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Application Type
Code Version
Application Status
Comments
Archived
Product Manufacturer
CoNdODWOONghSORATTACHMENTS
ARETHE RESPONSIBIUTY OF THE
COMR40M OR RECORD
Authorized Signature
Technical Representative
Address/Phone/Email
Quality Assurance Representative
Address/Phone/Emall
Category
Subcategory
Compliance Method
Florida Engineer or Architect Name who developed
the Evaluation Report
Florida Umnse
Quality Assurance Entity
Quality Assurance Contract 0lpiration Date
Validated By
FL1654-R22
Revision
THESE PLANS AND ALL PROPOSED WORK
2017
ARE SUBJECT TO ANY CORRECTIONS
Approved
REQUIRED BY FIELD INSPECTORS THAT
MAY BE NECESSARY IN ORDER TO
COMPLY WITH ALL APPLICABLE CODES.
r.
P LYG S
1111 W. Newport Center Drive
Deerfield Beach,
FL 33442 "
(954) 233-1378
EM 242
alender@polyglass.mm
Aries Lender
alender@polyglass.com
Maury Alpert
1111 W. Newport Center Drive
Deerfield Beach, FL 33442
(912) 429-8610
MAlpert@polyglass.com
Adel Lender
1111 W. Newport Center Drive
Deerfield Beach, FL 33442
(954) 233-1230
ALender0polyglass.mm
Roofing
Modified Bitumen Roof System
SCANNED
BY
St. Lucie County
Evaluation Report from a Florida Registered Architect or a Licensed
Florida Professional Engineer I
M Evaluation Report - Hardmpy Received
Robert Nieminen
PE-59166
UL LLC
10/06/2018
John W. Knezevirh, PE
121 Validation Checklist - Hardmpy Received
Certificate of independence FI 1654 R22 COI 2017 01 COI NI In
Referenced Standard and Year (of Standard)
Standard
Year
ASTM D6162
2008
ASTM D616
20 08
ASTM D6164
201111
ASTM D6
2011
ST. LUCIE COUNTY BUILDING D�I N
ASTM D6509
F144470
2009
2012
REVIEWED FOR
4PLIANC
FM 4474
2011
REVI E
UL 1897
2012
CAT
PLANS AND PERM MUST BE KEPT J B
SITE OR NO INSPECTIONS) WILL E ADE
m
Equivalence of Product Standards
Certified By
Sections from the Code
Product Approval Method Method 1 Option D
Date Submitted 09/14/2017
Date Validated 09/2512017
Date Pending FBC Approval 09/22/2017
Date Approved 12/12/2017
Summary of Products
FL V
Model, Number or Name
Description
1654.1
Polyglaw SBS and APP
SBS and APP modified bitumen roof systems
Modified Bitumen Roof
Systems
Limits of Use
Installation Instructions
Approved for use in HVHZ: No
FL1654 B22 11 2017 09 FINAL At ER POLYGLASS MODBIT FL3654-
Approved for use outside HVHZ: Yes
R22 odf
Impact Resistant: N/A
Verified By: Robert Nieminen PE-59166
Design Pressure: +N/A/-622.5
Created by Independent Third Party: Yes
Other: 1.) The design pressure In this
Evaluation Reports
application relates to one partictilar assembly,
FL1654 R22 AE 2017 09 FINAL R P M DB
1122.0df
over concrete deck. Refer to the ER Appendix for
other systems and deck types. 2.) Refer to ER,
Created by Independent Third Party: Yes
Section 5 for other Limits of Use.
1. :: 2601 Blair Stone Road. Tallahassee M 32399 phone: 850 487-1826
The Sfete of FbMa Is en FA/Ff0 employer. Wwrian 2002.20t] SteR M flmida. :: Rivacv Statement :: p¢esslhlirty Smttmen:: neRmd Statement
Under Horde law, email addresses are pubic remrds. If you do not wan your e-ma0 addmss mlaa a In response he a publk-reeema repast, de not seed de
mailto Mb edty.rnamed, momot the ofae by phone or by trudRioel maR.If we have any Wades, Please mntaz1050.98).1395. epu of to Sedbn 45
(1), Fbrida Saatut , enedNe 0daber 1, H112, Ikaames hoopsed under Oleptar ass, IS- must praNde the Department with an MIR adMea if they have an
emals ona Rfed may he used for oRvlal cmnmunimbe wed the lkensee. Hdweverema0 addresses are public record. If You do not wish to supply a personal a
please p W. Me Depsrenent with an snail address wh1ch ran be made avulabie M the public. To determine Uyou area Ikenaeee ueder Dopier ass, FS., I
oid bous.
product Approval ImccepUu
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FL#
Application Type
.Code Version
Application Status
Comments
Archived
Product Manufacturer
Address/Phone/Email
Authorized Signature
Technical Representative
Address/Phone/Email
Quality Assurance, Representative
Address/Phone/Email
Category
Subcategory
Compliance Method
FpplicaEon netiil
FL16048-R6
Revision
2017
Approved
Im
Td-Built'. Materials. Group, LLC
PO Box 70
Rutherford, N) 07070
(800)516-1485
david.ruiz@tribuiltmg.com
David Ruiz.
david.rui@tribuiltmg.com
David Ruiz
250 Route 17 North
East Rutherford, NJ 07073
(201) 842-2449
david.miz@tribuiltmateriaisgmup.com
Roofing
Underlayments
SCANNED
BY
-St. Lucie County
Evaluation Report from a Florida Registered Architect or a Licensed
Florida Professional Engineer
L. Evaluation Report— Hardcopy Received ,
Florida. Engineer or Architect Name who developed
Robert Niernmen
the. Evaluation Report'
Flodda License
PE-59166
Quality Assurance Entity
ULLLC
Quality Assurance Contract Expiration Date
07/18/2020
Validated. By
John W. Knezevich, PE
El Validation Checklist- Hardcopy Received
Certificate of Independence
Referenced Standard and Year (of Standard)
.Equivalence of Product Standards
Certified By
Sections from the Code
FLI6048" R6 COT 2017 01 COI Nieminen.ndf
Standard
Year
ASTM D1970
2015
ASTM G155
2005
FM 4474
2011
FRSA/TRI April 2012 (04-12).
2012
UL 1897
2012
Product Approval Method Method 1 Option D
Date Submitted 09/25/2017
Date Validated 10/01/2017
Date Pending FBC Approval 10/03/2017
Date Approved 12/12/2017
Summary of Products
f I
FL #
Model, Number or Name
Description
16048.1
TRI-BUILT Roof Underlayments
Self -adhering, modifiedbitumen roof underlayments
Limits of Use
Installation Instructions
Approved for use in.HVHZ: No
FL16048 R6 11 2017 09 FINAL ER TRI-
Approved'for use outside HVHZ: Yes
BUILT UNDERLAYbFlyTS FL16048-R6.odf
Impact Resistant: N/A
Verified By: Robert Nieminen PE-59166
Design Pressure: +N/A/-150
Created by Independent Third Party: Yes
Other: 1.) The design pressure noted herein pertains to use
Evaluation Reports
of foam -on the systems overtop the self -adhering
FL16048 R6 AE 2017 09 FINAL ER TRt-
undedaymentfor one -particular application.. See ER Section
BUILT NNDERLAYMENTS FL16048-R6.odP
5.6.4 for details. 2.) Refer to ER Section 5'for other Limits of
Created by Independent Third Party: Yes
Use.
Bah. ue.1
Cb .t Utt :: 2601 Blair Srone Road: Trllpaastee R 32399 Phonre 850-a87-1824
The Stem or nbdta b an AvoS0 employer. QNMht 2007-2013 Sam of noada.:: Prlvad Statement ::Att Sslann Statement :: Refund Slatement
T). Fbdda Salutes; eVec9ive a ber 1. 2012. licensees licensed under Chapter 455, F.S. Tort pro
rnzdp av dad may be used foroMd.1 communiratien wif the leansee. However emba addresses.
pkase GnMde the Department with an email -add. Which mn be made Bvadabb to the pubic. To
'( hhe e.
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