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FL # FL1654-R23 RECE�F�
Application Type Revision SCANNED 210�e
Code Version 2017 BY
Application Status Approved St. Luca CountyPe m5 ou O Pow c°t v
Comments90 —06)150
Archived
Product Manufacturer
Address/Phone/Email
Authorized Signature
Technical Representative
Address/Phone/Email
Quality Assurance Representative
Address/Phone/Email
POLYGLASS USA
1111 W. Newport Center Drive
Deerfield Beach, FL 33442
malper @poly l Ecomxt REVIEWED FOR
malDert@polyg lass.com
CODE COMPLIANCE
ST. LUCIE COUNTY
BOCC
Maury Alpert
malpert@polyglass.com
Maury Alpert
1111 W. Newport Center Drive
Deerfield Beach, FL 33442
(912)429-8610
MAlpert@polyglass.com
Category Roofing
Subcategory Modified Bitumen Roof System
Compliance Method Evaluation Report from a Florida Registered Architect or a Licensed Florida
Professional Engineer
011 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
09/13/2021
Validated By
John W. Knezevich, PE
.+.% Validation Checklist - Hardcopy Received
Certificate of independence
Referenced Standard and Year (of Standard)
Standard
Year,
ASTM D6162
2008
ASTM D6163
2008
ASTM D6164
2011
ASTM D6222
2011
ASTM D6509
2009
FM 4470
2012
FM 4474
2011
UL 1897
2012
Equivalence of Product Standards r
Certified By
Sections from the Code
Product Approval Method Method 1 Option D
Date Submitted 10/08/2018
Date Validated 10/13/2018
Date Pending FBC Approval 10/21/2018
Date Approved 12/11/2018
Summary of Products
i
FL #
Model, Number or Name
Description
1654.1
Polyglass SBS and APP Modified
SBS and APP modified bitumen roof systems
Bitumen Roof Systems
Limits of Use
Installation Instructions
Approved for use in HVHZ: No
FL1654 R73 11 2018 10 FINALG
R23.odf
Approved for use outside HVHZ: Yes
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 application
Evaluation Reports
relates to one particular assembly over concrete deck.
FL1654 R23 AE 2018 10 FINAL Y MOD 4
R23.odf
Refer to the ER Appendix for other systems and deck
types. 2.) Refer to ER, Section 5 for other Limits of
Created by Independent Third Party: Yes
Use.
Back Nezt
Contact Uls:: 2601 Blair Stone Pod Tallahassee FL 32399 Phone: 850-482-1824
The state of Florida is an AVEEO employer. Cpixdght 2002-2013 State of Florida.:: rPWacv Statement:: AccesslblllN Statement:: Refund Statement
Under Honda law, email addresses are public records. If you do not want your e-mail address released In response to a public -records request, do not send electronic
mail ro this entity. Instead, contact Me office by phone or by traditional mall. If you have any questions, please contact 850.487.1395. -Pursuant ro Section 455.275(1),
Florida statutes, effective October 1, 2012, licensees licensed under chapter 455, F.S. must provide one Department with an email address if they have one. The emails
provided may be used for official communication with the licensee. However small addresses are public record. If you do not wish to supply a personal address, please
provide the Department with an email address which can be made available to the public To determine if you are a licensee under chapter 455, F.S., please dI& be.
Product Approval Accepts:
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