RF-11-1381Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP - 162651
Scheduled Inspection Date: October 26, 2011
Inspector: Grande, Claudio
Owner: CHURCH, MIAMI SHORES BAPTIST
Job Address: 370 GRAND Concourse
Miami Shores, FL 33138 -2747
Project: <NONE>
Contractor: MURPHY ROOFS
Permit Number: RF -8 -11 -1381
Permit Type: Roof
Inspection Type: Final Roof
Work Classification: Repair Roof
Phone Number (305)758 -0559
Parcel Number 1132060136040
Phone: (305) 892 -1700
Building Department Comments
REPAIR VALLEY & WALL AND LEAK SOUTH SIDE TILE
Passed.
Failed
Inspector Comments
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
October 25, 2011
For Inspections please call: (305)762 -4949
Page 6 of 33
1
Project Address
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204
Parcel Number
Applicant
370 GRAND Concourse
Miami Shores, FL 33138 -2747
1132060136040
Block: Lot:
MIAMI SHORES BAPTIST CHURL
Owner Information
Address
Phone
CeII
MIAMI SHORES BAPTIST CHURCH
401 NE 95 ST
Miami Shores FL 33138
(305)758 -0559
Contractor(s)
MURPHY ROOFS
Phone CeII Phone
(305) 892 -1700 (305)215 -9494
Valuation:
Total Sq Feet:
$ 1,200.00
400
1
Type of Work: Repair
Additional Info: REPAIR
Classification: Residential
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee - Repairs
Scanning Fee
Technology Fee
Total:
Amount
$1.20
$2.00
$2.00
$0.40
$100.00
$3.00
$1.60
$110.20
Pay Date Pay Type Amt Paid Amt Due
Invoice # RF -8 -11 -41604
08/02/2011 Check #: 3999 $ 50.00 $ 60.20
08/15/2011 Check #: 4003 $ 60.20 $ 0.00
Available Inspections:
Inspection Type:
Roof Repair
Final Roof
Roof Review
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated.
August 15, 2011
Authorized Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
August 15, 2011 1
6 BUIL ING
PERMIT APPLICATION
FBC 20
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 Type: BUILDING
OWNER: Name (Fee Simple Titleholder):
Address:
City:
)3Y:
C ETV b -�
AUG 01g011
Permit No.
Master Permit No.
ROOFING
Ate<QA—Th
Phone #:
State: Zip: 3) ie/k, .
Tenant/Lessee Name: Phone #:
Email:
JOB ADDRESS:
City: i
Folio/Parcel #:
Miami Shores
Miami Dade
Zip:
Is the Building Historically Designated: Yes
CONTRACTOR: Company Name:
Address:
City:
NO Flood Zone:
Phone #:34 Otc.-51WCJ
Zip: �','`
Qualifier Name: Phone #:��'/
State Certification or Registration Certificate of Competency #:
Contact Phone #: Email Address:
DESIGNER: Architect/Engineer: Phone #:
Value of Work for this Permit: $° 2 9� F
$ � Square/Linear Footage of Work:
Type of Work: ❑Addition ❑A1te tion UNew ❑Repair/Replace
Description of Work: 1� k,
°� . \ I'LL ' 4' ►V, = A D S
PLC i ft' -7(1 ST1 C 1 L
❑Demolition
CATI 5 %D%
l
* * * ** * * * ** * * * * * * * * * * * * * * * * * * * * * * * ** Fees************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
<)
Submittal Fee $ Permit Fee $ �� o 4 CCF $ CO /CC $
Scanning Fee $
Notary $ Training/Education Fee $
Double Fee $ Structural Review $
Radon Fee $
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)
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 fir :i spection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection t be approved and a reinspection fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this X6"
day o
,20J , by £ v i %ii /
who is perso kn
t't�ll own to me or who has produced
As identification and who did take an oath.
NOTARY PUBLIC:
Si
Print:
My Commissio
Contractor
The foregoing instrument was acknowledged before me thi�
U 7
day of - , 20 /1 , by 92�7%S in 1�
who is perso s : ly known to me or who has produced
as identification and who did take an oath.
7 ( Plans Examiner
Structural Review
(Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09)
NOTARY PUBLIC:
Sign: C.7'. -a- Y)Vt4A----
Print: 4. —Za-ra c in/r/ter-
My Commission
Zoning
Clerk
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
Florida Building Code Edition 20
High - Velocity Hurricane Zone Uniform Penult Applicatio
Spr•_tinn A (General Infnrmitinn)
Master Permit No. Process No.
Contractor's Name
Job Address 7-2
Miami Shores Village
APPROVED
BY
DATE
ZONING DEPT
BLDG DEPT
6/-`(
r .'( 1R.)FCT TO COMPLIANCE WITH ALL FEDERAL
l Form.
`,1 A f F: AND COUNTY RULES AND REGULATIONS
❑ Low Slope
❑ Asphaltic
Shingles
❑ Mechanically Fastened Tile
❑ Metal Panel /Shingles
❑ Prescriptive BUR -RAS 160
ROOF TYPE
❑ New Roof ❑ Reroofing ❑ Recovering
ROOF SYSTEM
INFORMATION
❑ Mortar /Adhesive Set Tile
❑ Wood Shingles /Shakes
Low Slope Roof Area (SF) Steep Sloped Roof Area (SF)
'ASS y a)
Section R (Roof plan)
Sketch Roof Plan: Illustrate all levels and sections, roof drains, scuppers, overflow scuppers and overflow drains.
Include dimensions of sections and levels, clearly identify dimensions of elevated pressure zones and location of
parapets.
❑ Maintenance
Total (SF)
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FLORIDA BUILDING CODE — BUILDING
ROOF ASSEMBLIES AND ROOFTOP STRUCTURES
Florida Building Code Edition 2007
High- Velocity Hurricane Zone Uniform Permit Application Fonn.
SActinn D (Steep SInped Roof System)
Roof System Manufacturer:
Notice of Acceptance Number: / \9
Minimum Design Wind Pressures, If Applicable (From RAS 127 or
Calculations):
P1: P2: P3:
Maximum Design Pressure
(From the Product Approval Specific System):
Steep Sloped Roof System flest riptinn
\ Deck Type:
Type Underlayment:
Insulation:
Ridge Ventilation?
J
Fire Barrier:
Mean Roof Height:
Fastener Type & Spacing: r I .� 9S
Adhesive Type:
Type Cap Sheet:
poly
Roof Covering:
Type & Size Dri
Edge:
54-
lv" vo °' ?
FLORIDA BUILDING CODE — BUILDING
01;11,1Y,.
'T con Miami
course
70
.Grand
t„1
CYNY
BUILDING CODE COMPLIANCE OFFICE (BCCO)
PRODUCT CONTROL DIVISION
NOTICE OF ACCEPTANCE (NOA)
MIAMI -DADE COUNTY. FLORIDA
METRO -DADE FLAGLER BUILDING
140 %VEST FLAGLER STREET. SUITE 1603
MIAMI, FLORIDA 33130-1563
(305) 375 -2901 FAX (305) 375 -3908
CertainTeed Corporation
1400 Union Meeting Road
P.O. Box 1100
Blue Bell PA 19422
SCOPE:
This NOA is being issued under the applicable rules and regulations governing the use of construction
materials. The documentation submitted has been reviewed by the BCCO and accepted by the Building
Code and Product Review Committee to be used in Miami Dade County and other areas where allowed
by the Authority Having Jurisdiction (AHJ).
This NOA shall not be valid after the expiration date stated below. The Miami -Dade County Product
Control Division (In Miami Dade County) and/or the AHJ (in areas other than Miami Dade County)
reserve the right to have this product or material tested for quality assurance purposes. If this product or
material fails to perform in the accepted manner, the manufacturer will incur the expense of such testing
and the AHJ may immediately revoke, modify, or suspend the use of such product or material within
their jurisdiction. BORA reserves the right to revoke this acceptance, if it is determined by Miami -Dade
County Product Control Division that this product or material fails to meet the requirements of the
applicable building code.
This product is approved as described herein, and has been designed to comply with the Florida Building
Code and the High Velocity Hurricane Zone of the Florida Building Code.
DESCRIPTION: CertainTeed Underlayment Systems
LABELING: Each unit shall bear a permanent label with the manufacturer's name or logo, city, state
and following statement: "Miami -Dade County Product Control Approved ", unless otherwise noted
herein.
RENEWAL of this NOA shall be considered after a renewal application has been filed and there has
been no change in the applicable building code negatively affecting the performance of this product.
TERMINATION of this NOA will occur after the expiration date or if there has been a revision or
change in the materials, use, and/or manufacture of the product or process. Misuse of this NOA as an
endorsement of any product, for sales, advertising or any other purposes shall automatically terminate
this NOA. Failure to comply with any section of this NOA shall be cause for termination and removal of
NOA.
ADVERTISEMENT: The NOA number preceded by the words Miami -Dade County, Florida, and
followed by the expiration date may be displayed in advertising literature. If any portion of the NOA is
displayed, then it shall be done in its entirety.
INSPECTION: A copy of this entire NOA shall be provided to the user by the manufacturer or its
distributors and shall be available for inspection at the job site at the request of the Building Official.
This revises NOA # 10- 0119.01 and consists of pages 1 through 7.
The submitted documentation was reviewed by Alex Tigera.
NOA No.: 10- 0608.01
Expiration Date: 11/24/14
Approval Date: 11/18/10
Page 1 of 7
ROOFING COMPONENT APPROVAL
Category:
Sub - Category:
Material:
Roofing
Underlayment
SBS
TRADE NAMES OF PRODUCTS MANUFACTURED OR LABELED BY APPLICANT:
Product
WinterGuard HT
Manufacturing
Location #1
WinterGuard Granular
Manufacturing
Location #2
WinterGuard Sand
Manufacturing
Location #2
Diamond Deck
Manufacturing
Location #3
MetaLaymentm
Manufacturing
Location #1
Black Diamond'
Base Sheet
Manufacturing
Location #2
Flintlastic GTA
Manufacturing
Location #1
All Weather /Empire
Base Sheet
Manufacturing
Location #1
Dimensions,
36" x 65' rolls
Roll Weight: 45 lbs
Test
Specification
ASTM D 1970
36" x 65' rolls • • ASTM .D 1970
Roll Weight: 72 lbs
36" x 65' rolls ASTM D 1970
Roll Weight: 72 lbs
48" x 250'
Roll Weight: 38 lbs.
ASTM D 226
39 3/8" x 61' ASTM D 1970
Roll Weight: 54 lbs.
39 3/8" x 68' 7 ";
Roll Weight: 76 lbs.
MIAMI-DADE COUNTY
APPROVED
39 3/8" x 32' 10 ",
Roll Weight: 105
lbs.
39 3/8" x 65' 10 ",
Weight: 70 lbs.
ASTM D 1970
ASTM D
6222, Grade G,
Type I
ASTM D 4601
Type II
Product
Description
Modified fiberglass reinforced, bituminous sheet
material for use as an underlayment in sloped
roof assemblies. Designed as an ice & rain
shield.
Granular surfaced modified, fiberglass
reinforced, bituminous sheet material for use as
an underlayment in sloped roof assemblies.
Designed as an ice & rain shield.
Embedded sand surfaced modified, fiberglass
reinforced, bituminous sheet material for use as
an underlayment in sloped roof assemblies.
Designed as an ice & rain shield.
Synthetic, scrim reinforced underlayment for use
under shake, shingles, slate or metal roofing.
A film surfaced, self - adhering underlayment for
use under metal roofing.
Granular surfaced modified, fiberglass
reinforced, bituminous sheet material for use as
an underlayment in sloped roof assemblies.
Designed as an ice & rain shield. Not for use as
an Anchor Sheet. Direct adhesion to wood
deck not permitted in the HVHZ.
Granule surfaced APP Modified Bitumen
membrane with non -woven polyester mat
reinforcement for torch application.
Asphalt coated fiberglass reinforced base sheet.
NOA No.: 10- 0608.01
Expiration Date: 11/24/14
Approval Date: 11/18/10
Page 2 of 7
Product Dimensions • Test
Specification
Flintlastic SA Cap FR 33'11" x 39 -3/8" TAS 103
Manufacturing
Location #1
Flintlastic GMS
Manufacturing
Location #1
Product
Description
Fiberglass reinforced, fire retardant SBS cap
sheet.
39 -; /8" x 33'11" ASTM D 6164 Granule surfaced SBS Modified Bitumen
Roll Weight: 97 lbs. Grade G, Type membrane with non -woven polyester mat
I reinforcement for mop application.
MANUFACTURING LOCATION:
1. Little Rock, AR.
2. Shakopee, MN
2. Hangzhou, China
EVIDENCE SUBMITTED:
Test Agency
Momentum Technologies, Inc.
Trinity l ERD
Test Identifier
AX31G8D
AX31G8G
RX02J9A
C8440.04.08
C9560.05.08
C12960.06.09
3530.12.05 -1 -R1
3523.03.05 -R2
C32240.03.10
C3500.04.10
C30280.12.09 -R2
C30890.03.10 -1
Test Name/Report
ASTM D4601
ASTM D6222
ASTM D6164
ASTM D4798, D 1970
ASTM D1970
TAS 103
AC 152 & ASTM D1623
ASTM D1623
TAS -104 / ASTM D 4977
TAS -103
ASTM D 226
ASTM D1970
Date
09/05/08
06/05/09
12/22/09
04/08/08
05/27/08
06/02/09
10/05/09
01/12/10
03/04/10
04/01/10
12/11/09
03/17/10
NOA No.: 10- 0608.01
Expiration Date: 11/24/14
Approval Date: 11/18/10
Page 3 of 7
APPROVED ASSEMBLIES:
Deck Type 1:
Deck Description:
System E(1):
Anchor Sheet:
Surfacing:
Deck Type 1:
Deck Description:
System E(2):
Anchor Sheet:
Membrane:
Surfacing:
Wood, Non - insulated
"/;," or greater plywood or wood plank
Anchor sheet mechanically fastened to deck.
(4 :12 or Above) One or more plies of Diamond Deck with a minimum 4" headlap
and a 6" end lap mechanically fastened to deck with approved nails and tin caps 6"
o.c. at the laps and two staggered rows 12" o.c. the field of the roll.
(2:12 to < 4:12) One or more plies of Diamond Deck with a minimum 20" headlap
and a 12" end lap mechanically fastened to deck with approved nails and tin caps
6" o.c. at the laps and two staggered rows 12" o.c. the field of the roll. Vertical
joints should be offset 36" minimum.
Shall be acceptable for use in approved asphaltic shingles, wood shakes, &
shingles, quarry slate, and metal roof applications. Must Comply with applicable
Roofing Application Standards and Building Codes
Wood, Non - insulated
`9/3," or greater plywood or wood plank
Anchor sheet mechanically fastened to deck, membrane adhered.
One or more plies of ASTM D 226 Type I1 or ASTM D 2626 with a minimum 4"
headlap and a 6" end lap mechanically fastened to deck with approved nails and tin
caps 6" o.c. at the laps and two staggered rows 12" o.c. the field of the roll.
One or more plies of Flintlastic GTA torch applied to anchor sheet or WinterGuard
HT, WinterGuard Granular, WinterGuard Sand, MetaLayment or Black Diamond
Base Sheet self - adhering membrane adhered to the anchor sheet with a minimum
3" headlap and 6" end lap. Place the first course of membrane parallel to the eave,
rolling the membrane to obtain maximum contact. Remove the release membrane
as the membrane is applied. Vertical strapping of the membrane is acceptable. If
membrane is strapped, then anchor sheet must also be strapped.
Shall be acceptable for use in approved asphaltic shingles, wood shakes, &
shingles, quarry slate, and metal roof applications. Must Comply with applicable
Roofing Application Standards and Building Codes
NOA No.: 10- 0608.01
Expiration Date: 11/24/14
Approval Date: 11/18/10
Page 4 of 7
Deck Type 1:
Deck Description:
System E(3):
Anchor sheet:
Ply Sheet:
Membrane:
Surfacing:
MIAMI-DADE COUNTY
APPROVED
Wood, Non - insulated
"y/,," or greater plywood or wood plank
Anchor sheet mechanically fastened to deck, membrane adhered.
One ply of ASTM D 226 Type 11 organic felt or All Weather/Empire Base
mechanically attached with a minimum 4" side lap and a minimum 6 "end lap.
Anchor sheet shall be applied at a right angle (901 to the slope of the deck with
approved annular ring shank nails and tin caps at a fastener spacing of 6" o.c. at the
side lap, and two 12" o.c. staggered rows along the center of the base sheet.
(Optional) One or more plies of an ASTM D226 ply sheet adhered in a full
mopping of approved asphalt applied within the EVT range and at a rate of 20-40
lbs. /sq.
One ply of Flintlastic GMS adhered in a full mopping of Type IV asphalt applied
within the EVT range and at a rate of 20-40 lbs./sq. or Flintlastic GTA torch
applied to the preceding sheet or Flintlastic SA Cap FR self - adhering membranes
adhered to the preceding sheet with a minimum 4" side lap and 6" end lap. Place
the first course of membrane parallel to the eave, rolling the membrane to obtain
maximum contact. Remove the release membrane as the membrane is applied.
Vertical strapping of the membrane is acceptable. If membrane is strapped, then
anchor sheet and ply sheet must also be strapped.
When used in Tile roof systems the cap sheet shall be back nailed to deck with
approved annular ring shank nails and tin caps at a maximum 12" o.c. at the side
laps and 6" o.c. at the end laps. No nails or tin caps shall be exposed.
Flintlastic SA Cap FR, Flintlastic GTA and Flintlastic GMS may be used with any
approved roof tile system mechanically fastened or foam adhered.
Must comply with appropriate Roofing Application Standard RAS 118, RAS 119,
RAS 120 and applicable Building Codes.
NOA No.: 10- 0608.01
Expiration Date: 11/24/14
Approval Date: 11/18/10
Page 5 of 7
LABELING:
All membranes or packaging shall bear the imprint or identifiable marking of the manufacturer's name or
logo and the following statement: "Miami -Dade County Product Control Approved" or the Miami -Dade
County Product Control Seal as shown below.
MJAMFDADE COUNTY
APPROVED
BUILDING PERMIT REQUIREMENTS:
Application for building permit shall be accompanied by copies of the following:
1. This Notice of Acceptance.
2. Any other documents required by the Building Official or applicable building code in order to
properly evaluate the installation of this material.
LIMITATIONS:
1. Fire classification is not part of this acceptance.
2. CertainTeed underlayment roofing systems utilizing Flintlastic GTA, WinterGuard HT, WinterGuard
Granular, WinterGuard Sand, Diamond Deck, MetaLayment or Black Diamond Base Sheet as a cap
membrane shall be acceptable for use in asphaltic shingles, wood shakes, & shingles, quarry slate,
and metal roof applications.
3. CertainTeed underlayment roofing systems utilizing Flintlastic SA Cap FR, Flintlastic GTA or
Flintlastic GMS as a cap membrane shall be acceptable for use in foam adhesive set and
mechanically fastened roof tile systems.
4. This acceptance is for prepared roofing applications. Minimum deck requirements shall be in
compliance with applicable building code. CertainTeed underlayment roofing systems shall be
installed in strict compliance with applicable Building Code.
5. CertainTeed underlayment roofing systems membranes shall be applied to a smooth, clean and dry
surface with deck free of irregularities.
6. CertainTeed underlayment roofing systems membranes shall not be applied over an existing roof
membrane as a recover system but may be applied over an approved roofing Base /Anchor sheet
underlayment.
7. WinterGuard HT, WinterGuard Granular, WinterGuard Sand, Black Diamond Base Sheet, Flintlastic
SA Cap FR, MetaLayment, Diamond Deck, Flintlastic GMS, and Flintlastic GTA shall not be left
exposed as a temporary roof for longer than 180 days of application.
8. CertainTeed underlayment products may be used with any approved roof covering Notice of
Acceptance listing CertainTeed underlayment products as a component part of an assembly in the
Notice of Acceptance. If CertainTeed underlayment products are not listed, a request may be made
to the Authority Having Jurisdiction (AHJ) or the Miami -Dade County Product Control Department
for approval provided that appropriate documentation is provided to detail compatibility of the
products, wind uplift resistance, and fire testing results.
9. All nails in the deck shall be carefully checked for protruding heads. Re- fasten any loose decking
panels. Sweep the deck thoroughly to remove any dust and debris prior to application.
10. When applying the membrane in the valley, start at the low point and work to the high point, rolling
the membrane from the center outward in both directions.
11. Roll or broom the entire membrane surface so as to have 100% contact with the surface, giving
special attention to overlap areas.
MIAMI-DADE COUNTY
APPROVED
NOA No.: 10- 0608.01
Expiration Date: 11/24/14
Approval Date: 11/18/10
Page 6 of 7
LIMITATIONS:
12. Flash vent pipes, stacks, chimneys and penetrations in compliance with Roof Assembly current
Product Control Notice of Acceptance and applicable Building Code.
13. All systems using Flintlastic SA Cap FR, and Flintlastic GMS shall be limited to the maximum roof
slopes outlined in the table below:
•Slopes up to 4:12 — Stage by placing two tiles perpendicular to the slope followed by maximum
four tiles on top parallel to the slope (Illustrated in Figure 1 below).
*Slopes of 4 :12 up to and including 7:12 — Horizontal batten strips are required. Stage tiles
upslope and touching horizontal battens; tiles (maximum 10) must be stacked parallel to the
slope (See Figure 2 below).
*Slopes greater than 7:12 — Horizontal batten strips are required as described in the tile
manufacturer's NOA per RAS 118 and RAS 119.
Front View
Figure 1: Staged Method,
Front View
Figure 2: Batten Method
Side View
Figure 2: Batten Method
END OF THIS ACCEPTANCE
NOA No.: 10-0608.01
Expiration Date: 11/24/14
Approval Date: 11 /18 /10
Page 7 of 7
06/29/2011 14:25 8006946363
TBTCLA
PAGE 01/02
CERTIFICATE OF INSURANCE
o6r`(MMIIDDi")
• . o
Risk Rctoxi oniPurc Trades rou qualified Liability the Risk inc, Inc.. of A
Risk Retention Purchasing Group gaalified umler the Risk Retention Act of 1986;
Federal Law 97-45.
7400 South Union Park Ave., Suite 201
Midvale, UT 84047
800 -R51 -8364
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
AND CONFERS NO RiGHTS UPON THE CERTIFICATE HOMER. THIS
CERTIFICATE OF INSURANCE DOES NOT AFFIRMATIVELY OR
NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED
BY THE INSURANCE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
suRED
Murphy Roofs. inc
10903 N.E. 8 Court
INSURER A NOTICE: Coverage Is being provided as part of a Master Group
INSURER B! Pefley issued to members of the Tranawvrld Building Trades and
Centraotors Liability Win, Inc,
INSURER C: , a Risk Retention 'Purchasing Group' authorized under the RIsk
INSURER D: Retention Act of 1988; Federal Law 87-45.
Biscayne Park , FL 33161
"i,IMITS BROWN ARE THOSE IN
EFTECT AS OF POLICY INCEPTION"
Ptinro Insurance Company
COVERAGES
The policies of Insurance Bated below have been Iaaued to the Insured named above for the policy Indicated. Notwithstanding any requirement, tern or condition of any contract or
other document with respect to which the certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the tease, exclusions and
condeiara of such policies. Aggregate liMits shown may have bean reduced by paid claims.
TYPE! QF INSURANCE POLICY NUMBER DA 1M DtYYi (MMmA vY) LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILnY
PRC2 93- 11060011
_
06/09/2011
04109/2012
pACH OCCURRENCE
$ 41011•00
PRE DAMAGE (Any emit firm)
$ Nht
a
Claims Made
MED EXP (Any errs pe'eon
s N/A
1i1
mil
P R80NAL ADV INJURY
1 N1A
Manuscript Policy
GENERAL AGGREGATE
R: 5300,000.00
Gen AGGREGATE UNIT APPLIES PE*
n R�� ■ ,n LOC
PRODUCTS - COMPtDP AG
$ .
Per Person
a 1;300,000.00
11AUTOUABLTTY
AU�
1�1
Ill
MI
Ill
IM
�
IIAI
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON.OWNEDAUTOB
O,T.R.RD.
NUAL
$
BODLY INJURY
(Per Pn, n)
s
BODILY INJURY
(perAmitleni)
$
PROPERTY DAIwlAGE
iPerAaaetere)
GARAGE LIABILITY►NANUSDRBPT FORM
SOHSOULE AUTO
PER PERSON
1
111
I-1
•
IU1
Iiil
II
•
O.KLL.
DRN6 AWAY
D.O.C.
CAROO
ON HOOK
CONTRACTUAL LIABIL TY
WRONGFUL REPOSSESSION
PER ACCIDENT
s
AGGREGATE
e
PROPERTY DAMAGE
8
EXCESS
■
III
UABI.rTY
OCCUR 1111 C44lMS MADE
EACH OCCURRENCE
5
AGGREGATE
it
RETENTION t
LJMiTATION OF COVERAGE FOR ADOmONAL INSURED
D0SCRPTION OP OPERATiofsLoGATIDNSNPtuCLESIEXCLUSiONS ADDED BY ENDORBP NTISPSCIAL PROVISIONS
Coverage is timitcd to only insured Betivitics or operations an the Participant Member Declaration Certificate or as may be separately endorsed. Roofing - residential
LA 1 CERTIFICATE HOLDER U ADDITIONAL INSURE
■ LOSS PAYEE
Miami Shores Village
10050 Northeast 2nd Avonert
Miami Shores , PL 33138
Fax Number. 3057568972
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
FAILURE TO DO 80 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND
UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORED REPRESENT*
ft, 41.1vigirtil.
,
2011 -06-30 04:20
8006946363
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