 'S' Nuevo Tile 3M 2-Component Foam Roof Tile Adhesive AH-160 66.5 3M 2-Component Foam Roof Tile Adhesive AH-160 38.7 4 Large paddy placement of 63 rams of 3M 2-Com onent Foam Roof Tile Adhesive AH-160. 4 Medium add placement of 24 rams of 3M 2-Com onent Foam Roof Tile Adhesive AH-160. Table 8: Attachment Resistance Expressed as a Moment-Mf(ft-lbf) for Mortar Set Systems Tile Tile Attachment Profile Application Resistance Spanish 'S' Nuevo Tile Mortar Set 24.5 5 Tile-Tite Roof Tile Mortar. 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". BORAL ROOFING LLC SPANISH`S'NUEvo CONCRETE ROOF TILE(LAKE WALES,FL.) (LOCATED ON UNDERSIDE OF TILE) NOA No.: 12-0308.19 MMI-DAD,couNn Expiration Date: 05/20/14 Approval Date: 06/21/12 Page 5 of 6 0 . 0000.. 0000:0 .. . .. . . . 0 0000.. . .. 0000.. 6. BUILDING PERMIT REQUIREMENTS 0 0 0 0 : 0000 0000.. 6.1 Application for building permit shall be accompanied by copies of the following?•• ••:000 6.1.1 This Notice of Acceptance. :...:. 6.1.2 Any other documents required by the Building Official or applicable 91�ldn code-in order to properly evaluate the installation of this system. . 0..0 0 • . ...... 0 . . :4066: .. 0000 PROFILE DRAWINGS • 0000 17" 9-3/4" SPANISH`S'NUEVO CONCRETE ROOF TILE(POMPANO BEACH,FL.) END OF THIS ACCEPTANCE NOA No.: 12-0308.19 MLAMI-DADe COUNTY Expiration Date: 05/20/14 Approval Date: 06/21/12 Page 6 of 6 ...... . .. ...... MIAM ••••'• • MIAMI-DADE COUNTY,FLORIDAmain • • METRO-DAD$FLA4tY ER BLUM8 ••••• BUILDING CODE COMPLIANCE OFFICE(BCCO) 140 WEST FLAGLER69ft*oIVRT,SUMAS •••••• PRODUCT CONTROL DIVISION MIAML,Fl,pjtlDA 331304563 .• (305)375-290= "(305)375-29iP8 • NOTICE OF ACCEPTANCE(NOA) """ Kirsch Building Products,LLC. •• :000 • 1464 Madera St.#387 •• • Simi Valley,CA 93065 SCOPE: This NOA is being issued under the applicable rules and regulations governing the use of construction materials.The documentation submitted has been reviewed by Miami-Dade County Product Control Division and accepted by the Board of Rules and Appeals(BORA)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 Division (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. BORA reserves the right to revoke this acceptance,if it is determined by Miami-Dade County Product Control Division 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 and the High Velocity Hurricane Zone of the Florida Building Code. DESCRIPTION:Sharkskin Roof 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 new NOA consists of pages 1 through 6. The submitted documentation was reviewed by Jorge L.Acebo. • NOA No.: 09-1123.02 w�►aecowvrrExpiration Date: 07/14/15 •• . . Approval Date: 07/14/10 Page 1 of 6 4444.. 4444.. ROOFING COMPONENT APPROVAL • 460.6. Category Roofing 4444 4444.. 0 0 0 0 0 0 Sub-Category: Underlayment 6006 ••••• Material: Polypropylene 64;49; ;444;4 4.466 0 64466. . 00 4 TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT:••6•• 0 0.0.6 4 . 6 . 4444.. 66 . .466 6 4 Product Dimensions Test Product 6 0 0 0 Specification Description Sharkskin Compym 48"x 250' ASTM D226, A multi-layer laminated roof underlayment Type I or II comprised of a high-strength woven polypropylene base with a UV&antioxidant protection bond layer and a slip-resistant top layer. Sharkskin UltraTM 48"x 250' ASTM D226, A multi-layer laminated roof underlayment Type I or H comprised of a high-strength woven TAS 104 polypropylene core with a UV&antioxidant protection bond layer to both sides and a slip- resistant top layer. Sharkskin Ultra 48"x 250' ASTM D226, A multi-layer laminated roof underlayment RadiantTm Type 1 or II comprised of a high-strength woven polypropylene care with a reflective barrier on the underside and a UV&antioxidant protection bond layer on both sides and a slip- resistant top layer. Sharkskin Ultra SATM 48"x 125' TAS 103 A multi-layer laminated roof underlayment comprised of a high-strength woven polypropylene core between two layers of UV &antioxidant protection bond and a self- adhering underside and a slip-resistant top layer. EVIDENCE SUBMITTED: Test Agency Test Identifier Test Name/Report Date Trinity I ERD K6550.08.07 TAS 114-C 08/20/07 K0810.12.05-R1 ASTM D 1623 (AC 152) 10/06/09 K3140.05.10 ASTM D-1623 05/18/10 K6540.07.07-R2 ASTM D 226 10/08/09 K6540.03.08-1 TAS 103/TAS 117-B 03/10/2008 K6540.03.08-2 TAS 104/TAS 117-B 03/10/2008 K9210.05.08-R1 TAS 103/TAS 104 11/13/09 ASTM D 5147/ASTM D 4798 NOA No.: 09-1123.02 rnar�pncEcou Expiration Date: 07/14/15 Approval Date: 07/14/10 Page 2 of 6 0000.. 0090:0 .. . .. . 9 0 0000.. . .. 900009 APPROVED SHARK,SI�N SYSTEM ASSEMBLIES: """ ' 0000.. 0999 0. 9999.0 Deck Type 1: --Wood ..•• ••••• 0000.. :00.:0 0000. Deck Description: /32"or greater plywood or wood plank • • 99 .0 . 0..... System E(1): Base sheet mechanically fastened to deck,subsequent cap IV IU - %'self-adhePed. . . . . 0000.. All General and System Limitations shall apply. •••••• Base sheet: One or more plies Sharkskin Ultra applied in single covdge'method;d6ft1! '• minimum 4" horizontal laps and minimum 6"vertica.l laps applied as sWified below. Fastening. Mechanically fastened with approved nails & tin caps spaced 6" o.c. at the 4" horizontal overlaps and 10" o.c. in a grid pattern having three, equally spaced, staggered rows in the field of the sheet. Ply Sheet: (Optional)Sharkskin Ultra SA,self-adhered with minimum 2"horizontal overlaps and minimum 6"vertical overlaps. Place the first course of membrane parallel to the eave,rolling the membrane to obtain maximum contact.Remove the release liner as the membrane is applied. Membrane: Sharkskin Ultra SA,self-adhered with minimum 2"horizontal laps and minimum 6"vertical laps.Place the first course of membrane parallel to the eave,rolling the membrane to obtain maximum contact.Remove the release liner as the membrane is applied. When used in Tile roof systems the cap sheet shall be back nailed to deck with approved annular ring shank nails and tin caps at a maximum 12"o.c.at the side laps and 6"o.c.at the end laps. No nails or tin caps shall be exposed Surfacing: Approved for asphalt shingle,mechanically fastened roof tile,foam-adhered roof tile,non-structural metal roofing,wood shakes&shingles or slate roof assemblies as specified within the Roof System NOA. Note: For tile roof assemblies,refer to RAS 118, 119 or 120 and the tile manufacturer's NOA. For foam-adhered tile roof assemblies,approved use is limited to Polyfoam the foam adhesive. NOA No.: 09-1123.02 hwaApEcouMtr Expiration Date: 07/14/15 •••• Approval Date: 07/14/10 Page 3 of 6 0000.. 0000.. 00%00 . 00 .00000 Deck Type 1: Wood 000000 :*000: 0000 Deck Description: i9/32"or greater plywood or wood plank '0006 0 00 00' :.0.0 0000.. 0000. System E(2): Base sheet mechanically fastened to deck . . :000:0 0 0 0 0.0 .. .. . 6696.6 All General and System Limitations shall apply. 0000.. 6 00 . Base sheet: One or more plies Sharkskin Comp® or Sharkskin Ultra®O pplied as sisal ed :**00: below: 6 6 6 .60006 00 0 0000 Fastening: For slopes 3.5 : 12(16.2°)or greater: 66:6 Shall be applied in single coverage method, overlapping each course with a minimum 4"horizontal lap. Mechanically fastened with approved nails&tin caps spaced 6" ox. at the horizontal laps and 10" o.c. in a grid pattern having three, equally spaced,staggered rows in the field of the sheet. For slopes 2.5:12(11.8')to 3.5:12(16.2°): Shall be applied in a double coverage method, overlapping each course with a minimum 24"horizontal lap.Mechanically fastened with approved nails&tin caps spaced 6"o.c. within 4"of the bottom edge of the horizontal laps and 10"o.c. in one staggered row in the field of the sheet. Surfacing: Approved for asphalt shingle,non-structural metal roofing,wood shakes& shingles or slate roof assemblies as specified within the Roof System NOA. Deck Type 2: Wood Deck Description: 19/32"or greater plywood or wood plank System E(3): Base sheet mechanically fastened to deck. All General and System Limitations shall apply. Base sheet: One or more plies Sharkskin Ultra®applied as specified below: Horizontal Battens: Fastening:For slopes 3 : 12(14°)or greater: Sharkskin Ultra shall be applied in single coverage method, overlapping each course with a minimum 4" horizontal lap. Mechanically fasten Sharkskin Ultra with approved nails&tin caps spaced 6"o.c.at the horizontal laps and 10"o.c. in a grid pattern having three,equally spaced,staggered rows in the field of the sheet. Install battens over Sharkskin Ultra in accordance with RAS 119, Counter Battens: Fastening:For slopes 3 : 12(1411)or greater: Install vertical battens in accordance with RAS 118. Sharkskin Ultra shall be laid horizontally in single coverage method, parallel to the eave with minimum 4-inch horizontal laps and minimum 6-inch vertical Iaps over the vertical battens. Mechanically fasten Sharkskin Ultra with approved nails&tin caps spaced 6"o.c. at the horizontal laps and 10" o.c. in a grid pattern having three, equally spaced, staggered rows in the field of the sheet.Horizontal laps shall be sealed with butyl- based tape or other material specifically approved by Miami-Dade Product Control &Kirsch Building Products. Vertical laps shall be minimum 6-inch wide and shall break over a vertical batten to allow water to run away from the center point of the vertical batten. Surfacing: Approved for non-structural metal roofing,wood shakes&shingles or slate roof assemblies as specified within the Roof System NOA, NOA No.: 09-1123.02 MIAMI.04DE COUNTY Expiration Date: 07/14/15 • Approval Date: 07/14/10 Page 4 of 6 ....•. . .. .•,,.. Deck Type 1: Wood Deck Description: 19/32"or greater plywood or wood plank •'•' 9 ' .... . ...., System E(4): Base sheet mechanically fastened to deck. ' ' ...... . . ..... All General and System Limitations shall apply. •' •. ,••••. Base sheet: One or more plies Sharkskin Ultra Radiant®applied as specifi$d b8lcty: .•,.:. Horizontal Battens: Fastening:For slopes 3 : 12(141)or greater: 00 0 *see :....: Sharkskin Ultra Radiant® shall be applied with the reflective side up in.6$gle coverage method, overlapping each course with a minimum 4" horizontal lap. Mechanically fasten Sharkskin Ultra with approved nails&tin caps spaced 6"o.c. at the horizontal laps and 10" o.c. in a grid pattern having three, equally spaced, staggered rows in the field of the sheet. Install battens over Sharkskin Ultra in accordance with RAS 119. Counter Battens: Fastening:For slopes 3 : 12(14°)or greater: Install vertical battens in accordance with RAS 118. Sharkskin Ultra Radiant® shall be laid horizontally with the reflective side up in single coverage method, parallel to the eave with minimum 4-inch horizontal laps and minimum 6-inch vertical laps over the vertical battens. Mechanically fasten Sharkskin Ultra Radiant®with approved nails &tin caps spaced 6"o.c. at the horizontal laps and 10"o.c. in a grid pattern having three,equally spaced, staggered rows in the field of the sheet.Horizontal laps shall be sealed with butyl-based tape or other material specifically approved by Miami-Dade Product Control & Kirsch Building Products. Vertical laps shall be minimum 6-inch wide and shall break over a vertical batten to allow water to run away from the center point of the vertical batten. Surfacing: Approved for non-structural metal roofing,wood shakes&shingles or slate roof assemblies as specified within the Roof System NOA. Deck Type 2: Steel Deck Description: Minimum 18-22ga.,Type-B,33ksi steel deck System E(5): Base sheet mechanically fastened to deck. All General and System Limitations shall apply. Base sheet: One or more plies Sharkskin Ultra applied in single coverage method with minimum 4" horizontal laps and minimum 6"vertical laps applied as specified below. Fastening: Sharkskin Ultra is attached to the roof deck with Miami-Dade listed corrosion resistant#10, #12 or#14 screws and metal stress plates. Screws shall engage the top flute of the steel deck and be of sufficient length for minimum Y4-inch penetration. Screws & plates spaced 6" o.c. at all laps and three staggered rows 10"o.c.in the field of the roll or as specified within the roof system approval. Surfacing: Approved for non-structural metal roofing assemblies as specified within the Roof System NOA. NOA No.: 09-1123.02 Expiration Date: 07/14/15 oe�ot Approval Date: 07/14/10 Page 5 of 6 0000.. • 0000•. GENERAL LIMITATIONS: 1. Fire classification is not part of this acceptance. """ ' :••••: 2. This acceptance is for prepared roofing applications. Minimum deck require%pl%shall bg-lit•%• :0000' compliance with applicable building code.Sharkskin Roof Underlayments slpjjtt%installo in 0 00:000 strict compliance with applicable Building Code. 00 06 6.66• Vas** 006666 3. All Sharkskin Underlayments shall be applied to a smooth,clean and dry surfs"-wiih deck free ." of irregularities.Deck shall be fastened in strict compliance with applicable Auilam%Codl%-AV 6 •••• • nails in the deck shall be carefully checked for protruding heads. Re-fasten*y 1ptie decking :0 0 f,: panels. Sweep the deck thoroughly to remove any dust and debris prior to appli'batibn :906 • • 4. Sharkskin Ultra may be used in asphaltic shingle,direct-deck/batten wood shake&shingle " direct-deck/batten quarry slate or direct-deck/batten non-structural metal roof applications. 5. Sharkskin Comp may be used in asphaltic shingle,direct-deck wood shake&shingle,direct-deck quarry slate or direct-deck non-structural metal roof applications. 6. Sharkskin Ultra Radiant may be used in battened non-structural metal roof,battened wood shakes &shingles or battened slate roof applications. Sharkskin Ultra Radiant shall not be used as a tile,asphalt shingle,direct-deck wood shakes&shingle,direct-deck non-structural metal or direct-deck slate underlayment. 7. Sharkskin Comp or Sharkskin Radiant shall not be used as a roof tile underlayment or as part of a roof tile underlayment system. 8. The Sharkskin Ultra and Sharkskin Ultra SA two-ply underlayment system may be used in asphalt shingle,mechanically fastened tile,foam-adhered tile,wood shake&shingle,quarry slate or non-structural metal roof applications. 9. The standard maximum roof pitch for The Sharkskin Ultra and Sharkskin Ultra SA two-ply underlayment system shall be 5:12 for flat tile and profiled tiles with lugs.A maximum of 10 tiles per stack are allowed when loading rile on the underlayment. 10.Sharkskin Roof Underlayments shall not be applied over an existing roof system as a recover application but may be applied as specified herein as part of an approved underlayment system. 11. Sharkskin Roof Underlayments shall not be left exposed as a temporary roof for longer than 180 days of application. 12. Sharkskin Roof Underlayments are components used in roof systems assemblies. Roof system assemblies are approved under specific Notice of Acceptance. Refer to Prepared Roofing System Product Control Notice of Acceptance for listed approval of this product with the specific prepared roofing assembly. 13. Sharkskin Roof Underlayments may be used with any approved roof covering Notice of Acceptance listings the Sharkskin product(s)as a component part of an assembly in the Notice of Acceptance. If Sharkskin Roof Underlayments are not listed,a request may be made to the Authority Having Jurisdiction(AHJ)or the Miami-Dade County Product Control Department provided that appropriate documentation is provided to detail compatibility of the products,wind uplift resistance and fire testing results. 14.Flash vent pipes,stacks,chimneys and penetrations in compliance with Roof Assembly current Product Control Notice of Acceptance and applicable Building Code. 15.All membranes or packaging shall bear the imprint or identifiable marking of the manufacturer's name or logo,or following statement: "Miami-Dade County Product Control Approved"or the Miami-Dade County Product Control Seal as shown below. ruaru�ane END OF THIS ACCEPTANCE NOA No.: 09-1123.02 Expiration Date: 07/14/15 PROVEDP° corrtr Approval Date: 07/14/10 Page 6 of 6 t �� Miami Shores Village Y 02 2016 TA Building Depart m* &' t BY. 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 20a�'s BUILDING Master Permit No. � PERMIT APPLICATION Sub Permit No.l t ❑BUILDING ❑ ELECTRIC R*ROOFING ❑ REVISION ❑ EXTENSION [R ENEWAL r-1 PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS ❑ CHANGE OF [:] CANCELLATION ❑ SHOP Q CONTRACTOR DRAWINGS Q JOB ADDRESS: 11� 1 7G V. t 1 54Y City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: //:!/01 "30 29® Is the Building Historically Designated:Yes NO Occupancy Type: i . Load: Construction Type: 94S Flood Zone: BFE: FFE: OWNER:Name(Fee Simpleiitleholder): LXQ � '® Phone#: Address: t(W. WjC e- _ City: 1 G"1 J { S State: Zip: Tenant/Lessee Name: Phone#: Email: /' L CONTRACTOR:Company Name:�/�'7�iG �f �l��G Phone#:6ro_d:/70 6•/r6y[ Address: 11'kI AJ+,,% qi � City: Nl.k tt"o C L State: Zip: Qualifier Name: ,.'/ 6 e�'v'�._f%_ Phone#: State Certification or Registration#: L'CC l3 Zp`ii E Certificate of Competency#: DESIGNER:Architect/Engineer: NZA! Phone#: Address: City: State: Zip: Value of Work for this Permit:$ tQ _ Square/Linear Footage of Work: 1 Type of Work: % Addition ❑ Iteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: 0 /-Lo , �� Specify color of color thru tile: tlew4 Submittal Fee$ ® Co Permit Fee$ CCF$ r CO/CC$ Scanning Fee$ �-� Radon Fee$ � _ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ 9 Double Fee$ Structural Reviews$ Bond$ 0? TOTAL FEE NOW DUE$ 3D (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'PROPERTY1 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 bf the recorded notic f commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit iJissd. the abs ce of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature a �" Signa OWNER or AGENT ONTRA R Thq,fDregoing instrument was acknowledged before me this The foregoing instrume t was acknowledge before me this day of Ot 447t,""( 20 by O o'� day of ("(O� .20 1 r ,by /��1� Lv��y who is p ovally kno to �?t_5�� LL 1IE�-who is personally known to me or who has produced as me or who has produced --r�VUP_ L 1wmls identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PLI Sign: \1+ Print =�• N�:Ont O Seal: � �® a< s 'v®� Public.State of Florida Szal• Notary Z�•'Sqp 60 5�. � Sindia Alvarez My Commission FF 156750 r� `••:"ue;.•°• oR�yoP Expires 09/03/2018 OF FLi •**•�s�r•s****�*s**��xw*****yaw *** er�xm�x�xs 4a�*****s**��•r* • •s�x� rix**six*s*�x*x�ss*�xx��x*r•►r•s�r•a APPROVED BY L� Plans Examiner Zoning 3J Structural Review Clerk (Revised02/24/2014) STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET (850) 487-1395 TALLAHASSEE FL 32399-0783 DANIEL, CARLSON K KAMEL'S PLACE LLC 1199 NW 88 STREET MIAMI FL 33150 Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range ' from architects to yacht brokers,from boxers to barbeque restaurants, x and they keep Florida's economy strong. STATE OF FLORIDA DEPART BUSINESS AND Every day we work to improve the way we do business in order to 3` PROF serve you better. For information about our '1ULATION www.myfloridalicense.com. There you can fi mo el information CCC1328324. 'U6/11/2014 about our divisions and the regulations that impact you, subscribe y d to department newsletters and team more about the Department's CERTIFI C R initiatives. DANIEL; CAR KAMEL'S PLA Our mission at the Department is: License Efficiently, Regulate Fairly. ` + We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida, and congratulations on your new license( } IS CERTLFIED under the provisians of Ch.489 FS. EXPI ation date:qUC,31,ZQ76 L140fi110Qpp824 RICK SCOTT, GOVERNOR DETACH HERE _ KEN LAWSON. SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD CCC 1328324 The ROOFING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. 4 Expiration date: AUG 31, 2016 DANIEL, CARLSON K .� -r ❑ KAMEL'S PLACE LLC hf 1199 NW 88 STREET MIAMI FL 33150 - Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOT ABILL—DO NOT PAY LBT) 5984175 BUSINESS NAME/LOCATION RECEIPT NO. EXPIRES KAMELS PLACE LLC RENEWAL SEPTEMBER S 2016 8940 NW 9 CT 6242945 MIAMI, FL 33150 Must be displayed at place of business Pursuant to County Code Chapter 8A—Art.9&10 OWNER SEC.TYPE OF BUSINESS PAYMENT RECEIVED KAMELS PLACE LLC 196 GENERAL BUILDING BY TAX COLLECTOR CONTRACTOR 75.00 09/15/2015 Worker(s) 1 CGC1512952 ECHECK-15-162815 This Local Business Tax Receipt only confirms payment of the Local Business Tax.The Receipt is not a license, permit or a ceMcation of the holders qualifications,to do business.Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. HIML The RECEIPT N0.above must be displayed on all commercial vehicles—Miami—Dade Code Sec 88-276. MI® For more information,visit www.miamidadegovRaxcollector Du CERTIFICATE OF LIABILITY INSURANCE 9/22/2015D/vvrr) 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 CO EACT INSURANCE TODAY INC PHONE 954 915-3035 FAX 4536 North University Drive tamuray y ton so .com Lauderhill, FL 33351 INSURERISI AFFORDING COVERAGE NAICO INTERNATIONAL INS INSURED KAMEL r S PLACE LLC INSURER B: 8940 NN 9TH CT. INSURER C' MIAMI, FL 33150 INSURER D: jNSURFR F: 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. INSA LTR TYPE OF INSURANCE PO CY EFF POLICY P LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE 0 OCCUR $ 100.000 1G06A005921-01 6/22/2015 /22/2016 MED EXP one ,son $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POUCY O PRO- [3 LOC PRODUCTS-COMPIOPAGG $ 1,000,000 OTHER. JECTDED PER CLAIM $ 1,000 AUTOMOBILE LIABILITY COMBINED SINGLELIMIT $ ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOSAUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS UMBRELLA UABOCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ WOR KERS COMPENSATION R OTH, AND EMPLOYERS'LIABILITYSTATUTE ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under NS below DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schadule,may be attadedH more space is required) GENERAL CONTRACTOR LICENSE # CGC1512952 ROOFING CONTRACTOR LICENSE # CCC1328324 ER11FICATE HOLDER CANCELLATION CITY OF MIAMI SHORES VILLAGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 100550 NE 2ND AVE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN MIAMI SHORES, FL 33138 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Q JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION **CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 9/4/2015 EXPIRATION DATE: 9/3/2017 PERSON: DANIEL CARLSON FEIN: 020629810 BUSINESS NAME AND ADDRESS: KAMEUS PLACE LLC 1199 NW 88 STREET MIAMI FL 33150 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL LICENSED ROOFING CONTRACTOR CONTRACTOR Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt...apply only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 Miami shores Village Building Department 10050 N.E.2nd Avenue RS�e Miami Shores, Florida 33138 Tel: (305) 795.22044 Fax: (305) 756.$972 OWNERS'S AFFIDAVIT OF EXEMPTION ROOF TO MALL CONNECTION HURRICANE MITIGATION RETROFIT FOR EXISTING SITE- BUILT SINGLE FAMILY RESIDENTIAL STRUCTURES PE SUANT TO SECTION 553.844 F.S. To: Miami Shores`tillage Building Department Date: /�9 10050 NE 2n1 Ave Miami Shores, Fi 33138 Re: Owner's Name: e-® 0 ✓ Property address: G S �� S Roofing Permit Number: Dear Building Official: 1 Le , ®.,v- certify that I am not required to retrofit the roof to wall connections of my building beC .,. just valuation for the structure for purpose of ad valorem taxation is less than$300,000.00.Please attach proof of ad valorem taxat;un. o The building was constructed in compliance with the provisions of the Florida Building Code(FBC)or with the provisions of 1994 edition of the South Florida Building Code(1994 SFBC) LJ 0 Signature Print Name 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 ` nuu AA y%i �.•'41 COFI, ' cP i Notary Public,Sate of Florida at Large_ A�:� • When the just valuation o;the structure for purpose of ad valorem taxation is equal to or more than$300,000.00,annot con3h&ted; t FBG nor a 9994 SFBC.Then you must provide a building application from a General Contractor for the Roof to Walt connection Hurrican :els.�•. ` :. ;4> Revised on 512112009 .... tons" shores Village e� Building Department �ZOR10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers'Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if: 1. The officer owns at least 10 percent of the stock of the corporation,or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations;and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporakpfficers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers'compensation exemption.In these circumstances,Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company. Therefore.You may be personally liable for the worker compensation injuries of any person allowed to work under this permit Please check with your insurance carrier since most property insurance policies DO NOT cover this type of liability. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Owner Contractor Print Name: V 4e()rk 1:z y 6� t"')CkTc d--t Print Name: cr, ® o +L Signature: t Signature: State of Florida) State of Florida) County of Miami-Dade) County of Miami-Dade) Sworn to and subscribed before me this 1 b' Sworn to and subscribed before me this day of b ,20 day day o IEDEO,20 . FIGUEROA _ ► Notary Public State of Florida Notary Public-State of Florida( ) mala varez (SEAL) A Pa M Co ` Ex Commission 18 188750 Type of Identification produce 2 ° Commission i#s Mar 3,20 t 7 e of Identification pro res 09103/2018 o. r ' Miami S Villagehores Building Department 10050 N.E.2nd Avenue 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 2^d Ave Miami Shores, FI 33138 Re: Owner's Name: Property Address: /& ! 'kr&'-> Roofing Permit Number: Dear B ' ing Official: I ' � certify that I am not required to retrofit the roof to wall connections of building because: my o The just valuation for the structure for purpose of ad valorem taxation is less than$300,000.00. Please attach proof of ad valorem taxation. o The building was constructed in compliance with the provisions of the Florida Building Code(FBC)or with the provisions of 1994 edition of the South Florida Building Code(1994 SFBC) Signature Print Name State of Florida County of Dade The undersigned,being the first duly sworn,deposes and says that he/she is the owner ,,�,,,ve pro�in Id, Sworn to and subscribed before me this '"� •� day of vc,K b Notary Public-State of Florida My Comm.Expires Mar 3,,2017 1Z commission#EE 879484. Notary Public, Sate of Florida at Large �,�� • When tlu3 just valuation of the structure for purpose of ad valorem fixation equal to or rwre ftn wo wo.00,and the building was not constructed wFBC nor a 1994 SFBC.Then you must provide a building application from 8 General Canhctor for the Roof to wan connection Hunicas Mftlileg n.