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RF-13-23Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 186140 Permit Number: RF- 1 -13 -23 Scheduled Inspection Date: February 25, 2013 Inspector: Bruhn, Norman Owner: Job Address: 374 NE 95 Street Miami Shores, FL 33138- Project <NONE> Contractor: AMENGUAL ELECTRIC INC Permit Type: Roof Inspection Type: Final Roof Work Classification: Tile Phone Number Parcel Number 1132060136060 Phone: 786- 344 -6710 Building Department Comments RE ROOF EXISTING TILE WITH EAGLE MALIBU TILE # 2603 SANBORN BLEND Infractlo Passed Comments INSPECTOR COMMENTS False Paeeetl/J /f'�li� Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 183758. Replace sidewalk prior to final Remove dumpster. NB February 22, 2013 For Inspections please call: (305)762 -4949 Page 14 of 25 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 r jAasi 2 = FBC 20 BUILDING Permit No.gF PERMIT APPLICATION Master Permit No. Permit Type: BUILDING JOB ADDRESS: 39-4 itJEcric sta_12UE---1— ROOFING I City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: O,2- e 6 0 6 0 Is the Building Historically Designated: Yes 4,."- NO Flood Zone: OWNER: Name (Fee Simple Titleholder):Ell l'attesE441 e(Zs Phone#: Address: 84-Lf tJ s-ra City: PO V1+1 1--t■ cs, M 61t) fg 3 State: F L. Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: 44 eoe e 1 perrf Phone#: Address: ell51 t■-) ra,-r€ r(as City: Nt—V. C1/4,0.-AA State: Zip: B31 Qualifier Name: Seta:Iva At 424n 6-ct Phone#: 6:).C21 /0 6 3 6 Li State Certification or Registration #: C6-CDO Li Certificate of Competency #: Contact Phone#: ¥ ti2q3 Email Address: Ma CA . dOCQU fi yle160 • COrdr-) DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ g ei0 0 Type of Work: OAdditi6 3.A.SkA Description of Work: Wa.lii3.:1 *Xi' • " Square/Linear Footage of WaikOi issit6 AR. le.t,4 cum> Atql% tinOtMN10.43 t41 DNew DRepair/Replace eps At ailielitiitiOil magmata miiblvessl in* UM* Color thru tile: ***************************************Fees******************************************** Submittal Fee $ Permit Fee $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Structural Review $ Double Fee $ CCF $ CO/CC $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) r 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 �e approved and a reinsp' ton fee ' .11 be char Signature (10.- : / �L� �L/ %gna er or A nt ontract The foregoing instrument was ac owledged before me thi The oregoing instrument was acknow edged efore me this °Z I day of 3, , 20 .I ti ), by , day of , 20 .13, by who is personally known to me or who has produced who is personally known to me or who has produced Pf 1 J f-; As identification and who did take an oath. NOTARY PUBLIC: Sign: PA My Commission Expires: Gf/n Lk_ as identification and who did take an oath. NOTARY PUBLIC: ' ° co O Sign: Print: My Combos APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 3 /12/2012)(Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) NOTICE OF CO ENCEH NT A BF.CONDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF MIST INSPECTION FERM1T NO. TAX FOLIO NO. /.3249‘toe)/36306 STATE OF FLORIDA COUNTY OF DADE 1111111111111111 11111111111111 MINIM CFI'," 210 1 3R 0058269 OR Bk 28455 Ps 4339i (1Ps) RECORDED 01/23/2013 1159:36 HARVEY RUVIM, CLERK OF COURT MIAMI-DADE COUNTY FLORIDA LAST PAGE THE UNDERSIGNED hereby gives notice that improvements will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement 1. Legal description of property and street address: 3Aie (.51-pee-- 7- /am' fo aida- .51.31) 2. Description of improvement 77c- /Lae, /4" 3. Owner (s) name and address! _r,21 2.4be4.4) esae, ro-x2Eit4's 3c, qr- ?I/0/w /eh 33/31 Interest in property: Name and address of fee simple titleholder 1 7.447-3 \-tereAd4P-nos 4. Contractor's name and address: AltreVcfri-e feehe-/ C 385-1 io /.?, -roakAcE. I ? al A- 33 P- 5. Smety: (Payment bond required by owner from contractor, if any) Name and address: Antmmt of bond: $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13 (1) (a) 7., Florida Statutes: Name and address: 8.1n addition to himself , Owner designates the following person (s) to receive a (b) 7., Florida Statutes: Name and address: of the Lienor's Notice as provided in Section 713. 13 (1) 9. Expiration date of this Notice of Commencement (the n date is 1 year from the date of recording unless a different date is specified) Signature of Print Owner's Name 6(f 76?i24("4 g CIA f leict;Iyagrepmul by:1>Cra-i 4 12.ila iC rn Swo to and subscribed befme me this go day ofPi0 44- . Le ,o-ca. Notary Public TRICIA MIMS Address: Print Notary's Name My Commission Expires: STATE OF FLORIDA, COUNTY OF DAVE I HEREBY CERTIFY that this is a true oopy of the daY of A D 20 and • Seat 14, CLERK, of CircuR and County Courts t73�? D.C. 10/23/2812 13:49' 7865366680 AmENGUAL ELECTRIC IN PACE 02/86 1111: PC,C1K.glu: Vihr. /. r111.i0i111 I Arks .r:roon[1- 9.11( f1.,PrON11N:,;• 1 4CLSA1 " ;rs I' +l(1•M 11 i. r AP114 WC# 6206161 STATE OF FLORIDA. , Lil+iPllBT l= B Off' 9Ui, co @E's cwou 114cm.Q'CWGmaDB}AR �`%G i CTF. . CG1�7'i1RA seas 11L207 MVP/ 2 • ', + n` r'• . ;1 , Q .1 201B 2.801i519 8O3I30040.25r,, ..• .�',a�� ...x�l . I. Tile, CTRzCUl Ct retRic tat '} _• n •. 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' --- : :r .. c,,, °., 057667-9 tom 8 Al FNaUAL f EL.5CRXC INC 33126 12 TERR memo ANIMAL ELECTRIC INC 19'6 ELECTRkAL CONTRACTOR loam .0%-tor.A1 w 07/30/2012 02280030002 01)0045.04 Ms 0ThER MOB MX P�19�1M& PAO R RENEWAL 05766/ -9 CC 0 882013851 WORKER /S DOWIMFORWARO AMIE CAI.' ELECTRIC INC DER 385 101 12 TERR Mt FL 35126 11${1111 1„„11,11t1,11,,,,1,1,11 riftlllliil111e�liifi �l XWW30Idd0 6ZL90ZZ50E 01 :60 6T0Z /ZZ /Z0 10/23/2012 13:49 7865366680 AMENGUAL ELECTRIC IN 610 . STWTE QP FLORIDA DT1#AR 3T8 $ :3 Y�L' ENSE. 54. NP RDGCtY.ATIoN PAGE 01/136 SRQ0'2311701121 The• • GEN , CQ '!OR, 1Tanaedr 1ooalow XS C SPtZD . • Maar 016.. .px'ovisiones of: etta �r stegf; Expiration date: A 314. 2 O14 .. 44 AMMIGVAL • 3853. NW 12TH %ERR IfrAICE 1c. 'FL 3312 �rl ty _ t4.• jj '! tL �:rt•; nptti rt1 yt�.i r•r • ow, 4 •.:. ' r•��•1.j4 '' tom. `, M v 'N GOVERNOR I • OISPLAYAS REQUIRED•8`YrLAw ENV LAWSON SSIORSTMT 065472.4, 5 G AL'W griic INC 3851 ae�AMx This 18 NOT A GU -0R NOT PAY °awl NGUAL ELEcTRIc INC ' 9 atq `L MIME CONTRACTOR tow mow t3 u MAATS3 +pig` vua'" 07/30/2012 1 000045.00 SEE OTHER eiD€e pRENEWAL STATES !#67114 E WoRKEo S DO NOTWAf10 AMEENEUAL ELECTRIC INC ANEW:0AL 3ERlARD MIAMZNFL133126R I, II is ,, 11141 I 111111,111111M ! + 1 •1 13 FOWILWArkt U. IkOUTASIM PAO MAK A1. PRUalr NO ?As 065472 -4 E0/Z0 301u1d XV1430I.9d0 6ZL90ZZ50E OT :50 6I0Z /ZZ /T0 CERTIFICATE OF LIABILITY INSURANCE DATE ($1$UDDNyyy) 01/2?(13 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDEFZI. 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(lea) must be endorsed. Ir suBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certficate does not confer rights to the certificate holder in Nu of such endorsement(s). PRODUCER USA General Insu)7nDS Corp/USA Insu 5841 S.W. 137th Ave. Miami, FL 33183 Phone (305) 386 -3305 . Fax (305) 388 -677$ INSURED CONTACT NAME rAlfi No Ear 005) 3aa-$305 E-MAIL ESS: gretell onzate2 g gyahao.aoan INSURERI$) AFFORDINa COVERAGE f ( No (305) 386-877$ BERNARD AMENGUAUJORGE ROUSSEAU DBA AMENGIJAL ELECTRIC I 3851 NW 12 TERR Milani, FL 33128 (954) 4104364 INSURER A: INTERNATIONAL INSURANCE CO OF HANNOVER LTD • INS ER B : INSURER C : NAIL 0 INSURER D COVERAGES CERTIFICATE NUMBER: INSURER E INSURER F • THIS INDKSATED. CERTIFICATE EXCLUSIONS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN AND CONDITIONS OF SUCH POLICIES. LB@TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .v,v,\ noolosauRi A$OVE FOR THE POLICY PERIOD WITH RESPECT TO WHICH THIS 1S SUBJECT TO ALL THE TERMS, Q L R -L A TYPE OF INSURANCE ADD INSR UB SUEUt PODGY NUMBER P gbiDa M POLICY EXP MM U fA g GENERAL LIABILITY N N IGOBC000231-00 12/16/2012 12/18/2013 EACH OCCURRENCE $ 1.000.000.00 n COMMERCIAL GENERAL UABRriY MAGE $ f rTED PREMISE31ES aecunence) $ 100,000.00 ❑ • CLAIMSAU106 .� OCCUR MEO E� (ter o�9D — $ 5,000.01] • PERsoNAL a ADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ 2,000,000.00 GEML AGGREGATE UMrr APPLIES PDT: PRODUCta - COMPIOP AGO $ 2,000,000.00 n POLICY • • LOC S AUTDMDBILE LIABILITY ❑ ANY AUTO 211115=0SINSLE LIMIT $ BODILY INJURY (Per pew) $ ❑ Og1NED ■ pSpC7H7ppEDULEO e001LY INJURY (Perac ident 5 ED ■ WIRED AUTOS ■ AAUUTTOS GE PE'J S • • rpa• rPa d S ■ UMBRE„ A LIAR ■ OCCUR EACH OCCURRENCE • ECCESS UAB • CLAIMS -MADE AGGREGATE $ $ DED • RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑NIA (Mandatary In NH) @� y�� De under TO YI IM1T ER ❑ TORY! mntrg ■ ER $ E L EACH ACCIDENT EL DISEASE - EA EMpLOYB S D CION OF OPERATIONS Slaw . EL DISEASE • PODGY mar $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Alma ACORD 101. Addis curl Remarks Schad- ale, If more apace Is required) CERTIFICATE HAI TfFR _--. - -.. - - - - -- City Of Miami Shores 10080 NE 2nd Ave Miami Shores, FL 33138 ACORD 25 (2010/05) OF SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTA 0)1988 -2010 ACORD CORPORATION_ MI rights reserved. The ACORD name and logo are registered marks of ACORD 01/23/2013 06:12 3052206729 OFFICEMAX CERTIFICATE OF LIABILITY -INSrU A -E PAGE 01/01 01/22/2013 THISVERTIRICA OE1MPIOAt rDOER.NOT•I,t ? VELY OR NN6t3e,'rIVEI:Y' pAliIENM EX ' CR.AL NO MGR •ERA E•C8 _, • D US& ig 4iJt 11;3/41e tIS .. Nyo co . 'l'ENp • 1' GiH• Y6il;: ��ERI I{ �F' 1,. ��1 �11�D ;�Y`1�71e.pCll3�1�9:88EO1116:. 'T'FIRIZERTIFIC'ATEii • INIIRtJiANGEV ORSNOT:t xYS' f• 6iui sAC9rmA4 'T (SSGi1tio'disfURERmicAL1 WOtt(zE"b :i' SPiti`4'r1VV' ORy tI D.ThR:�1 i;RNID1 •• 1MPOR ANi3 W cello hO IBnADDSkRrY. ONALtiteuREDi:l pall4yes):ntttt)•memo. itSuBf asAlsoN*W p ; • oubJn .11104cr•(Orta•arstt ife9aloti 6•Ii't o *Roy, :O iii potlilea t1t rreoguhamtondaapasme ita.a statementon this :cater* • does: r'Solilelit 1*.csraRCatte boater :fnbaen•orstgeRendarlitatent( 0 wre ortumd rte' iaas. ,SIOVIr• .SlatiAe 120 t1t s,F 7 c /tin loPptl $4aU •Z1i4.i 1/- fta. AMENOUAL ELECTRIC TNC. 3851 NW 12TH TERRACE MtAM.r, F1.33126 a+asa�oaau • tlasvRefaA• empiNkadal weeadrap ret Cualc TY'i%deri00• Cehrhy. aal$URiER J31 I$8r1RENCt N:, r prod! NSLIREFM CORTIF TENLI ' ' a2- 289013T1!-1 nItsv • • .. -- 1 Nu • • • Rut t 1`ktf�;.•1 I . r..r.. .. . ,ne.��.......�w.er..r �v.��u�mmeu .AaPVit KM ME :°." •,.,• 0,, ‘0. y.. - �JT; T6ti6fl Qraiii pltttlNiTal� C G7 t�R O gr/0 N 'C �YJ41NPPEG., TIOIM 1Ca'a:7it1 CEdi:tl NIAltiVAY VEISSl•1p:ORMAY. Ltpaottiow . . • m mi i iMll)i7GYW{Lftl�•�, !:1--■ EMT OCtlifunnisi • Vzottavpdlt En caw ! OEM T T77-e.q , _ @ • •ti6V!}RAb .. a �. fIIs •• • • .Nam x xs' y r 104127tY0010 MIAMI SHORES VLi.LA.GiE BUILDING DEPARTMENT 10050 NE 2nd AVENUE MIAMI SHORES, FL 33138 KO W16.(2010,101# p otouLO;ARr OF, TH2 ABentEuscrearpoufFoocOAW6E1AsmatirbgietNn 2xPlItAtorrtvarerteRtOA OETIAIVERECt aMAECG w 11 T r Pouch PRts/asaoiai: l 0 AiPCq. N ally figAt.ra viryod Jan. 15. 2013 7:07AM No. 1395 P. 1 A� °I CERTIFICATE OF LIABILITY INSURANCE DATE o ) 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 pollcy(tes) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the pollcy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsemenl(s). MODEM ( The Contractors Choice Agency BO Box 13645 • Chandler AZ 85248 CONTACT Jon Rock FA GNP • (800) 918 -3589 1 ra .No; cum SEa -9951 EMAIL 74n0nginsuranceonline . coot INSURERS) AFRORDINS COVERAGE NAIL 9 SOURER A Oat '1 Contractors insurance 12293 INSURED Elkis Construction Inc 7647 W 18th Lane Hialeah FL 33014 INSURER B : 5/15/2012 INSURER C: EACH OCCURRENCE INSURERD: X — INSURER E : REMISES (Ea RENTED INSURER F MEDEXP (Any alaparsonl CERTIFICATE NUMBER_CL0 8 6180 0557 • 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 MATH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED RY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO•ALL THE TERMS. EXCLUSIONS AND CONDMONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. s, IN$R TYPE OF INSURANCS ADnL tat SUER ante E____ NUMBER POU�E t POLICY EXP rMOLISC XP UMRS A GENERAL RAL LIABILITY _ 213/000009965-05 5/15/2012 6/15/2013 EACH OCCURRENCE $ 1,000,000 X — COMMERCIAL GENERA. UAoceurreAceS JCLAIMS -MADE X OCCUR REMISES (Ea RENTED 5 50,000 MEDEXP (Any alaparsonl 5 5,000 PERSONAL &ADV INJURY s 1,000,000 GENERAL AGGREGATE 5 1 000. 000 GEN'LAGGREGATE UMIT APPLIES PER x1 MUM, nJF I ^ ILOC PRODUCTS - COMPIOPAGG , 5 1, 000,000 5 AUTOMOBILE — _ UABWtiY ANY AUTO ALL Q1NP1E0 MVO! SINGLE LIMIT _s BODILY INJURY per pew) 5 AUTOS HIRED AUTOS 8C ULED A -0WNED AUTOS ,„ _ BODILY INJURY (PeracaidenJ 5 PROPERTY DAMAGE (Dracedentl S 5 UMBRELLA UAB EXCESS I.IAB OCCUR cvms-mAoe NIA • 1 EACH OCCURRENCE AGGREGATE S oeo l I RGTEr.JON$ moil R PAD S WORKERS COMPENSATION EMPLOYER$' WfBIu? YIN ANY PROPRIETOR/PARTNER/EXECUnve F ES/MEIM EXCLUDED? S Uyes dasaibe larder DEStciRIPTION OF OPERATIONS Ecjuw E.L. EACH ACCIDENT S EL DISEASE .EAEMPLOYa $ EL DISEASE - POLICY OMIT 5 DESCRIPTION Or OPERATIONS I LOCATIONS 'VEHICLES (AtlacI1 ACORD 101, AddlUonaI Remarks Schedit a, H more apace le required) CANCELLATION (305) 756 -8972 Miami Shores Village Building Department 10050 NE Second Ave Miami Shores,, FL 33138 ACORD 26 (2010106) IN3025 nmrkm m SHOULD ANY OF THE ABOVE bESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED R5PRESENrATTVE Robert Rock /JON 01888-2010 ACORD CORPORATION. All rights reserved. Theo Ar[1RI1 Hama And In tin wro rania }arced m u'I, m of Ar:f)Af Y oo[oc, --rtro aoka aiUnIS& iolr nci acK, • _6 r•ok Miami Shores Village Building Department 90050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION Permit Type: BUILDING JOB ADDRESS: 3 N E q r City: Miami Shores County: Folio/Parcel #: ill —32 ®a . "' /3- i® 0 c Is the Building Historically Designated: Yes JAN 072013 TA_34C20 Permit No. Master Permit No. ROOFING Miami Dade Zip: OWNER: Name (Fee Simple Titleholder): J'i°t -rte Address: 3-z? toe 495- s rfeG'�" City: Yalu/ Share s NO Flood Zone: S Phone#: 3 ^2cD 50 U"'_ State: `FL. Zip: Tenant/Lessee Name: Phone#: Email: J / (••it , i V 02-61 a- CONTRACTOR: Company Name: p���•� -r 5 Ccls�i S %�/� d� ®� �C.. Phone#: !� %9- Address: 7 6 Sr 7 & • / 0 1-mz1 City: 1A-C. air. State: E� Zip: 5 v. c Qualifier Name: %,/ 09m) NJ . ..„5-�.Qi2ii Phone#: (3-i'r) CL 7 9 ° O 1 6 1 State Certification or Registration #: Ge. e /32-9/ / 9 Certificate of Competency #: ,[ Contact Phone#: ( 3 r ) ` � - 7 9 ` 0 2- C' / Email Address /s a i4 0 S .�/ iC- /Atv -,% b e-'-'1 DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $_ 7 et Square/Linear Footage of Work: ❑Alteration UNew ORepair/Replace r � ® sffie Type of Work: ❑Addition Description of Work: h 0,21100 ODemnition `'Co, ; -7; a /2 Auto ! e tgak su &makr1' Cori --1I{ *x *** ****** **x *** Fees***** x�********* *** * *****�x�x****x�x�x�**44** ** Submittal Fee $ Permit Fee $ rod CCF $ CO/C- Scanning Fee $ Radon Fee $ DBPR $ Bona $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NO Ni DUE $ c/O •iO Y 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOIT.F,RS, HEATERS, TANKS and 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 approv and a reinspection fee will be charged. Signa �,��' // ,i / Signature 4 er or Agent ' Contractor The foregoing instrument was acknowledged before me this "4 The foregoing instrument was acknowledged before me this 41-0 62 e Elizabeth Rubio tl _ I.by;CLQ�t-� -� r who has produced FL WE :KS who is personally known to me or who has prod»r<ed i day ofUA who 's person ly known to me As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: Sign: 1' NOTARY PUBLIC: Sign: ibi-^- Print: 1 Print: My Commission Expires: METH My Commission Expires: A+ * W COMMISSION HENNA EXPIRES:o�ba1Z,2011 tl.ei.m�, rR+�eu + aFee 9ovientruSedpelNehgfake APPROVED BY Structural Review Zoning Clerk Pre \cgs +tk (RAY gccil CetkA4 ifattu-d wkkk. efak�' &Ad eecad (Revised 3 /12/2012)(Revised 07 /10/07)(Revised 06/10/2009)(Revised 3/15/09) n f^ 0 461 `l ^ e (/ wk. c I 1 mity.& bk c Ib\ lvitcalf4 ay\. evic ,t)-cn,ppG C40K. I'rti' �. Miami Shores Village 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 10050 NE 2nd Ave Miami Shores, Fl 33138 Re: Owner's Name: 45-1/.246E4-6 ?"1.-Pli 0 r o S Property Address: 'I- q5 S Try€ J Roofing Permit Number: Dear B ' ' ing Official: -rtify that I am not required to retrofit the roof to wall connections of my building because: *The just valuation for the structure for purpose of ad valorem taxation is less than $300,000..00. Please 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 Date: 49/./0-7/ of 1994 edition of the Florid- lding Code (1994 SFBC) g w � u Signature V1,%?t4 /- 11a%' VAcia 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 Li AT' day of 20 PATRICIA KRAUSE SWOOIATISSICKI A EEO EXPIRES Apr11 56,2015 Pablo Mambo Notary Public, Sate of Florida at Large • When the just valuation of the structure for purpose of ad valorem taxation is equal to or more than $300,000.00, and the building was not constructed with FBC nor a 1994 SFBC. Then you must provide a buitding application from a General Contractor for the Roof to Wall connection Hurricane Mitigation. Revised on 5/21/2009 Property Information Map My Home Miami -Dade County, Florida Page 1 of 1 Property Information Map Aerial Photography - 2012 0 28 ft This map was created on 1/2/2013 2:34:39 PM for reference purposes only. Web Site © 2002 Miami -Dade County. All rights reserved. Summary Details: Folio No.: 11- 3206 - 013 -6060 Property: 374 NE 95 ST Mailing BANKUNITED Address: 2 Living Units: 7815 NW 148 ST MIAMI Adj Sq Footage: LAKES FL Lot Size: 33016- Property Information: Primary Zone: 1100 SGL FAMILY - 2301 -2500 SQ CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds /Baths: 3/2 Floors: 2 Living Units: 1 Adj Sq Footage: 2,082 Lot Size: 9,600 SQ FT Year Built: 1940 $0/$296,164 1 53 41 6 53 42 MIAMI City: SHORES SEC 1 AMD $50 000/ $228,261 PB 10 -70 W25FT OF Legal LOT 2 & ALL LOT 3 BLK Description: 45 LOT SIZE 75.000 X 128 COC 23626 -3246 23754 -1907 0605 1 OR 28089 -4172 1211 12 Assessment Information: Year: 2012 2011 Land Value: $137,256 $119,353 Building Value: $158,908 $158,908 Market Value: $296,164 $278,261 Assessed Value: $296,164 $278,261 Exemption Information: ear: 2012 2011 Homestead $0 525,000 2nd Homestead: NO YES Taxable Value Information: Year: 2012 2011 $330,200 Applied Applied Taxing Authority: Exemption/ Taxable Exemption/ institutions Value: Value: Value: Regional: $0/$296,164 $50,000/ $228,261 County: $0/$296,164 $50,000/ $228,261 City: $0/$296,164 $50 000/ $228,261 School Board: $0/$296,164 $25,000/ $253,261 Sale Information: Sale Date: 12/2011 Sale Amount: $330,200 Sale O /R: 28089-4172 Sales Deeds to or from financial Qualification Description: institutions View Additional Sales http: / /gisims2 .miamidade.gov /myhome /printmap. asp? mapurl= http: / /gisims2.miamidade.gov... 1/2/2013 CFN: 20120934829 BOOK 28418 PAGE 1967 DATE:12/27/2012 02:43:25 PM DEED DOC 2,385.00 HARVEY RUVIN, CLERK OF COURT, MIA -DADE CTY Prepared by and return to: VeronicaJara Kahane & Associates, P.A. 8201 Peters Road, Suite 3000 Plantation, FL 33324 File Number: 09 -30846 Consideration: $397,500.00 (space above this line for recording data) Special Warranty Deed This Special Warranty Deed made this g u day of November, 2012, between BankUnited whose post office address is 7815 NW 148 Street, Miami Lakes, FL 33016, grantor, and Elizabeth Rubio Mederos, a married woman, whose post office address is P.O. Box 521155, Miami, FL 33152, grantee: (Whenever used herein the terms grantor and grantee include all the parties to this instrument and the heirs, legal representatives, and assigns of individuals, and the successors and assigns of corporations, trusts and trustees) Witnesseth, that said grantor, for and in consideration of the sum of TEN AND NO /100 DOLLARS ($10.00) and other good and valuable considerations to said grantor in hand paid by said grantee, the receipt whereof is hereby acknowledged, has granted, bargained, and sold to the said grantee, and grantee's heirs and assigns forever, the following described land, situate, lying and being in Miami -Dade County, Florida, to-wit The West 25 feet of Lot 2, and all Lot 3, in Block 45, An Amended Plat of Miami Shores Section No. 1, according to the map or Plat thereof, as recorded in Plat Book 10, Page 70, of the Public Records of Miami -Dade County, Florida. Parcel Identification Number: 11- 3206 -013 -6060 Together with all the tenements, hereditaments and appurtenances thereto belonging or in anywise appertaining. To Have and to Hold, the same in fee simple forever. And the grantor hereby covenants with said grantee that the grantor is lawfully seized of said land in fee simple; that the grantor has good right and lawful authority to sell and convey said land; that the grantor hereby fully warrants the title to said land and will defend the same against the lawful claims of all persons claiming by, through or under grantors. In Witness Whereof, grantor has hereunto set grantor's hand and seal the day and year first above written. AC# 6306717 br )O- 430 -48 -4 JUAN: JAME SERRA 7647 W 18 LN HIALEAH, FL 33014 -3213 DOS: 01 -31 -1948 sex M HGT: 5 -05 ISSUED: 01 -32 -200° EXPIRES: C9+$' : • REST:A ENDORSE' P T040901120294 3psrtt an of a motor vshtc7s constitutes consent to any wbosty test rsqure.d by Im. THIS DOCUMENT HAS A COLORED BACKGROUND • MICROPRINTING • LINEMARK' PATENTED PAPER STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD SEQ# L12082701698 BATCH NUMBER LICENSE NBR 08/27/2012 128056632 CCC1329119 The ROOFING CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2014 SERRA, JUAN J ELKIS CONSTRUCTION INC 7647 W 18TH LN HIALEAH FL 33014 RICK SCOTT GOVERNOR KEN LAWSON SECRETARY DISPLAY AS REQUIRED BY LAW 07 -27 -2011 JEFF ATWATER STATE OF FLORIDA CHIEF FINANCIAL OFFICER 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: 07/27/2011 EXPIRATION DATE: 07/26/2013 PERSON: SERRA JUAN J FEIN: 208713978 BUSINESS NAME AND ADDRESS: ELKIS CONSTRUCTION INC 7647 WEST 18 LANE HIALEAH FL 33014 SCOPES OF BUSINESS OR TRADE: 1- ROOFING CONTRACTOR 3- REMODELING 2- GENERAL CONTRACTOR IMPORTANT: Pursuant to Chapter 440. 05114), F.S., an officer of a corporation who elects exemption from this chapter by tiling a certificate of election under this �� C� PRINTED WITH E WRONM NTALLY FR ENDLY INKS FSC Mixed Sources taadardatbraxanadscatess CaamSOSOCCOMMI wegateap City of Hialeah Business Tax Receipt Mayor Carlos Hernandez 2012 -13 703048-9 BUSINESS NAME 1 LOCATION ELKIS CONSTRUCTION INC 7647 W 18 LA 33014 HIALEAH THIS IS RIOT A BILL — DO NOT PAY , NEW STATE8CCC1329119730668 -1 OWNER KIS CONSTRUCTION INC Sec. T of Business 196 SPECIALTY BUILDING CONTRACTOR 1 THIS Is ONLY A LOCAL BUSINESS TAX RECEIPT. IT DOES NOT PERMIT THE SENATE EXERTING TO OAR ZONING LAWS OF THE COUNTY OR CITIES. NOR DOES IT MEW ME HOLDER PERMIT OR ANY OMER REQUIRED BY LAW. THIN IN NOT A CERTWICATnOI OF THE HOLDER'S OUALDTCA. TIONS. RRST-CI ASs U.S. POSTAGE PAID PMAML FL PERMIT NO. 231 WORKER /S PAYMENT RECEIVED MIAMI -DADE COUNTY TAX COLLECTOII 08/30/2012 02240007001 000090.00 SEE OTHER SIDE DO NOT FORWARD ELKIS CONSTRUCTION INC JUAN J SERRA PRES 7647 W 18 LA HIALEAH FL 33014 IM1ll111ll1lfi111111I1111h1ll 111hhi1f 11Ii11hAhn liduks YgA Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Apglicationform Section A (Gene I In Master Permit No. Process No. DE Contractoes Name 5 ebn,s4-..e.eis,, r 4, M - (-OP AMP, ,■2 • ell I 7 "4-1 p€ 9s s-r- wham Shores Village VED BY 0 New Roof BLDG DEPT DATE bUtSJEGI 10 COMPLIANCE WITH ALL FEDERAL. ROOF CATEGORY STATE AND COI MTV RULES AND REGULATIONS 0 Mechanically Fastened Tile 0 Metal Panel/Shingles 0 0 Prescriptive BUR-RAS 150 ROOF TYPE Mortar/Adhesive Set Tile Wood Shingles/Shakes Are there Gas Vent Stacks? Yes Nole Type: Natural Li LPGXL1 'Re-Rooflng 0 Recovering 0 Repair 0 Maintenance . ROOF SYSTEM INFORMATION Low Slope Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF) oso Section B (Roof Plan Sketch Roof Plait illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains. Include dimensions of sections and levels, dearly Identify dimensions of elevated pressure zones and location of parapets. o 0 misimmormarimmiummommommummosommommurammummommummummummummunnummemma INNOMINOMMUMMUMMOMMINUMNINMVMSEXP2MWOMPKWOOMMEMMUMIMMEMMIMMOSIMMUMM immalummilmignimmulammiggimmummomMilmAPPEAmmumMIUMEMMONIMISMOOMMUMMOMMNIIM IIMMIUMMEMOMMONMOMEMUMMMINUOVmmigiummoNWMAMMOsmummAINUMMAMSOMMUMMINSIMMME ISOMMUMMEMOMMUSUNUMMISMOSIVAIMMINIMMMEWANAMMIMMUMWIRMONMOSINMMUMWMMMOIMMMII UNIMMAIRMMONEMUMMORMUMUMR2QAMMXIMMUMPANOSMONMENEmmufilimmismamminummOMOMM IUMNIOMMOMMUNOMMINIMPIEMINSIAMMOOMMMOMPAMUMMUMMKIMOMMMENRIMMIMMUMUMMERMIMMI INIMMUNIMMEMINUMMONAmMINFAMEMIRANIMICAMENIMMEMMUMMOIWIMEMMIIMORMIMMOMINI IMINImmonlimmummilmgmmummigimagmhmilywoMMEMMENUMMEMOMWMISOMMOMMORMEMMIMMENM mismammummummormistammismximmumilw4mmilom ' MONOMUNNMOMOSSIMS issummerammumminammocsmsrummpnaaNsamommemmemumaimminmsomilmorlimmonsiminms VolmummumumminimernmarmusummimmaimmaNzkmmimmumparriessmummillmmummommumear liCOMMENIMWOOMMISUMMMOMMMUIVARMnilmONMAIMMUMMONNORNOWIPAMIMMECAUXOSNIM•MMWOUX IMINIMPINMENENNOMOOMANNOMMOPL'iMMOMAIMMMOMMIMMIMMUNKUMMUMMIKAWMINMESUMMOMMIMME IIMMEMINIMMISMOMMMMAMWMPM4MWMAMRUMMMOMOMOMMEMEMNIMMONNUMMIMEMENNIMIOMMINIUM IMOOMNIMUMMIUMIMMEMIIMMISIMMIAMOINUMIMMS MEMMIIMMINIMMMUMOMMMIMMOOMMISMIRMS. IMONMOMEMEM__ __401EMPPROMmingrampimmimammemp W __ Amissmaimmilimmomms ININNIMMNMOINVIIRMIMMUMMOMMOVIIMIMMEMMANNOMMUMIN PTIMPUMNIMMOVOMMIMMOMMIM INMSOMManarAMANIMMOIMMSOMINNOMMINSWIRMEMMINIMMMOU*9 APAIMRAMEMMOOMMISMSOMPUM 11011111111MSOMMIAMSNOMOMMIMOMMIMMEMMINIMMWMORIMIIIIRMWA.,---9DOMMINIMOMMINIMMINUSIMME •MMENINIMM IMMUMMOMMIWASNOWNOMMINNWOMMERRWMINOW immillimumassommanisimmins sam55src4Masmimlissimig555immi5 tOmMasammomplimmuu5manspilmaimmumninamasall riammtin0 NONOMOpmmummornswommemmunimmmumminimmummamissamssinimunalms esmsz101— : misammaimumwmommilmmurammummommilmmunonummumnsmammumgmenrsummir NOOMMES WIMMUMWWWWINOMINAmmammOMUMMIIMMOMMAMOUNONOMMSONOMMUMMIONOWNIX IMMINROMNOWMUMMUMMEINVMM insimm.mmilmoimmenonsimmmUlmismismanimmimm*MNSE inummiummummommmummummisum mmumwroninunimmummumminmOmminnumemminmammilim MINMENIMOmmoNglemmumummilommisomwmAyLninimmumpuinsmummismisimplimmormimm COMMXIMMOWamommum mommilliminammilmommillarnspiimminlia NOMMOMM isammsamMaimassaimen, top _ SUMNIMINIMOOMMMOMOMMUMMOMMIMENSMIS MOSIMMI VUEMMUMOMUNINOME311 fesa0 -r1111111111NEROPOMNIMINOMOMINIMMOMMISMOMOMPOROMMINIMI VOMMOISSOMMIXIMOSIM.,— -1r illimaNOrmumnimmillimminummismilminsminOmmirnm IMMWMPINIMMIMMUMMININ Oissumamomumulammomemmommummuinummussinammiss IMONIMESUMRSOINOMMINMSOMMOMMOMMEMOMUNIMMINIOMMONMOMMINIMMINWOOMMINNWOMNIMMIN summairrommixammilimmummummimmomminimmissmsommormimmOmmommusimmoum pilmammsnolummalimminimMINOOMmimMomminisimorawriammommimmismismilanammormilm MONNUMUMEMOMUNNOMMIOMMOINSWISMEMMMOMMIMINIMMIMMINSMOMMOSMESNUMMOMMOMMVIM IMMEMEMMUMMEMNOSIMUSIMMOMMMEMEMENMOSMIMMUOMMIIMMEMWOMMIIMINNIMNRISMIUMNIMIMO RUMMEMOMOMMUMMMUMMUMWMUMMXIMMINNMOMMIUMMOMMIMMOMMUNIMENWOMMIXONSMINIMM IMMUMWOMMOMMIMIUMMIMINMOMMINIMMOMUMMWOMMENNOMMOOMMOMMMUUMEMORIONMSNORM onsmannaMmumminamismpsimminsamimummammimmisimminummienseplummummumumni immennanamommismigilimmummlniiimmermlimorimmumillmonnunomanummummism IMONOUNSWIMMUNINEMUSONNOMMORMWOMMMOOMMMIONNSIMMONSIMMIN r ISMINUMMIBOmismin gemumnimmummillimisuirmsammissimmarnimmagmlimininisminia0 ONMEnnunipslanimmis NOMMEMMUMMUMM. minnnunninumnimnprinnnonnmenninnonnnonnanninnnonninanninininnum onnnininnunnnum n UMMINOMMUMMINUMMMEMMIMUMMONEMMINIMINSMOOSIIMMIIMMUMMIUM IMMIMMUNWMOIMM minlisionsmormirmosimmilumempumpammiumnrnommONOOmmummannums innummunnnonnonnnanninninnonnunnommonnMonninnmemignamilmOmMOmmummirnannO010 snmornwininmsnnunnnunnonnonninnennnonninninnnonenninennenwnsimnnunannonnengopnep 123_01-48 12/09 PAGE 2 Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Application Form INSTRUCTION PAGE COMPLETE THE NECESSARY SECTIONS OF THE UNIFORM ROOFING PERMIT APPLICATION FORM AND ATTACH THE REQUIRED DOCUMENTS AS NOTED BELOW: Roof System Required Sections of the Permit Application Form Attachments Required See List Below Low Slope Application A,B,C 1,2,3,4,5,6,7 Prescriptive BUR -RAS 150 A,B,C 4,5,6,7 Asphaltic Shingles A,B,D 1,2,4,5,6,7 Concrete or Clay Tile A,B,D,E 1.2.3.4.5,6,7 Metal Roofs A,B,D 1,2,3,4,5,6,7 Wood Shingles and Shakes A,B,D 1,2,4,5,6,7 Other As Applicable 1,2,3,4,5,6,7 ATTACHMENTS REQUIRED: 1. Fire Directory Listing Page 2. From Notice of Acceptance: Front Page Specific System Description Specific System Limitations General Limitations Applicable Detail Drawings 3. Design Calculations per Chapter 16, or if Applicable, RAS 127 or RAS 128 4. Other Component Notice of Acceptances 5. Municipal Permit Application 6. Owners Notification for Roofing Considerations (Re- Roofing Only) 7. Any Required Roof Testing/Calculation Documentation 123_01 -48 12/09 PAGE 1 1 PO 1 ®,L 1 Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Application Form Section D (Steep Sloped Roof System) Roof System Manufacturer: ECicile , ?wp ®A,6 R ea c4 Notice of Acceptance Number: /1— 0,34W Minimum Design Wind Pressures, If Applicable (From RAS 127 or Calculations): P1: /S / P2: 48 • C P3: (/6 Maximum Design Pressure (From the NOA Specific System): VS' S Method of tile attachment: a/y r-947 hes, VV !'°/'d /Ci v°-Le ,pQ cid I, Roof Slope: 4/ :12 Steep Sloped Roof System Description Deck Type: QOX „�ety'ulooa� 5� ype Underiayment: nsulatlon: Fire Barrier: Ridge Ventilation? 0/4 astener Type & Spacing: dhesive Type: Mean Roof Height: 14. / Sr A2'/ S /p h° `Tcf Ps -✓ ype Cap Sheet: ogo oof Covering: Hfrpizu z Cbuoie Aoi? cedar -4-t1 fr U Type & Size Drip 123_01 -48 12/09 PAGE4 Florida Building Code Edition 2007 High Velocity Hurricane Zone Uniform Permit Application Form Section E (Tile Calculations) For Moment based file systems, choose either Method 1 or 2. Compared the values for Mrwith the values from Mf. If the Mf values are greater than or equal to the Mr values, for each area of the roof, then the tile attachment method is acceptable. Method 1 "Moment Based Vic Calculations Per RAS 127" A.O P 21/ ' 1) - Mg C =Md6 NOA 1VIi P2: z m ago l - Mg :64.x/ ffi 11�i L. ±! �i.- NOA 11� (-'a :/ /4: z ea' z ) - Mg: re szi m b ! a- NOA M Method 2 "Simplified Tile Calculation Per Table Below" Required Moment of Resistance (Mr) From Table Below NOA Mr Mr Required Moment Resistance* Mean Roof Height — Roof Slope 212 15' 20' 25' 30' 40' 34.4 38.5 38.2 39.7 3:12 4:12 322 30.4 34.4 322 38.0 33.8 37.4 35.1 39.8 37.3 5:12 28.4 30.1 31.6 32.8 34.0 6:12 7:12 26.4 24.4 28.0 25.9 20.4 27.1 30.5 282 32.4 30.0 *Must be used in conjunction with a list of moment based tile systems endorsed by the Broward County Board of Rules and Appeals. For Uplift based tile systems use Method 3. Compared the values for F' with the values for Fr. If the F' values are greater than or equal to the Fr values, for each area of the roof, then the tile attachment method is acceptable. Method 3 "Uplift Based Tile Calculations Per RAS 127" (Pi: zl: = z w: =. ) —W: z cos B: = FH: NOAF (P2: z 1: = z w: = ) — W: z cos B: = Fes: NOA F (P3 : z l: = w: ) - W: ens 9: = Fes: NOA F' Where to Obtain Information Description Symbol Where to find Design Pressure P1 orP2 or P3 RAS 127 Table 1 or by an engineering analysis prepared by PE based onASCE 7 Mean Roof Height H Job Site Roof Slope 0 Job Site Aerodynamic Multiplies. Restoring Moment due to Gravity NOA NOA Attachment Resistance Mf NOA Required Mont Rest Calculated MiNm. m Attachment Resistance F NOA Required Uplift Resistance Fr Calculated AvemgeTileWeight Tfe Dimensions W NOA 1= length w= width NOA All caka>adons must be submitted to the Building Official attlm time ofpemnitappliwHon. 123_01 -48 12/09 PAGE 5 BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT (BNC) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Eagle Roofing Products LLC 1575 East C.R. 470 Sumterville, FL 33585 MIAMI -DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 33175 -2474 T (786) 315 -2590 F (786) 315 -2599 www.miamidade.gov /bu ildina/ 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 BNC - 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. BNC 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: Malibu Concrete Tile LABELING: Each unit shall bear a permanent Iabel 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 renews NOA #06- 0526.09 and consists of pages 1 through 7. The submitted documentation was reviewed by Alex Tigera. HAMI DADE COUNTY APPROVED NOA No.:11- 0321.01 Expiration Date: 10/05/16 Approval Date: 05/12/11 Page 1 of 7 ROOFING ASSEMBLY APPROVAL Category: Sub Category: Material: Roofing Roofing Tiles Concrete 1. SCOPE: This approves a system using Eagle Roofing Products Malibu Concrete Roof Tile, as manufactured by Eagle Roofing Products LLC in Sumterville, FL. and described in Section 2 of this Notice of Acceptance. For locations where the pressure requirements, as determined by applicable Building Code does not exceed the design pressure values obtained by calculations in compliance with RAS 127 using the values listed in section 4 herein. The attachment calculations shall be done as a moment based system. 2. PRODUCT DESCRIPTION: Manufactured by Applicant Dimensions Malibu Concrete Tile 1= 17" w =12 A" '' /A" thick Trim Pieces MANMADE COUNTY APPROVED 1= varies w = varies varying thickness Test Specifications TAS 112 TAS 112 Product Description Low profile, interlocking, high pressure extruded concrete roof tile equipped with three nail hole and double roll ribs. For direct deck or battened nail -on, mortar or adhesive set applications. Accessory trim, concrete roof pieces for use at hips, rakes,•ridges and valley terminations. Manufactured for each tile profile. NOA No.:11- 0321.01 Expiration Date: 10/05/16 Approval Date: 05/12/11 Page 2 of 7 2.1 EVIDENCE SUBMITTED: Test Agency Test Identifier PRI Construction Materials PRI06178 Technologies Redland Technologies Redland Technologies Redland Technologies The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. Redland Technologies Redland Technologies Professional Service Industries, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. The Center for Applied Engineering, Inc. MIAMI•DADE COUNTY APPROVED Test Name/Report TAS 112 7161 -03 Static Uplift Testing Appendix III TAS 102 & TAS 102(A) 7161 -03 Wind Tunnel Testing Appendix I1 TAS 108 (Nail -On) P0402 Withdrawal Resistance Testing of screw Sept. 1993 vs. smooth shank nails Date 08/23/06 Dec. 1991 Dec. 1991 94 -060B 94 -084 P0631 -0I Letter Dated Aug. 1994 224 -47099 25- 7094 -1 25- 7094 -7 25- 7094 -4 Project No. 307025 Test #MDC -76 25- 7183 -1 25- 7183 -2 Static Uplift Testing TAS 101 (Adhesive Set) Static Uplift Testing TAS 101 (Mortar Set) Wind Tunnel Testing TAS 108 (Mortar Set) Wind Tunnel Testing TAS 108 (Nail -On) Physical Properties TAS 112 Static Uplift Testing TAS 102 (4" Headlap, Nails, Direct Deck, New Construction) ❑ Static Uplift Testing TAS 102 (4" Headlap, Nails, Battens) Static Uplift Testing TAS 102 (4" Headlap, Nails, Direct Deck, Recover/Reroof) Wind Driven Rain TAS 100 Static Uplift Testing TAS 102 (2 Quik -Drive Screws, Direct Deck) Static Uplift Testing TAS 102 (2 Quik -Drive Screws, Battens) March, 1994 May 1994 July 1994 Aug. 1994 Sept. 1994 Oct. I994 Oct. 1994 Oct. 1994 Oct. I994 Feb. 1995 Feb. 1995 NOA No.:11- 0321.01 Expiration Date: 10/05/16 Approval Date: 05/12/11 Page 3 of 7 The Center for Applied 25- 7214 -2 Engineering, Inc. 25- 7214 -6 Celotex Corporation 528454 -2 -1 Testing Services 520109 -2 Walker Engineering, Inc. Evaluation Calculations Walker Engineering, Inc. Evaluation Calculations Walker Engineering, Inc. Evaluation Calculations Walker Engineering, Inc, Evaluation Calculations Walker Engineering, Inc. Evaluation Calculations Walker Engineering, Inc. Calculations Walker Engineering, Inc. Calculations Static Uplift Testing TAS 102 (1 Quik -Drive Screw, Direct Deck) (1 Quik -Drive Screw, Battens) Static Uplift Testing TAS 101 Two Patty Adhesive Set System March, 1995 Sep. 1998 Dec. 1998 April 1999 25 -7183 March 1995 25 -7094 February 1996 25 -7496 April 1996 25 -7584 December 25- 7804b -8 1996 25- 7804 -4 & 5 25- 7848 -6 Aerodynamic Multiplier Sep. 2006 Restoring Moment Due to Gravity Sep. 2006 3. LIMITATIONS: 3.1 Fire classification is not part of this acceptance. 3.2 For mortar or adhesive set tile applications, a static field uplift test in accordance with TAS 106 may required, refer to applicable building code. 3.3 Applicant shall retain the services of a Miami -Dade County Certified Laboratory to perform quarterly test in accordance with TAS 112, appendix `A'. Such testing shall be submitted to the 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. MIAM I:ADE COUNTY APPROVED NOA No.:11- 0321.01 Expiration Date: 10/05/16 Approval Date: 05/12/11 Page 4of7 . INSTALLATION 4.1 Eagle Roofing Products LLC Malibu Concrete Tile and its components shall be installed in strict compliance with Roofing Application Standard RAS 118, RAS 119 and RAS 120. 42 Data For Attachment Calculations Table 1: Average Weight (W) and Dimensions (I x w ) Tile Profile Weight -W (Ibf) Length -I (ft) Width -w (ft) Malibu Tile 9.5 1.417 1.04 Table 3: Restoring Moments due to Gravity - MA (ft-Ibf) Tile Profile Table 2: Aerodynamic Multipliers - X 'ft3) 5 ":12" Tile 7 ":12" greater Battens X (ft3) A. (ft3) Battens Profile Battens Batten Application Direct DeckApRlication Malibu Tile Battens Direct Deck 0.305 (0.282 ) Table 3: Restoring Moments due to Gravity - MA (ft-Ibf) Tile Profile 3 ":12" 4 ":12" 5 ":12" 6 "12" 7 ":12" greater Battens or Direct Deck Malibu Tile Battens Direct Deck Battens Direct D$k Battens Direct Deck Battens Direct Deck 6.30 6.65 6.21 6.54 6.08 6.41 5.93 6.25 5.77 6.08 Table 4: Attachment Resistance Expressed as a Moment - Mf (ft -tbf) for Nail -On Systems Tile Profile Fastener Type Direct Deck (min 15/32" plywood) Direct Deck (min. 19/32" plywood) Battens Malibu Tile 2 -10d Ring Shank Nails 27.8 37.4 28.8 1 -1Od Smooth or Screw Shank Nail 8.8 , 11.8 4.1 2 -10d Smooth or Screw Shank Nails 16.4 21.9 7.1 1 #8 Screw 25.8 25.8 22.9 2 #8 Screw 47.1 47.1 49.1 1 -10d Smooth or Screw Shank Nail (Field Clip) 24.3 24.3 24.2 1 -10d Smooth or Screw Shank Nail (Eave Clip) 19.0 19.0 22.1 2 -10d Smooth or Screw Shank Nails (Field Clip) 35.5 35.5 34.8 2 -10d Smooth or Screw Shank Nails (Eave Clip) 31.9 31.9 32.2 2 -10d Ring Shank Nails' 43.0 67.5 50.9 Installation with a 4" tile headlap and fasterners are located a min. of 21/2" from head of tile. MIAMI•DADE COUNTY APPROVED NOA No.:11- 0321.01 Expiration Date: 10/05/16 Approval Date: 05/12/11 Page 5 of 7 Table 5: Attachment Resistance Expressed as a Moment Mf (ft -Ibf) for Two Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Malibu Tile Adhesive` 26.1f3 2 See manufactures component approval for installation requirements. 3 Flexible Products Company TileBond Average weight per patty 11.4 grams. Polyfoam Product, Inc. Average weight per patty 8 grams. Table 6: Attachment Resistance Expressed as a Moment - Mf (ft-lbf) for Single Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Malibu Tile Polyfoam PolyProTM : -. Polyfoam PolyProTM 45.55 4 Large paddy placement of 54grams of PolyProTM. 4 Medium paddy placement of 24grams of PolyProTM S. 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 Elegi-R7 FLORIDA MALIBU CONCRETE ROOF TILE LABEL, SUMTERVILLE. PLANT (LOCATED ON UNDERSIDE OF TILE) MIAMI.DADE COUNTY APPROVED NOA No.:11- 0321.01 Expiration Date: 10/05/16 Approval Date: 05/12/11 Page 6 of 7 Table 7: Attachment Resistance Expressed as a Moment - Mf {ft -Ibf) for Mortar Set Systems Tile Profile Tile Application Attachment Resistance Malibu Tile Mortar Set.' 20.60 S. 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 Elegi-R7 FLORIDA MALIBU CONCRETE ROOF TILE LABEL, SUMTERVILLE. PLANT (LOCATED ON UNDERSIDE OF TILE) MIAMI.DADE COUNTY APPROVED NOA No.:11- 0321.01 Expiration Date: 10/05/16 Approval Date: 05/12/11 Page 6 of 7 6. BUILDING PERMIT REQUIREMENTS: 6.1 Application for building permit shall be accompanied by copies of the following 6.1.1 this Notice of Acceptance. 6.1.2 Any other documents required by Building Official or Applicable building code in order to properly evaluate the installation of this system. MIAMIDADE COUNTY APPROVED MALIBU CONCRETE ROOF TILE END OF THIS ACCEPTANCE NOA No.:11- 0321.01 Expiration Date: 10/05/16 Approval Date: 05/12/11 Page 7 of 7 SECTION 1524 HIGH VELOCITY HURRICANE ZONES REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS 1524.1 As it pertains to this section, it is the responsibility of the roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of this section.. The provisions of Chapter 15 of the Florida Building Code, Building govern the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of the agreement between the owner and the contractor. The owner's initial in the adjacent box indicates that the item has been explained. . Aesthetics - Workmanship: The workmanship provisions of Chapter 15 (High Velocity Hurricane Zone) are for the purpose of providing that the roofing system meets the wind resistance and water intrusion performance standards. Aesthetics (appearance) issues are not a consideration with respect to workmanship provisions. Aesthetic issues such as color or 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. Renailing Wood Decks: When replacing roofing, the existing wood roof deck may have to be renailed incordance with the current provisions of Chapter 16 (High Velocity Hurricane Zones) of the Florida Building Code. (The roof deck is usually concealed prior to removing the existing roof System). 3. Common Roofs: Common roofs are those which have no visible delineation between neighboring u (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 work to be performed. _4. Exposed Ceilings: Exposed, open beam ceilings are where the underside of the roof decking can . be ed from below. The owner may wish to maintain the architectural appearance, therefore, roofing nail penetrations of the underside of the decking may not be acceptable. The Florida Building Code provides the option of maintaining this appearance. 5. Ponding Water: The current roof system and /or deck of the building may not drain well and may ca se water to pond (accumulate) in low -lying areas of the roof. Ponding can be an indication of structural distress and may require the review of a professional structural engineer. Ponding may shorten the life expectancy and performance of the new roofing system. Ponding conditions may not be evident until the original roofing system is removed. Ponding conditions should be corrected. 6. Overflow , scuppers (wall outlets): It is required that rainwater flow off so that the roof is not ov rloaded from a build up of water. Perimeter /edge walls or other roof extensions may block this discharge if overflow scuppers (wall outlets) are not provided. It may be necessary to install overflow scuppers in accordance with the Florida Building Code, Plumbing. 7. Ventilation: Most roof structures should have some ability to vent natural airflow through the interior of the tructural assembly (the building itself). The existing amount of attic ventilation shall not be reduced. It may be beneficial to consider additional venting which can result in extending the service life of the roof. er's /A nt's Signatur 31,Y E r sacti- Property Address Date �f 1 /3 Permit Number Rev:1/20/2005, Computer Services, Building Department FROM , (MON) JAN 7 2013 11 :28/ST.11:26/No. 6802286526 P 1 MIAMI. 64�t of DEPARTMENT OF PERMT7 "PING, F,NVlRONMENT, AND REGULATORY AFFAIRS (PERA) HOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) 3M Company 3M Center ,Building 0220- 05 -E-06 St. Paul, MN, 55144 -1000 u 7 Na MIAMI - p;E PRODUCT CONTROL SEC'T'ION 11805 SW 26 Street, Room 208 Miami, Florida 33175 -2474 T (7136) 315 -2590 F(786)315-2599 w ww. min mida dc.sav/yera 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 PERA - 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 AI-IJ 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;DadOounty,Product Control Section that this product or material fails to meet the requirements of the applicable builditig.coiie ;:. This product is approved as described herein, andhas been designed to comply,' with the Florida Building, Code including the High Velocity Hurricane:Zone,of.thc Florida Building Code. DESCRIPTION: 3MTM 2- Component 'oam Roof Tile Adhesive AH -160" • LABELING: Each unit shall bear a permanen=t 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 negativel. gffecti '.tlie% format= .. _. ' Y- n8 Pte' ce:ofthis'.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 renews and revises NOA# 11- 0124.04 and consists of pages 1 through 7. The submitted documentation was reviewed by Alex Tigera. MIAMIOADE COUNTY APPROVED NOA No.: 12- 0228.18 Expiration Date: 05/10/17 Approval Date: 05/10/12 Page 1 of 7 THE TERMS AND CONDITIONS ON THE REVERSE SIDE ARE PART OF THIS SALE FROM, (MON)JRN 7 2013 11 :28 /ST. 11 :26 /No. 6802286526 P 2 ROOFING COMPONENT APPROVAL: Category: Sub Category: Materials: Roofing Roof tile adhesive Polyurethane SCOPE: This approves 3MTM 2- Component Foam Roof'1'lie Adhesive AH -160 as manufactured by 3M Company as described in Section 2 of this Notice of Acceptance. For the locations where the design pressure requirements, as determined by applicable building codc, docs not exceed the design pressure values obtained by calculations in compliance with Roofing Application Standard RAS 127, for use with approved flat, kw, and high profile roof tiles system using 2- Component Foam Roof Tile Adhesive AH -160. Where the attachment calculations are done as a moment based system for single patty placement, and as an uplif based system for double patty systems PRODUCTS MANUFACTURED BY APPLICANT: Product Dimensions 3MTm 2- Component Foam Roof Tile Adhesive AH- 160 Foam Dispenser RTF1000 ProPaelo t) 30 & 100 N/A N/A • Test Specifications TAS 101 PRODUCTS MANUFACTURED ii:: HERS: Product Description Two component polyurethane foam adhesive .Dispensing Equipment Diipensiiii.Equiptnent Any Miatni -Dadc County Product ControtAccepted.RoofTile Assembly.having a current NOA which list moment resistance values with the use of 2- Component Foam Roof Tile Adhesive AH.164 • roof tile adhesive. MANUFACTURING LOCATION:.:... 1. Tomball, TX. PHYSICAL PROPERTIES: Property Density Compressive Strength Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability Closed Cell Content M1AM1oADE CO APPAOVED Test ASTM D 1622 ASTM D 1621 ASTM D 1623 ASTM D 2127 ASTM E 96 ASTM D 2126 AS'I'M D 2856 Results 1.6 lbs. /ft_' 18 PSI Parallel to rise 12 PSI Perpendicular to rise 28 PSI Parallel to rise 0.08 Lbs. /Ft2 3.1 Perm / Inch +0.07% Volume Change a7, -40° F., 2 weeks +6.0% Volume Change @158 °F., 100% Tumidity, 2 weeks 86% NOA No.: 12- 0220.18 Expiration Date: 05/10/17 Approval Date: 05/10/12 Pate 2 of 7 THE TERMS AND CONDITIONS ON THE REVERSE SIDE ARE PART OF THIS SALE FROM , (MON) J A N 7 2 0 1 3 1 1 :29 /ST. 1 1 :26 /No. 6802286526 P 3 Note: The physical properties listed above are presented as typical average values as determined by accepted ASTM test methods and are subject to normal manufacturing variation. EVIDENCE SUBMITTED: Test Agency Center for Applied Engineering Miles Laboratories Polymers Division Ramtech Laboratories, Inc. Southwest Research Institute Trinity Engineering Celotex Corp. Testing Services LIMITATIONS: 1. Piro classification is not part of this acceptance. Refer to the Prepared Roof Tile Assembly for tire rating. 2. 3MTM 2- Component Foam Roof Tile Adhesive AI-I-160 shall solely be used with fat, low, & high tilt profiles. 3. Minimum underlayment shall be in compliance with the Roofing Application Standard RAS 120. 4. Roof Tile manufactures acquiring acceptance for the use of 3MTM 2- Component Foam Roof Tile Adhesive AII- 160 roof tile adhesive with their tile assemblies shall test in accordance with TAS 101. 5. Roof Tile manufactures acquiring acceptance for the use of HANDI -STICK roof tile adhesive with their tile assemblies shall test in accordance with TAS 101 with section 10.4 as modified herein, Test Identifier #94 -060 257818 -1 PA 25- 7438 -3 25- 7438 -4 25- 7438 -7 25 -7492 NB- 589 -631 9637 -92 01- 6743 -011 01- 6739 -062b[1] 7050.02.96 -1 ,52845a 2=r ;528454 -94 . 528454 =10 -1 520109 -1 520109 -2 520109 -3 520"1'09:6 52'Y109 -7 520;191 -1 520109 -2 -1. ::. ;. Test Name /Report TAS 101 TAS 101 SSTD 11 -93 SSTD 11-93 SSTD 11 -93 ASTM D 1623 ASTM E 108 ASTM E 108 ASTM E 84 TAS 114 TAS 101 T4:101 Date 04/08/94 12/16/96 10/25/95 11/02/95 12/12/95 02/01/94 04/30/93 11/16/94 01/16/95 03/14/96 10/23/98 12/28/98 03/02/99 F 2 F'= MS w NOA No.: 12- 0228.18 Expiration Date: 05/10/17 Approval Date: 05/10/12 Page 3 of 7 THE TERMS AND CONDITIONS ON THE REVERSE SIDE ARE PART OF THIS SALE FROM (MON) JAN 7 2013 11 :29 /ST. 11 :26 /No, 6802286526 P 4 INSTALLATION: 1. 3M'1'M 2- Component Foam Roof Tile Adhesive AH -160 may be used with any roof tile assembly having a current NOA that lists uplift resistance values with the use of 3MTM 2- Component Foam Roof Tile Adhesive All -160. 2. 3MTM 2- Component Foam Roof Tile Adhesive All -160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The waffle assembly's adhesive attachment with thc use of 3MTM 2- Component Foam RoofTile Adhesive AH-160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed thc uplift resistance determined in compliance with Miami -Dade County Roofing Application Standards RAS 127. The adhesive attachment data is noted in the roof tile assembly NOA. 3. 3M''"' 2- Component Foam RoofTile Adhesive AH -160 and its components shall be installed in accordance with Roofing Application Standard RAS 120, and 3M Company's 3MTM 2- Component Foam Roof Tile Adhesive All- 160 Operating Instruction and Maintenance Booklet, 4. Installation must be by a Factory Trained 'Qualified Applicator' approved and licensed by 3M Company. 3M Company shall supply a list of approved applicators to thc authority having jurisdiction. 5. Calibration of the Foani Dispenser RTF1000 dispensing equipment is required before application of any adhesive. The mix ratio between the "A" component and the "B" component shall be maintained between 1.0 -1.15 (A): 1.0 (B). The dispense timer shall be set to deliver 0.0175 to 0.15 pounds per tile as determined at calibration. No other settings shall be approved. 6. 3MTM 2- Component Foam Roof Tile 'Adhesive AH- 160;.shall be applied with Foam Dispenser RTF1000 or ProPack® 30 & 100 dispensing equipment• only.' 7. 3MTM 2- Component Foam RoofTileAdhesive AH -160 shall not be exposed;permanently to sunlight. • 8. Tiles must be adhered in freshly applied, adhesive. Tile must be set withii2.to 3 minutes after MTM 2- Component Foam Roof Tile Adhesive AH- 160has been dispensed.' 9. 3MTM 2- Component Foam Roof Tile Adhesive AH -160 placement: aiid tuilimurm patty weight shall be in accordance with the'Placeme_ nt Details'herein. Each generic tile profile requires the specific placement noted herein. • Table :- Adhesive Placement: Far Each:t;,enerlc Tile' Profile Tile Profile Placement Detail Single Paddy Weight Min. (grams) Two Paddy Weight per paddy Min. (grams) Flat, Low, High Profiles #1 35 N/A Higth Profile (2 Piece Barrel) #1 I.7 /side on cap and 34 /pan N/A Flat, Low, High Profiles #2 24 N/A Flat, Low, High Profiles #3 8 NOA No.: 12- 0228.18 Expiration Date: 0S/10/17 Approval Date: 05/10/12 Page 4of7 THE TERMS AND CONDITIONS ON THE REVERSE SIDE ARE PART OF THIS SALE FROM (MON) JAN 7 2013 11 :29/ST. 11:26/No. 6802286526 P 5 LABELING: All 3MTM 2- Component Foam Roof Tile Adhesive AH -160 containers shall comply with the Standard Conditions listed herein. BUJLD.1NC PERMIT REQUIREMENTS: As required by the Building Official or applicable building code in order to properly evaluate the installation of this system. ADHESIVE PLACEMENT DETAIL 1 SINGLE PATTY °P 244"f piunNdirYritoliels 111pip*, ;. IWOOMopptlallen 'nTi{n1�p1M' 10MeLPYM�irIflu 1aY1` 11 Thin 7[NMWt 4.oloantllM. IMdodoymvnt `_.t "' NOA No.: 12- 0228.1$ Expiration Date: 05/10/17 Approval Date: 05/10/12 Page 5 of 7 THE TERMS AND CONDITIONS ON THE REVERSE SIDE ARE PART OF THIS SALE FROM (MON) JAN 7 2013 11 :29/ST. 11 : 26 /No. 6802286526 P 6 ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY NOA No.: 12- 0228.18 Expiration Date: 05/.10/17 Approval Date: 05/10/12 Page 6 of 7 THE TERMS AND CONDITIONS ON THE REVERSE SIDE ARE PART OF THIS SALE FROM (MON)JAN 7 2013 11:30/3T. 11:26/No. 6802286526 P 7 ADHESIVE.PLACEMENT DETAIL 3 DOUBLE PATTY Single paddy undo' tile Single paddy between tile 2 ln.171n. medium slam paddy says course only caul; Weephole Faye closure Drip edge Single paddy -.• 'Under tits , . Sir* paddy en Mark/men, Single Daddy on top of tile Eno Carp Cave Closure in. z 7 in. medium eke paddy** course only fascia END OF THIS ACCEPTANCE NOA No,: 12-0228.18 Expiration Date: 05/10/17 Approval Date: 05/10/12 Page 7 or7 THE TERMS AND CONDITIONS ON THE REVERSE SIDE ARE PART OF THIS SALE