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Product:Aoproval Menu > P'99t ar aRbllcutlon search > ARollcatl®n .18 >' Application Detail
FL It
FL1654-R27
Application Type
Revision
Code. Version
2020
Application Status
Approved
Comments
Archived
Product Manufacturer
PO�LYrC51jkSS USA _ "
Address/Phone/Email
1_iilll!!llW�W.. INeeAwport Center Drive
Deerfield Beach,; FL 33442
(954.)-233;-1330 Exb.242
malpert@polyglass.com
Authorized Signature
Maury Alpert
n.ial,bert@polyglass.com
Technical Representative
TECH REP
Address/Phone/Email
1111.West NewporfCenter Drive
Deerfield Beach, FL 33442'
(866) 802-8017
uspdlyglasst.och,nical@polygIass.com
Quality Assurance Representative
QA REP
Address/Phone/Email
1111 West Newport Center Drive
D4erfield Beach, FL 33442
(8f38) 410.1375.`
uspolyglasstechnicai@ polyglass.com
Category
oof
Subcategory
odififed Bltunle Roo S s et�
RECEIVED
JAN 2 8 1011
Permitting Department
St. Lucie County
Fm � L F E_ ' P Y
W-212, -105.0
page 37 of � 4
SBS-S astofle> S` V
SBS-SA-E'lastofie SAP
Compliance `Method Evaluation Report from a Florida Registered Architecr'or a Licensed Florida
Professiopal Engineer
Evaluation Report - Hardcopy Received
Florida Engineer or Architect -Name who developed the Robert Nieminen
Evaluation Report
Florida License PE-59166
Quality Assurance Entity UL LLC
Quality Assurance Contract Expiration -Date 11/07/.2022
Validated By John' W. Knezevich,.PE
Certificate of Independence.
Referenced Standard and Year (of Standard)
Validation Checklist Hardcopy Received
FL1654 R27 'COI 202n nv rOI IU�FMINEN pOf
.Standard
year
.ASTM D4601
2012
ASTM D4897
2009
.ASTM'D6162
2015
ASTM D6163
2015
ASTK D6164,
2011
ASTM D6222
2011
ASTM D6509
2015
ASTM G1.55
2013.
FM 4470
2016
FM 4474
2'O11
UL 1697
2012
Equivalence of Product Standards
Certified By'
Sections frorn the Code
Product Approval Method
Method 1 Option D
Date :Submitted
10/02/2020
Date 'Validated
10/04/2020
Date�Pending FBG,Approval
10/12/Z020
Date Approved
12/15/2020
FL-# Model, Number or Name
Descriotien
.Limits of .Use
Approved•for use in-HVHZ: No
Approved'for use outside:HVHZ: Yes
Impact;Resistant: N)A.
Q(isign Pressuret +N/A/-622:5
Other: 1) The design, pressure, in this application relates
to one particular assembly
:over concrete- deck. Refer to the
ER Appendix for other systems and deck types: 2.) Refer to
ER, Section 5 for otherbmits oFUse: 3) Refe
for HVHZ jurisdictions. rto FL16717
Installation Instructions
BZZaR.df. % " . -
Verifed By: Robert'Nleminen PE-59166
Created--by1ndependentThird Party: Yes
Evaluation.; Reports;
FLif54 R27 AE 2020 '09 30 'FINAL Ea PC tinng� FL16Sd
B?LpAf
Created by Independent -Third Party: Yes
Contact.Us ::,260I'Alair Stone Road, Tallahassee FL=32399 phone: 850-487=1824
The State of Florida is an AA/EEOemployer. Pag44ght 2007-2013 State of Floritla ; 4!t acyStatement Accessibility Statement : Refund Statement
:Under Florida law,.'email,addresses are public records .If'you do not want your e-mail address releaseG in response to.a public -records requestldo not send electronic
Florida Statutes,
entity. Instead, contact he office Jjy phone or by traditional mail. If you have any questions, please contact 850.487:1395. *P,ursuant-to Section 45S 275(1),
Florida Statutes, effective°Dctnbeir 1, 2012, licensees,licensed under Chapter 45S, Fs. must, provide the Department with an email address if'ihey-have one. The e'mails
provided'may be.used:for official communication with the licensee. However email addresses are publlc,record.'Ifyou do not wish to suppiya personal address, please
.Provide:th4 Department with an.email address which can�be made available to the public. To determine if you area licensee under Ch'apter455; F.S., please click here
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