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RF-13-156Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 184815 Permit Number: RF -1 -13 -156 Scheduled Inspection Date: March 04, 2013 Inspector: Bruhn, Norman Owner: BARR, CHRISTOPHER Job Address: 93 NW 97 Street Miami Shores, FL 33150- Project: <NONE> Contractor: EVANS ROOFING Permit Type: Roof Inspection Type: Final Roof Work Classification: Tile Phone Number (215)7794371 Parcel Number 1131010330250 Phone: (954)566 -5238 Building Department Comments RE ROOFING TILE TO TILE Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed l% Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 04, 2013 For Inspections please call: (305)762 -4949 Page 17 of 32 — CARL-AB, T N C. IIIIIIIIII March 2, 2013 Evans Roofmg 1071 NE 43 St Oakland Park, FL 33334 RE: TILE UPLIFT TEST PROJECT INFORMATION PROVIDED BY CLIENT: 93 NW 97 St Miami Shores, FL Permit#: RF 1 -13 -156 Property ID: 11- 3101 - 033 -0250 Date inspected: March 1, 2013 Date completed: February 25, 2013 Roofmg Contractor: Evans Roofing Carlab, Inc Project # 13 -7640 Testing lab Certificate #: 09- 0127.04 Dear Sirs, In accordance with your request and authorization, a representative of Carlab, Inc coinpleted`th& Roof Tile Uplift Test at the above referenced project. This testing was performed in general accordance with Roofing Application Standard TAS No.106 Standard procedure for field verification of the bonding of mortar or adhesive set tile system and mechanically attached, rigid, discontinuous roof systems. The total of the tested roof surface area was estimated to be less than 2600 square feet, and the mean height of the roof is less than 30 feet above ground surface. The type of tile used for this project was reported to be Entegra Estate S Roof Tile. This tile was reported to have been foamed in place. At the time of this testing at least one test for every 100 square feet of roof tile in the perimeter area and one test for every 200 square feet of roof tile in the field area were performed. Walking on the roof surface or any other type of disturbance may loosen the tiles and alter the results of this test. Based on our test results, we conclude that the installation of the roof tile at the above referenced project meets the test requirement outlined in the above mentioned protocol. Attached please find a copy of our test report for your review. Should you have any questions or if we may be of further assistance, please do not hesitate to contact the undersigned. Respectfully submitted, Sergio Labiste, PE 61733 8730 SW 25 STREET • MIAMI • FL • 33165 • PHONE: 305.283.3512 •FAX: 305.226.0438 Test Test load (lbf) Test Status 1 35 Pass 2 35 Pass 3 35 Pass 4 35 Pass 5 35 Pass 6 35 Pass 7 35 Pass 8 35 Pass 9 35 Pass 10 35 .Pass 11 35 Pass 12 35 Pass 13 35 Pass 14 35 Pass 15 35 Pass 16 35 Pass 17 35 Pass 18 35 Pass 19 35 Pass 20 35 Pass 21 35 Pass 22 35 Pass 23 35 Pass 24 35 Pass 25. . 35 Pass .. 26 35 Pass 27 35 Pass 28 35 Pass 29 35 Pass 30 35 Pass 31 35 Pass 32 35 Pass 33 35 Pass 34 35 Pass 35 35 Pass 36 35 Pass TILE UPLIFT TEST FOR 93 NW 97 ST Miami Shores, FL Project#: 13 -7640 Test Test load (lbf) Test Status 37 35 Pass 38 35 Pass 39 35 Pass 40 35 Pass 41 35 Pass 42 35 Pass 43 35 Pass 44 35 Pass 45 35 Pass .46. 35 Pass 47 35 Pass 48 35 Pass 49 35 Pass 50 35 Pass 51 35 Pass 52 35 Pass 53 35 Pass 54 35 Pass 55 35 Pass 56 35 Pass 57 35 Pass 58 35 Pass 59 35 Pass 60 35 Pass , 61 35 Pass 62 35 Pass 63 35 Pass 64 35 Pass 65 35 Pass 66 35 Pass 67 35 Pass 68 35 Pass 69 35 Pass 70 35 Pass 71 35 Pass 72 35 Pass Test Test load (lbf) Test Status 73 35 Pass 74 35 Pass 75 35 Pass 76 35 Pass 77 35 Pass 78 35 Pass 79 35 Pass 80 35 Pass 81 35 Pass 82 35 P-ass,..: 83 35 Pass 84 35 Pass 85 35 Pass 86 35 Pass 87 35 Pass 88 35 Pass 89 35 Pass 90 35 Pass 91 35 Pass 92 35 Pass 93 35 Pass 94 35 Pass 95 35 Pass 96 35 Pass 97. .35 ... . Pam,..: 98 35 Pass 99 35 Pass 100 35 Pass 101 35 Pass 102 35 Pass 103 35 Pass 104 35 Pass 105 35 Pass 106 35 Pass 107 35 Pass 108 35 Pass 8730 SW 25 STREET • MIAMI • FL • 33165 • PHONE: 305.283.3512 •FAX: 305.226.0438 Test Test load (lbf) Test Status 109 35 Pass 110 35 Pass 111 35 Pass 112 35 Pass 113 35 Pass 114 35 Pass 115 35 Pass 116 35 Pass 117 35 Pass 118 35 Pass 11.9. . 35........ Pass 120 35 Pass 121 35 Pass 122 35 Pass 123 35 Pass 124 35 Pass 125 35 Pass 126 35 Pass 127 35 Pass 128 35 Pass 129 35 Pass 130 35 Pass 131 35 Pass 132 35 Pass 133 35 Pass 134 35 .......... Pass 135 35 Pass 136 35 Pass 137 35 Pass 138 35 Pass 139 35 Pass 140 35 Pass 141 35 Pass 142 35 Pass 143 35 Pass 144 35 Pass 145 35 Pass 146 35 Pass 147 35 Pass 148 35 Pass 149 35 Pass 150 35 Pass Test Test load (lbf) Test Status Test Test load lbf) Test Status 8730 SW 25 STREET • MIAMI • FL • 33165 • PHONE: 305.283.3512 •FAX: 305.226.0438 I N ,-. z w J Q U N 68 -I + — 1 1 + 1 1 + o 1 1 + _ + + + + + — — co 1 — + + + — + + + I I I I ,+ + + + + + — + + + .4. + + 8 8 1 I 1 — + + - + I I I I I I I I I I — + + + + + — + + + + I I I I 1 + I LEGEND wC + FIELD TEST — PERIMETER TEST 0 CORNER TEST A R E A B, 1 N C. ICERTIFICATE I ENGINEER AND PLANNERS OF AUTHORIZATION 6419 8730 &W, 25 SF., MIAMI, a 33165 TEI2 305 28135121 FAX= 305 216.0438 APPROX. ROOF TEST L❑CATI ❑NS AND DIMENSI ❑NS RE: Permit # - J- ( 3 ( SC T6tuty e: Miami Shores Viiiage Building Department INSPECTION AFFIDAVIT (Print name and drde License Type) License #: CCC 3,26:27-6 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 DATE: , 1 13 / 13 licensed a (n) Contractor / Engineer / Architect, FS 468 Buildin• or On or about 0(2\1;113 13.w , I did personally inspect the roof deck nailing and (Date & time) �C Secondary water barrier work at ct &'tj Q` %I Sr, i 11"it 51V4--f (Complete Job Site Address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S) Signature State of Florida County of Dade: The undersigned, being the first duly sworn, deposes and says that he /she is the contractor for the above property mentioned. Sworn to and subscribed before me this 1 Z day of f eGrvary ZOl 3 Notary Public, Sate of Florida at Large Niaal Guerrero \ Commission tEE332604 @� :Exphec: Jan. C5, 201 �A�t �'� •ONOED TB+RY b �Orfr�4 AM Nti1MY i SYRN1r IMIM `General, Building, Residential, or Roofing Contractors or any individual certified under 468 F.S. to make such an inspection. Include photographs of each plane of the roof with permit # and address # dearly shown marked on the deck for each inspection Revised on 5/21/2009 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 RE: Permit # 1 C 3 I SC l DATE: 002.1 1 3 / 13 INSPECTION AFFIDAVIT c (Print name and circle License Type) License #: CCC (3,26,27-C On or about 02\1; l 13:w licensed FS 468 Buildm . or Engineer / Architect, , I did personally inspect the roof deck nailing and (Date & time) ,� /' Secondary water barrier work at ct3 CI7ri+ STS / 1J474 yi7Li ,L C (Complete Job Site Address) Based upon that examination I have determined the installation was done according to the Hurricane Mitigation Retrofit Manual (Based on 553.844 F.S) Signature State of Florida County of Dade: The undersigned, being the first duly sworn, deposes and says that he/she is the contractor for the above property mentioned. Swom to and subscribed before me this I Z day of / e6rua"7 zoo 3 Notary Public, Sate of Florida at Large Nloel Guerrero \ P• 1Commissiott#EE862 4 �►� -- �.rEigairos: Jan. C6, 201 `o �'•'d!F tONOEO TIgtU - ! • NA INOTmY R SUTRA /tlWRf 'General, Building, Residential, or Roofing Contractors or any individual certified under 468 F.S. to make such an inspection. Include photographs of each plane of the roof with permit it and address # clearly shown marked on the deck for each inspection Revised on 5/21/2009 1 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO T..F- 1-13 -156 TAX FOUO NO. II -3101 .0 3 3 -0a25a STATE OF FLORIDA: COUNTY OF MIAMI -DADE: 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 11111111111111111111111111111111111111111 111 CFN 2013R01016!6 OR Bk 28478 Ps 4860 (1vs) RECORDED 02/07/2013 11:19:01 HARVEY RUVIN9 CLERK OF COURT MIAMI-DADE COUNTYp FLORIDA LAST F'AGE A� Space above reserved for use of recording office 1. al description of property and street/address: f lf 511 001 C Pt ties - cl L OTS I4 t IS >3 LtL . 1a9 q3 NUJ °41 Sr Mi SF +% 2. Description of Improvement . E '.i ink Ti Le•s 3. Owner(s) name and address: Interest In property: OuJNE Name and address of fee simple titleholder. 4. Contractor's name a 4 d. and phone number ))G '. ( Fi 5 t t )t N 'WP sT e17�1t P* - &L 30c, t - 846 3aai4 5. Surety: (Payment bond required by owner from contractor, If any) Name, address and phone number. Amount 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, address and phone number. 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Uenor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name, address and phone number. 9. Expiration date of this Notice of Commencement (the expiration date Is 1 year from the date of recording unless a different date Is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU l,R INTEND TO OBTAIN FINANCING, CONSULT WITH if .�V 1. , , • _-��++ ^�rr� t ■ COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT ' a�+'lrR `� Signature(s) ) of. = 0 / . Owner(s)' Authorized Officer/Director/Partner s Print Name C SrOPH6t PO Print N COUNTY OF MIAMI -DADE The foregoing_ iprstru a was acknowledged before me this 6 day of Fe /ru4.ry . a al3 By hrr'�top ?er Bar( U Individually, or U as for J.Personally known, or U produced the following type of'identificati Print Name: 'I'd Cucrivo (SEAL) ..�..� VERIFICATION PURSUANT TO SECTION 92525 FLORIDA STA1 USES Under penalties of perjury, I declare that I have read the foregoing and that the facts stated in it are true, to the best of my knowledge and belief. �a.!��r np %,, Nicol uoerreru ?• ,;, t %conmIss1on #EE862604 a�.. 1. IR Wrest sON 06, 017 NOTARY E aURETi Borg Signatur> (:`i of Own - ; or Owner(s)'s Authorized Officer/Director/Partner/Manager who signed above: By By 123.01-52 PAGE 3 9/10 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 PERMIT APPLICATION FEB 0 6 2013 FBC 200 Permit No. R F j-13,156 Master Permit No. Permit Type: BUILDING ROOFING JOB ADDRESS: e3 ii \jJ c'rn 5 r City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: t, - 3t0 i -033 ©c2S Is the Building Historically Designated: Yes FT Flood Zone: OWNER: Name (Fee Simple Titleholder): nifiSTOPilat, ?)4--llt Phone #: Q15-'7)9437/ Address: q 3 IV w Pf l ro ST (�� City: 4(�A-M.t S O1 State: i"• Tenant/Lessee Name: Zip: Phone #: Email: C itttS Mal, 6,4414l L o COM CONTRACTOR: Company Name: EUPI?JS (26i41141)6- Phone #: 3Os- 6 - 6 F416. Address: 1011 #i 43 "" ST City: t r State: Ft Zip: 3333 Qualifier Name: el f (d V24I O Jo '6 Phone #: 5 f _ $ R 3 _19036 State Certification or Registration #: CCC 13.2 ‘2 )- Certificate of Competency #: Contact Phone #: ,3a�- 896 - ��[6 Email Address: Et/j4 N S QooP ayocip. CD/vl Phone #: DESIGNER: Architect/Engineer: vp fil. ,,a ;may:. 4 :4 iI• , t a ar 111. In 'lP fdir ". 4 mt: $ t3 t o%0 .00 � f yppe o! Work: a Addition ❑ (A'+ lteration Description of Work: QE -YI /n� 00f; i 6- "N ceS Square/Linear Footage of Work: ❑a N1 ew Vtepair/Replace W 1.7'1 Ott liS o''`a ".s . a.' c2 too ❑Demolition • . t. 5� • y. Color thru tile: lily ffl T'& ********* * ** * * * * * * * * * * * * * * * * * * * ** * * * * * *F ************* * * * * * * * * * * * * * * * * * * ** * * * * * * * * * ** 'e9 Submittal Fee $ Permit Fee $ CC} CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ a 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, BOILERS, HEATERS, TANKS and MR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this 6 day of Je;.ua y , 20 )3 , by dips /o pAv 'Barr who is personally known to me or who has produced Pt DL As identification and who did take an oath. NOTARY PUBLIC: Sign: /� Print: All' C e, / V e r/' ° Nic®i u�rsrl My Commission Expires: °,,`•!'�� Commission;EE2' "6f16 k_514-"CO, ,Expires: Jan. 06, 2017 n t o AM NOTARY i VOW APPROVED BY Signature retractor The foregoing instrument was acknowledged before me this day of I vy , 20 L.3, by 16(CU OCV0 JC , who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: ®.a Nicol Guerrero ?�►t CarimissionffESON Expires 01, BONDED YiONJ Sign: Print: ,Oiscad 3 ae My Commission Expires: 5a/R. 06. 20/) Plans Examiner Zoning Structural Review Clerk (Revised 5/2 /2012XRevised 3/12/2012) XRevised 06 /10 /2009XRevised 3 /15 /09XRevised 7/10/2007) Prepared by and return to Maureen Cabra Greenspoon Marder PA 250 S. Australian Avenue #700 West Palm Beach, FL 33406 File Number: FNMA 122324REO Property Identification Number 11- 3101 - 033-0250 Grantee's Name Christopher Barr Property Address: 93 NW 97th ST Miami Shores, FL 33150 1111111 111111111111111111111 1 1111111111111111 CFN 201280940536 OR Bk 28421 Pas 3503 - 3504; (2vas) RECORDED 12f29/2012 10111144 DEED DOC TAX 1,482.00 HARVEY RUVINr CLERK OF COURT PiIAMI -DADE COUNTY, FLORIDA (SpaceAbove This Line For Recording Data) Special Warranty Deed This Special Warranty Deed made this J() day of IV 6V6 lt b€4.■ , 2012, between Federal National Mortgage Association whose post office address is 14221 Dallas Parkway Suite 1000, Dallas, TX 75254, grantor, and Christopher Barr, a married man, whose post office address is �� N. k '_, \'fin , 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 the Miami -Dade County, Florida, to -wit: Lots 14 and 15, in Block 129, of MIAMI SHORES SECTION NO. 6, according to the plat thereof, recorded in Plat Book 10, Page 39 of the Public Records of Miami -Dade County, Florida. Parcel Identification Number: 11- 3101 -033-0250 Subject to covenants, conditions, restrictions, limitations, easements and agreements of record, if any, taxes and assessments for the year 2013 and subsequent years, and to all applicable zoning ordinances and or restrictions and prohibitions imposed by governmental authorities, if any. 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 hilly 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: Signed, sealed and delivered in our presence: W' ess tune: ,,.„t $L State of Florida County of Palm Beach OR BK 28421 PG 3504 LAST PAGE • Federal National Mortgage Association organized and existing under the laws of the United States of America By: Greenspoon Marde Attorney-in-Fact / / BY: / I (A4 ∎yr aureen Cabra The bishu t�}v acknowledged before me this 30 day of N yvh4 t , 20 / UU of Greenspoon Marder PA as Attorney -in -Fact for Federal National Mortgage Association existing under the laws of the United States of America. Who is personally known to me or who { }has/have produced a valid drivers license as identification. Notary Public Printed Name: f lQ 'PR f vw -i- -' My Commission Expires: 4421/14-e...-7 FE9 p,� ��� rir SECTION R4402.13 HIGH VELOCITY HURRICANE ZONES — REQUIRED OWNERS NOTIFICATION FOR ROOFING CONSIDERATIONS R4402.13.1 Scope. As it pertains to the section, it is the responsibility of roofing contractor to provide the owner with the required roofing permit, and to explain to the owner the content of the section. The provisions of Section R4402 govem the minimum requirements and standards of the industry for roofing system installations. Additionally, the following items should be addressed as part of greement between the owner ant the contractor. The owner's initial in the designated space indicat i : ', • n explained. Aesthetics - Workmanship: the workman providing that the roof system meets the wind resistan Aesthetics (appearance) are not a consideration with such as color or architectural appearance, that are no the agreement between the owner and the contractor ;di ction 02 are for the purpose of rmance standards. visions. Aesthetic issues be addressed as part of Renailing wood decks: When replacing roofing, the existing roof deck may have to be renailed in accordance with the current provisions of Section R4403. (The roof deck is usually concealed prior to removing the existing roof system). . 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. CIS Exposed Ceiling: Exposed, open beam ceilings are where the underside of the roof decking can be viewed from below. The owner may wish to maintain the architectural appearance; therefore, roofing nail penetration of the underside of the decking may not be acceptable. This provides the option of maintaining the appearance. 5. 4 Ponding water: The current roof system and/or deck of the building may not drain well and may cause water to pond (accumulate) in low -lying areas of the roof. Pounding can be an indication of structural 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. e6 Overflow scuppers (wall outlets): It is required that 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. Ventilation: Most roof structures should have some ability to vent natural 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 which can result in extending the service life of•the roof./ I/ Owner /Agent's _S ignature- Date Contractor Signat Revised on 7/9/2009 LD ROOF l4 LIES AND ROOFTOP STRUCTURES Master Permit No Contractor's Name IJ U.) ct)ri' s r • RC AMi 5 tbQe --5 Pc Job Address Florkia Betting Code Edition 2010 High- Zane Unifcrtn Penttit Application Fenn. li C 11I1!!:,;i J{sit EVANS ROOFING Process No. 0 Low Slope 0 New Roof FC Reroofing ROOF CATEGORY O Mechanically Fastened Tile ® Metal PaneliShingtes o Prescriptive BUR -RAS 150 ROOF TYPE 0 RecoverMg ROOF SYSTEM INIFORMATION w 1– m co cal MalrfAttesive o ® Woog .E c� w 0 t rb Low SIB Roof Area (SF) Steep Sloped Roof Area (SF) Total (SF) x 100 Section B (Roof Plan) Sketch Roof Plan; Mustnate all Weis and sections, roof drains, overflow scuppers and overflow drains. Include dimensions of sections and levels, clearly identify dimensions of - elevated pressure zones and lunation of 1131 tit OINK a"— --a 1111 111111111111111111111111 ■r. owl ■1111■ 1Ksalm ■11■ 1111 INNS - [/', 11111:! ®1 15.34 2010 FLORIDA BUILDING COD — BUILDING Mean Roof Height a t $ Grkr t ' ROOF ASSEMBIJES AND ROOFTOP STRUCTURES Florida Building Code Edition 2010 Zone Firm. $20-MIUSIMPARINNIMOLSYMagd Roof System Manufacturer: °e. Notice of Acceptance Number: et �1�� Minimum Design Wind Pressures, r If Applicable (From RAS 127 or Menu ns : P2: 1,k71 P3:._� /Cinj1 St Sl Root Sy [ ri tP ion Dec Type: Rywaad Type Underlayment: Insulation: N8A Ridge Ventilation? NIA 30 Lba tel Fire Barrier. N(A Fastener Type & Spacing: Adhesive Type: 1 114" Ring Shrank Nails & 1 518" Ttn Caps l Spacing lr wield / 6- an perimeter f 4' an taps Hat Asphalt Type N tar Tile t8redettayment and Patyroam Potypra PH 160 (bleat= Patty 24 anima) for Tao kntallatton Type Crap Sheet 80 Lbs Tde Und ymmd" Roof Covering: Estate SCae1tes Type & Size Drip Edge: "r 3a3gatcaiaed 1520 2010 FLORIDA B RLDING CODE — BUILDING MIAMI DADS COUNTY BUILDING AND NEIGHBORHOOD COMPLIANCE DEPARTMENT (BNC) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) Entegra Roof Tile, Inc. 1289 NE 9th Ave. Okeechobee, FL. 34972 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.2ovibuilding/ 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: Estate "S" 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 renews NOA 11 I0- 0518.03 and consists of pages 1 through 6. The submitted documentation was reviewed by Alex Tigera. MIAM!•DADE COUNTY APPROVED NOA No. 11- 0510.02 Expiration Date: 08/23/16 Approval Date: 06/30/11 Page 1 of 6 ROOFING ASSEMBLY APPROVAL ,Category: Sub Category: Material: Roofing Roofing Tiles Concrete 1. SCOPE This approves a roofing system using Entegra Estate "S" Concrete Roof Tile, as manufactured by Entegra Roof Tile, Inc. in Okeechobee, FL. as described in Section 2 of this Notice of Acceptance, designed to comply with the Florida Building Code for High Velocity Hurricane Zone. For the locations where the pressure requirements, as determined by applicable Building Code, does not exceed the design pressure values obtain 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 Entegra Estate `S' I = 16 -1/2" Roof Tile w = 13" Trim Pieces 1= varies w = varies varying thickness 2.1 MANUFACTURING LOCATION 2.1.1. Okeechobee, FL. Test Specifications TAS 112 TAS 112 2.2 EVIDENCE SUBMITTED: Test Agency Test Identifier Redland Technologies Professional Service Industries, Inc. The Center for Applied MANMADE COUNTY APPROVED 7161 -03 7161 -03 7161 -03 P0402 P0631 -01 Letter Dated Aug. 1, 1994 224 -47099 94 -060B Product Description Low profile, interlocking, extruded concrete roof tile equipped with two 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. Test Name/Report PA 102 PA 102(A) PA 108 Withdrawal Resistance Testing of screw vs. smooth shank nails PA 108 PA 108 PA 112 PA 101 Date Dec. 1991 Dec. 1991 Dec. 1991 Sept. 1993 July 1994 Aug. 1994 Sept. 1994 March, 1994 NOA No. 11- 0510.02 Expiration Date: 08/23/16 Approval Date: 06/30/11 Page 2 of 6 Test Agency Engineering, Inc. Celotex Corporation Testing Services Walker Engineering, Inc. IBA Consultants, lnc. Test Identifier • Test Name/Report Date 94 -084 PA 101 May 1994 25-7094-1 PA 102 Oct. 1994 25- 7094 -7 PA 102 Oct. 1994 25- 7094 -4 PA 102 Oct. 1994 Project No. 307025 PA 100 Oct. 1994 Test #MDC -76 25- 7183 -1 PA 102 Feb. 1995 25- 7183 -2 PA 102 Feb. 1995 25- 7214 -2 PA 102 March, 1995 25- 7214 -6 PA 102 March, 1995 528454 -2 -1 PA 101 Sep. 1998 520109 -2 Dec. 1998 Calculations Aerodynamic Multiplier March 1999 2381 -264 TAS 112 01/08/08 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 and Neighborhood Compliance Department — Product Control Section 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. MIAMI•DADE COUNTY APPROVED NOA No. 11- 0510.02 Expiration Date: 08/23/16 Approval Date: 06/30/11 Page 3 of 6 4. INSTALLATION 4.1 Entegra Estate "S" Concrete Roof Tile and its components shall be installed in strict compliance with Miami Dade County Roofing Application Standard RAS 118, RAS 119, and RAS 120. 4.2 Data For Attachment Calculations. Table 1: Average Weight (W) and Dimensions (I x w ) Tile Profile Weight -W (Ibf) Length -I (ft) Width -w (ft) Entegra Estate 'S' Roof Tile 10.0 1.375 1.08 Table 3: Restoring Moments due to Gravity - M9 (ft -lbf) Table 2: Aerodynamic Multipliers - A (ft3) 3 ":12" Tile 5 ":12" X (ft3) Greater than 7 " :12" A (ft3) Profile Direct Deck Batten Application Direct Deck Application Entegra Estate 'S' Roof Tile Direct Deck 0.267 0.289 Table 3: Restoring Moments due to Gravity - M9 (ft -lbf) Tile Profile 3 ":12" 4 ":12" 5 ":12" 6 ":12" Greater than 7 " :12" Entegra Estate 'S' Roof Tile Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck Battens Direct Deck 5.91 6, 74 5.82 6.64 5.70 6.50 _ 5.56 6.33 5.40 6.14 Table 4: Attachment Resistance Expressed as a Moment - Mt (ft -Ibf) for Nail -On Systems Tile Profile Fastener Type Direct Deck (min 15/32 " plywood) Direct Deck (min. 19/32" plywood) Battens Entegra Estate 'S' Roof Tile 2 -10d Rinc,Shank Nails 27.8 37.4 28.8 1 -10d Smooth or Screw Shank Nail2 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)2 24.3 24.3 24.2 1 -10d Smooth or Screw Shank Nail (Eave Clip)2 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 1 Installation with a 4" tile headlap and fasteners are located a min. of 21/2" from head of tile. 2 When using only one fastener use the hole that is approximately 4 -3/4" away from interlocking edge. MIAMI DADE COUNTY APPROVED NOA No. 11- 0510.02 Expiration Date: 08/23/16 Approval Date: 06/30/11 Page 4 of 6 Table 5: Attachment Resistance Expressed as a Moment Mf (ft-Ibf) for Two Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Entegra Estate 'S' Roof Tile Adhesive 26.14 3 See manufactures component approval for installation requirements. 4 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 -Ibf) for Single Patty Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Entegra Estate's' Roof Tile Polyfoam PoIyProTM 86.61' Polyfoam PoiyProTM 45.56 5 Large paddy placement of 54 grams of PolyProTM. 6 Medium paddy placement of 24 grams of P0IVPrOTM. Table 7: Attachment Resistance Expressed as a Moment - Mf(ft -Ibf) for Mortar or Adhesive Set Systems Tile Profile Tile Application Minimum Attachment Resistance Entegra Estate 'S' Roof Tile Mortar Set 20.60 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 ". OR ESTATE "S" TILE LABEL (LOCATED ON UNDERSIDE OF TILE) 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. MIAMI DARE COUNTY APPROVED NOA No. 11- 0510.02 Expiration Date: 08/23/16 Approval Date: 06/30/11 Page 5 of 6 PROFILE DRAWING Nail Holes ENTEGRA ESTATE "5" CONCRETE ROOF TILE END OF THIS ACCEPTANCE MIAM6DADE COUNTY APPROVED NOA No. 11- 0510.02 Expiration Date: 08/23/16 Approval Date: 06/30/11 Page 6 of 6 DEPARTMENT OF PERMITTING, ENVIRONMENT, AND REGULATORY AFFAIRS (PERA) BOARD AND CODE ADMINISTRATION DIVISION NOTICE OF ACCEPTANCE (NOA) 3M Company 3M Center Building 0220- 05 -E -06 St. Paul, MN. 55144 -1000 MIAMI -DADE COUNTY PRODUCT CONTROL SECTION 11805 SW 26 Street, Room 208 Miami, Florida 33175 -2474 T (786) 315 -2590 F (786) 315 -2599 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 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: 3MTM 2- Component Foam Roof Tile Adhesive AH -160 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 renews and revises NOA# 11- 0124.04 and consists of pages 1 through 7. The submitted documentation was reviewed by Alex Tigera. NOA No.: 12- 0228.18 Expiration Date: 05/10/17 Approval Date: 05/10/12 Page 1 of 7 ROOFING COMPONENT APPROVAL: Category: Roofing Sub Category: Roof tile adhesive Materials: Polyurethane SCOPE: This approves 3MTM 2- Component Foam Roof Tile 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 code, does not exceed the design pressure values obtained by calculations in compliance with Roofing Application Standard RAS 127, for use with approved flat, low, 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 uplift based system for double patty systems PRODUCTS MANUFACTURED BY APPLICANT: Product Dimensions Test Product Description Specifications 3MTM 2- Component Foam N/A TAS 101 Two component polyurethane foam adhesive Roof Tile Adhesive AH- 160 Foam Dispenser RTF 1000 N/A ProPack® 30 & 100 N/A Dispensing Equipment Dispensing Equipment PRODUCTS MANUFACTURED BY OTHERS: Any Miami -Dade County Product Control Accepted Roof Tile Assembly having a current NOA which list moment resistance values with the use of 2- Component Foam Roof Tile Adhesive AH -160 roof tile adhesive. MANUFACTURING LOCATION: 1. Tomball, TX. PHYSICAL PROPERTIES: Property Density Compressive Strength Tensile Strength Water Absorption Moisture Vapor Transmission Dimensional Stability Test ASTM D 1622 ASTM D 1621 ASTM D 1623 ASTM D 2127 ASTM E 96 ASTM D 2126 Closed Cell Content ASTM D 2856 Results 1.6 lbs. /ft.3 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 @ -40° F., 2 weeks +6.0% Volume Change @158 °F., 100% Humidity, 2 weeks 86% NOA No.: 12- 0228.18 Expiration Date: 05/10/17 Approval Date: 05/10/12 Page 2 of 7 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 Test Identifier #94 -060 257818 -1PA 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 528454 -2 -1 528454 -9 -1 528454 -10 -1 520109 -1 520109 -2 520109 -3 520109 -6 520109 -7 520191 -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 TAS 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 TAS 101 03/02/99 LIMITATIONS: 1. Fire classification is not part of this acceptance. Refer to the Prepared Roof Tile Assembly for fire rating. 2. 3MTM 2- Component Foam Roof Tile Adhesive AH -160 shall solely be used with flat, low, & high tile 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 AH- 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. ■ F � W F'= MS NOA No.: 12- 0228.18 Expiration Date: 05/10/17 Approval Date: 05/10/12 Page 3 of 7 INSTALLATION: 1. 3MTM 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 AH -160. 2. 3MTM 2- Component Foam Roof Tile Adhesive AH -160 shall be applied in compliance with the Component Application section and the corresponding Placement Details noted herein. The roof tile assembly's adhesive attachment with the use of 3MTM 2- Component Foam Roof Tile Adhesive AH -160 shall provide sufficient attachment resistance, expressed as an uplift based system, to meet or exceed the 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. 3MTM 2- Component Foam Roof Tile 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 AH- 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 the authority having jurisdiction. 5. Calibration of the Foam 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 Roof Tile Adhesive AH -160 shall not be exposed permanently to sunlight. 8. Tiles must be adhered in freshly applied adhesive. Tile must be set within 2 to 3 minutes after 3MTM 2- Component Foam Roof Tile Adhesive AH -160 has been dispensed. 9. 3MTM 2- Component Foam Roof Tile Adhesive AH -160 placement and minimum patty weight shall be in accordance with the 'Placement Details' herein. Each generic tile profile requires the specific placement noted herein. Table 1: Adhesive Placement For Each Generic 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 High Profile (2 Piece Barrel) #1 17 /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: 05/10/17 Approval Date: 05/10/12 Page 4 of 7 LABELING: All 3MTM 2- Component Foam Roof Tile Adhesive AH -160 containers shall comply p y with the Standard Conditions listed herein. BUILDING 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 Nail through plastic cement Underlayment Paddy (Beneath Tile) 10 in. Eave Course Eave Closure Fascia Eave course only: Keep adhesive approx. 4 in. up from wee holes Nail through plastic cement Under ayment Paddy (Beneath Tile) Nail through plastic cement Underlayment 1 Paddy (Beneath Tile) 10 in. Eave Course Eave course only: Keep adhesive approx. 4 in. up from weepholes Fascia Weephole Eave closure Drip edge 1) Place enough adhesive to achieve 17 to 23 square inches in contact with the pan tile 2) Turn covers upside down. Place adhesive 112 in. To 1 in. From outside edge of cover tile. Then install the tile. 10 in Underlayment Optional 2x4's for steep pitch applications Nail through plastic cement Eave Course \ Eave course only: Keep adhesive approx. 4 in. up from weepholes Fascia Eave Closure Remov top portion of the eave course cover tile. Abut to second course of pan tiles. Ensure cave end of pan and cover tiles are flush at eave line. Eave closure (mortar shown) Weephole Fascia Boa Sheathing Optional Point-up Mortar on longitudinal edges of tile NOA No.: 12- 0228.18 Expiration Date: 05/10/17 Approval Date: 05/10/12 Page 5 of 7 Nail through plastic cement Underlayment ADHESIVE PLACEMENT DETAIL 2 SINGLE PATTY Paddy (Beneath Tile) Eave Course Eave Closure Nail through plastic cement Underlayment Paddy (Beneath Tile) 7 in. 2 in. Eave Course Fascia Weephole Eave closure Drip edge Nail through plastic cement Paddy (Beneath Tile) nderlayment Eave Course Fascia Eave Closure NOA No.: 12- 0228.18 Expiration Date: 05/10/17 Approval Date: 05/10/12 Page 6 of 7 ADHESIVE PLACEMENT DETAIL 3 DOUBLE PATTY Nail through plastic cement Paddy (between tile) Paddy (under tile) 3 in. x3in. Single paddy on under - layment Single paddy under tile Od ,Eave course Single paddy on top of tile 2 in. X 7 in. medium size paddy eave Fascia course only Nail through plastic cement Nail through plastic cement Underlayment Single paddy under tile Single paddy between tile 2 in. x 7 in. medium size paddy eave course only Single paddy on under - layment Single paddy on top of tile Eave Course Fascia Weephole Eave closure Drip edge Single paddy under tile Single paddy between tile ! in.x 3 in. Single /paddy on underlayment Single paddy on top of tile Eave Course Eave Closure 2 in, x 7 in. medium size paddy eave course only Fascia END OF THIS ACCEPTANCE NOA No.: 12- 0228.18 Expiration Date: 05/10/17 Approval Date: 05/10/12 Page 7 of 7 ROOF ASSEMBLIES AND ROOFTOP STRUCTURES Florida Building Code Edition 2007 High - Velocity Hurricane Zone Uniform Permit Application Form. Section F (Tile Cairfilations) For Moment based tile systems, choose either Method 1 or 2. Compare the values for Mr with 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. ppMethodd 1 "Moment Based Tile Calculations Per RAS 127" (� (Pt: x J, 01 = ( t -1 ) - Mg: Cl 1 = Mrl SS Product Approval Mf jjlC aC /� / Product Approval Mf `1 S S (P3:100: \ x 2.•®`J- = r Cq id) - Mg: v J! = Mr3, 2 .36 Product Approval Mf i C.• 5 (P2:&D x)d�,r��act =1"U ) -Mg:Yr t� = Mr2.0,44 Method 2 "Simplified Tile Calculations Per Table Below" Required Moment of Resistance (Mr) From Table Below Product Approval Mf Mr required Moment Resistance* Mean Roof Height -* Roof Slope . 16' 1 20' 212 25' 30' 40' 34A 1 36 6 3.12 32.2 2 6.12 A8.2 3e 7 42 2 36 0 37 4 39 8 32.2 28 4 1 _301 6.12 26.4 7.12 28 0 24.4 i 26.9 33 8 351 37 3 31 6 32 8 34 9 29.4 30.6 32A 27. _ 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 "Moment Based Tile Calculations Per RAS 127" (P1: x L = x w: _ ) - W: x cos B = Frt Product Approval F' (P2: x L = x w: = J - W: (Pa: x L = x w: = ) - W: x cos B = Fr2 Product Approval F' x cos 0 = F,, Product Approval F' Where to Obtain information Description Symbol Where to find Design Pressure P1 or P2 or P3 RAS 127 Table 1 or by an engineering analysis prepared by PE based on ASCE 7 Mean Roof Height H Job Site Roof Slope B Job Site Aerodynamic Multiplier d Product Approval Restoring Moment due to Gravity, Mg Product Approval Attachment Resistance Ms Product Approval Required Moment Resistance M8 Calculated Minimum Attachment Resistance F' Product Approval Required Uplift Resistance Fr Calculated Average Tile Weight W Product Approval Tile Dimensions L = length W = width _ Product Approval All calculations must be submitted to the building official at the time of permit application. FLORIDA BUILDING CODE — BUILDING 06 2013 e,e Miami Shores Vitiage 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: Of t S i c PwEe. i3 t,.. Property Address: (13 IV A) ciltl sr- Komi 6 it 00..e Roofing Permit Number: Dear Building Official: 1 c ti P..i S tC0 i*E t ail aa.. certify that I am not required to retrofit the roof to wall connections of my building because: r The just valuation for the structure for purpose of ad valorem taxation is less-Mein $300,000.00. Please attach proof of ad valorem taxation. ❑ The building was constructed in compliance with the provisions of the Florida Building Code (FBC) or with the provisions of 19 4 edition of the South Florida Building Code (1994 SFBC) Date: Signature 49 4 1 6 -r✓ Print Name �aierrrr CuerrA,ro State of Florida ` or mission #EC 'r6( 4 =C County of Dade �''hN I ��i BONDED THRU2p17 MA NOTARY A SURETY BONDS 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 6 day of iebrucr y aoi3 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 building application from a General Contractor for the Roof to Wall connection Hurricane Mitigation. Revised on 5/21/2009 A. Settlement Statement (HUD -1) OMB No. 2502 -0265 B. Type of Loan 1. ❑ FHA 2. ❑ RHS 3. O Cony Unins 4. 0 VA 5. ❑ Cony Ins. 6. 0 Seller Fin 7. ❑ Cash Sale. 6. File Number FNMA- 122324RE0 7. Loan Number 0899053808 8. Mortgage Ins Case Number , C. Note: This form is furnished to give you a statement of actual settlement costs. Amounts paid to and by the setdement agent are shown. Items marked "(p.o.e.)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. 0. Name & Address ofBorrower Cbriatogwithre 665 Madigan Avenue Morgantown, WV 26501 E. Name & Address of Seller Federal National Mortgage Association 14221 Dallas Parkway Suite 1000 Dallas , TX 75254 F. Name & Address of Lender Regions Bank d/b/a Regions Mortgage 2050 Parkway Office Circle Birmingham, AL 35244 G. Property Location Municipality Miami Shores, Miami -Dade County REO# A121KJI 93 NW 97th ST Miami Shores, FL 33150 H. Settlement Agent Narne Greenspoon Marder PA 250 S. Australian Ave. #700 West Palm Beach, FL 33401 561- 226 -2230 Underwritten By: First American Title Insurance Company I. Settlement Date - 11/30/2012 Fund: 11/30/2012 Place of Settlement Greenspoon Marder, PA 250 S. Australian Ave., Suite 700 West Palm Beach, F.L. 33401 J. Summary of Borrower's Transaction K. Summary of Seller's Transaction 100. Gross Amount Due from Borrower 400. Gross Amount Due to Seller 101; Contract sales price 5247,000.00 401. Contract sales price 5247,000.00 102. Personal property 402. Personal property 103. Settlement charges to borrower 514,029.50 403. 104. 404. 105. 405. Adjustments for items paid by seller is advance . Adjustments for items paid by seller ha advance . 106. County Property Taxes 12/01 /12 thra 12/31/12 5389.53 406. County Property 12/01/12 thmtm 12/31/12 5389.53 107. Flood Insurance 407. Flood Insurance 108. Windstorm Insurance 408, Windstorm Insurance 109. HOA Dues 409, HOA Dues 110. 410. 111. 411. 112. Non Ad- Valorem Assessmts 11/30- 9/30/13 $625,09 412. Non Ad- Valorem Assess-nits 11/30- 9/30/23 113. 413. S625.09 114. 414. 115. 415. 116. 416, 120. Gross Amount Due From Borrower 5262,044.12 420. Gross Amount Due to Seller 500. Reductions in Amount Due to Seller 200. Amounts Paid By Or in Behalf Of Borrower 201. Deposit or earnest money 57,410.00 501. Excess deposit (see instructions) 202. Principal amount of new loan(s) 5234,650.00 502. Settlement charges to seller pine 1400) 203. Existing loan(s) taken subject to 503. Existing loans) taken subject to 517,32122 204. 504. Payoff of fast mortgage loan 205. 505. Payoff of second mortgage loan 206. 506. 207. Seller Pays Owner's Policy 51,310.00 507. Seller Pays Owner's Policy 51,310.00 208. Seller Pays Doc Stamps 51,482.00 508. Seller Pays Doc Stamps 51,482.00 209. Seller Credit towards Closing Costs 59,525.00 509. Seller Credit towards Closing Costs 59,525.00 Adjustments for items unpaid by seller Adjustments for items unpaid by seller 210. County Property Taxes 510. County Property Taxes 211. Flood insurance 511. Flood Insurance 212. Windstorm Insurance 512. Windstorm Insurance 213. HOA Dues 513. HOA Dues 214. 514. 215. 515. 216. 516. 217. 517. 218. 518. 219. 519, 220. Total Paid By/For Borrower 8254,377.00 520. Total Reduction Amount Due Seller 300. Cash At Settlement From/fo Borrower 600. Cash At Settlement To/From Seller 829,638.22 301. Gross Amount due from borrower (line 120) i 5262,044.12 601. Gross Amount due to seller (line 420) slitslahi 302. Less amounts paid by /for borrower pine 220) 5254,377.00 602. Less reductions in amt. due seller (line 520) 529,638.22 303. Cash From Borrower The Public Reportin Burden forth' ll f' fu 57,667.12 603: Cash To Seller 5218,376.40 ° g ms ro ecnon o m roan e. is esumeted at 35 mmu es per response .for collecting, reviewing, and reporting the data. This agency may not collect this information, and you are not required o complete this form, unless it displays a currently valid OMB control number. No confidentiality is assured; this disclosure is mandatory. This is designed to provide the parties to a RESPA covered transaction with information during the settlement process. POC (B) - Paid Outside of Closing by Borrower. POC (S) - Paid Outside of Closing by Seller. POC (L) - Paid Outside of Closing by Lender. Previous editions are obsolete Page 1 of 5 HUD -1 PERMIT/i.' Miami Shores Village Building Department RECEIPT NN Contractor Owner tj Architect DATE: „,"`7 u A - e (77-C tc,/ 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 le{ PiPicked sets of plans and (other) fl Address: ) From the building department on this date in order to have corrections done to plans And/or get County stamps. I understand that the plans need to be brought back to Miami Shores Village Building Department to continue permitting process. Acknowledged by: PERMIT CLERK INITIAL: RESUBMITTED DATE: PERMIT CLERK INITIAL: Miami Shores Vivage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 January 30, 2013 Permit No: RF13 -156 Building Critique //Provide e p r oof of ownership. A recorded deed or title. Owners notification must be signed by the owner. 3. Section D and E wind pressures do not match. Provide pressures from RAS 127 Norman Bruhn CBO 305 - 762 -4859 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CONTRACTORS' REGISTRATION FORM ALL CONTRACTORS MUST PROVIDE COPIES OF LICENCES AND INSURANCES EACH TIME A PERMIT IS SUBMITTED OR THE VILLAGE MAY MAINTAIN A FILE WITH YOUR INFORMATION FOR A $30.00 FEE PER YEAR. IF CONTRACTOR IS A FLORIDA STATE CERTIFIED CONTRACTOR: A. COPY OF QUALIFIER'S STATE LIC CARD B. _ COPY OF LOCAL BUSINESS TAX RECEIPT C. >-- COPY OF LIABILITY INSURANCE (CERTIFICATE HOLDER TO BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKERS COMPENSATION (EITHER CERTIFICATE OR EXCEMPTION) IF CONTRACTOR HAS A MIAMI DADE COUNTY CERTIFICATE OF COMPETENCY: A. COPY OF CERTIFICE OF COMPETENCY OF QUALIFIER B. COPY OF MIAMI DADE COUNTY MUNICIPAL CONTRACTOR'S TAX RECEIPT C. COPY OF LIABILITY INSURACE (CERTIFICATE HOLDER MUST BE MIAMI SHORES VILLAGE BLDG DEPT) D. COPY OF WORKER COMP INSURANCE (EITHER CERTIFICATE OR EXEMPTION) YOUR INSURANCE COMPANY MUST ISSUE A CERTIFICATE HOLDER AS FOLLOW: MIAMI SHORES VILLAGE BLDG DEPT 10050 NE 2ND AVE MIAMI SHORES, FL 33138 COMPLETE CONTRACTOR'S INFORMATION BUSINESS NAME: Altus 19j& • BUSINESS ADDRESS: 101 ( 06 43f if CITY Atm; &I€ STATE T ' ZIP CODE 333311 BUSINESS PHONE: ( 954 ) 5a-.2333 FAX NUMBER (q511) "1 CELL PHONE (q 511 ) 566 ..733Y QUALIFIER'S NAME: Tte L &L, .%VOU 6 QUALIFIER'S LIC NUMBER: ea 13c 6216 E -MAIL ADDRESS (IF APPLICABLE): &UcS OCOr al/WO- (OM Created on 3119109 BY MLDV 1 RV 3126109 MLDV SMESS TAXRECEIPT 115 S. Andrews Ave., Rm. A -100, Ft. Lauderdale, FL 33301 -1895 — 954 -831 -4000 VALID OCTOBER 1, 2012 THROUGH SEPTEMBER 30, 2013 DBA: Business Name: EVANS ROOFING Receipt #:ROOF N /SHEET METAL CON Business Type: (CERTIFIED ROOFING CONT Owner Name: THIERRY DEVOVE /QUAL Business Opened:08 /10/1988 Business Location: 1071 NE 43 ST State /County /Cert/Reg:Ccc1326276 OAKLAND PARK Exemption Code: Business- Phone: 954- 566 -5238 Rooms Seats Employees 7 Machines Professionals For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT WHEN VALIDATED Mailing Address: EVANS ROOFING 1071 NE 43 ST OAKLAND PARK, FL 33334 -0000 This tax is levied for the privilege of doing business within Broward County and is non - regulatory in nature. You must meet all County and /or Municipality planning and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. 2012 - 2013 Receipt #05A- 11- 00010126 Paid 07/25/2012 27.00 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD 1940 NORTH MONROE STREET TALLAHASSEE FL 32399 -0783 DEVOVE, THIERRY EVANS ROOFING 1071 NE 43 ST OAKLAND PARR FL 33334 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, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better For information about our services, please log onto www.myfloridalicense.com. There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and leam more about the Department's initiatives. 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! (850) 487 -1395 :_ STATE OF FLORIDA AC# 6 i; 9 70 'DEPARTMENT`'OFE BUSINESS AND PROFESSIONAL REGULATION CCC132627' 2 1200224; CERTIFI "DEVVOVE EVANS RO RACTOR .IS CERTIFIED under the provisions "of'ch.489 >'sxpiratioa date, AUG ' 31, 2014 L12071101291 THIS DOCUMENT HAS A COLORED BACKGROUND • MICROPRINTING • LINEMARK"' PATENTED PAPER AC# 6197026 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND pROFESSIONAL'REGULATION CONST,RL CTION INDUSTRY LICENSING BOARD SEQ# L120711012S DATE BATCH NUMBER LICENSE NBR 07/11/2012 120022473 CCC1326278, The ROOFING CONTRACTOR Named below IS CERTIFIED Under the. provisions of Chapter m Expiration date: AUG 31, 2014 T} IERRY EVANS ROOFING 1071 NE 43 ST OAKLAND PARK RICK SCOTT GOVERNOR FL 33334 DISPLAY AS REQUIRED BY LAW KEN LAWSON SECRETARY 9549426310 FRANK H. FURMAN INC. 01:39:43 p.m. 01 -28 -2013 1 /1 t` CERTIFICATE OF LIABILITY INSURANCE DATE(MMlODYYYY) 1/28/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POLICIES AUTHORIZED IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 Frank H. Furman, Inc. 1314 East Atlantic Blvd. P. 0. Box 1927 Pompano Beach FL 33061 NAMEACT Denise Page PHONE Est! (954) 943 -5050 FAX (AfC. No. : IAic, Nol: (954) 942 -6310 E-MAIL denise @furmaninsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL ft INSURERA:Starr Indemnity & Liability 38318 INSURED 'Devove US Inc, DBA: Evans Roofing 1071 NE 43rd Street Oakland Park FL 33334 INSURER B : INSURER C: INSURER D: INSURER E : INSURERF: COVERAGES CERT 1FICATE NUNIBER:1z-13 renewal REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTIMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR ADDL SUER LTR INSR WVD A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE 1 X I OCCUR POLICY NUMBER POLICY EFF IMM /DDfYYYYI POLICY EXP IMMIDD/YYYYI LIMITS GE AGGREGATE LIMIT APPLIES PER POLICY '.t PRO - IFCT LOC AUTOMOBILE LIABILITY X X SIPGGL0015501 5/1/2012 5/1/2013 EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 $ 50,000 MED EXP (My one person) $ 5,000 PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 5 ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (ES accident) $ BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE DED RETENTION 1 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) It yes, describe under DESCRIPTION OF OPERATIONS below EACH OCCURRENCE AGGREGATE $ YIN N/A WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE DESCRIPTION OF OPERATIONS / LOCATIONS, VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space Is required) E.L, DISEASE - POLICY LIMIT CERTIFICATE HOLDER CANCELLATION City of Miami Shores Village 10050 NE 2nd Ave Miami SHores, FL 33138 4CORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Frank Furman, Jr /DP NS025 (201005)_01 �'CQR�'g' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 112$/2013 HOLDER. THIS BY THE POLICIES AUTHORIZED ' T-IIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 Alliance Insurance Solutions LLC PO Box 1777 St Petersburg, FL 33731 CONTACT NAME: Glen J. Distefanox 253 PHONE (A1C, No, Est): 727- 497 -1247 FAX (A/C, No): 727- 497 -1280 E-MAIL ADDRESS: gdistefano Q,sunzinsurance,com INSURER(S) AFFORDING COVERAGE NAIC 11 INSURERA: SUNZ Insurance Company 34762 INSURED Howard Leasing, Inc., Howard Leasing H, Inc. Howard Leasing III, Inc., Howard Leasing IV, Inc. 6302 Manatee Avenue West, Suite K Bradenton FL 34209 INSURER B: Aspen Re- London - Best Rating "A" INSURER c: Catlin Syndicate- Lloyds Best Rating A g " " INSURER D: Brit Syndicate - Lloyds - Best Rating "A" EACH OCCURRENCE INSURER E: DAMAGE TO REN (ED PREMISES (Ea occurrence) INSURER F : COVERAGES CERTIFICATE NUMBER: 1 REVISI THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL INSR SUBR WyD POLICY NUMBER POLICY EFF .(MMIDDIYYYYUMMIDDIYYYY)- POLICY EXP LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO REN (ED PREMISES (Ea occurrence) $ CLAIMS -MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER. POLICY PRO- JECT LOC PRODUCTS- COMP /OP AGG $ $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per ( 1 $ PROPERTY DAMAGE (Per accident) $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE - EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A WORKERS COMPENSA TION AND EMPLOYERS' LIA BILITY ANY PROPRIETOR /PARTNER /EXECUTIVE oFFICERIM EMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below YIN N NIA WCPE0000004003 5/14/2012 5/14/2013 ,% WCSTATU- TORY LIMITS 1/ o E(, E . EACH ACCIDENT $ 1,000,000 E . DISEASE - EA EMPLOYEE $ 1,000,000 E . DISEASE- POLICY LIMIT $ 1,000,000 B C D Workers Compensation Excess Coverage This is for informational purposes and nothing shall create any right under such reinsurance. _ DESCRIPTION OF OPERATIONS! LOCATIONS 1 VEHICLES (Attach A CORD 101, Additional Remarks Schedule, ifmore space is required) Coverage provided for all leased employees but not subcontractors of: Devove U S, Inc dba: Evans Roofing Location Effective: 6/1/2012 Fax: 954- 561 -7776 CERTIFICATE HOLDER CANCELLATION 746 City of Miami Shores Village 10050 NE 2nd Avenue Miami Shores FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE „,,-,1Z ..." 4,4Cer... Glen J Distefano ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CERT NO.: 15312322 receptionist 1/28/2013 10:57:38 AM Page 1 of 1