Loading...
HomeMy WebLinkAboutSUBMITTED PAPERSDATE: FEES DUE: \I RECEIPT #: Permit #: Planning & Development Services Department Building & Code Regulation Division SCANNED 2300 Virginia Avenue Y Ft. Pierce, FL 34982-5652 ,5 Tel.772-462-1553 �' LUCI@ COunty APPLICATION FOR ROOF PERMIT 1. Location/Site Addri 2. Parcel ID Number: Office Use Only Section Townshi Range Map Page Zoning Land Use Initials 3. Description of Project or Work Activity:e�����' 4. Total Roof Area (square feet): Q 5. Roof Pitch: 6. Type of Roof: [ Fiberglass Shingle [ ] Concrete Roof Tile [ ] Wood Shake / Shingle [ ] Tar & Gravel [ ] Modified Bitumen [ ] Other [ Product Approval required for all types of Roofing Material (2 Sets) [ ] All Commercial Roofing requires design by an Engineer or Architect (2 Sets) with Product Approval attached ** Roof Mitigation per F.S. 553.844 will be required. 7. Owner Information 1 8. Contractor Information Name: Y 4� FL Reg/Cert #: L20, 0, S 2 G `� Address:�XiEACounty Cert #: a -so I R City: gulamchtA State: Business Name-, � Zip: co n Phone: 41 0APhone: �1,k-dMk 9. Value of Construction: $ 'Note Dry -in and Final Inspection Required. Additional inspection may be required per Product Approval. CONTRACTOR/OWNER'S AFFIDAVIT: I certify that all of at mation contained in this application is correct and that all work will be done in complian wapplicable laws regulating construction and zoning. PRINT - ALIFIERS/OWNERS NAME SIGNATURE OF QUALIFIER/OWNER STATE OF FLORIDA, COUNTY OF I I ACKNOWLEDGED BEFORE ME THIS �_ DAY OF WHO PE SONA OWN TO ME OR HAS PRODUCED AS IDENTIFICATION NOTARY PUBLIC -STATE OF FLORIDA Karen S. Nielsen SIG R OF NO A TYPE OR PRINT NAME OF NOTARY (seal) Commission #DD1000358 COMMISSION NUMBER BO,,,­..-'Expires- DED ' Expires; JUKE 12, 2014 7T3RU ATLANTIC BONDING CO,, INC NOTICE TO OWNER: 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 YOUR LENDER OR ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Revised 4/26/2010 2014-01-13 17:08 j.a.tayLo -roofing 772 468 8397 >> P 4/7 DATE: �' FEES DUE: RECEIPT#: Permit ._ L .� " Planning & Development Services Departm nth a Building & Code Regulation Division a e 2300 Virginia Avenue Ft, Pierce, FL 34982-5657 Tel, 772-462-1553 APPLICATION FOR ROOF PERMIT 1. Location/Site Addn 2. Parcel ID Number: oirce Use Only Section Townshio Range Map Page I Zoning Land Use Initials 3. Description of Project or Work Activity �K1Y-Q,lhin� 4. TotaI Roof Area (square feet): 5. Roof Pitch: 6. Type of Roof: [ Fiberglass Shingle [ ] Concrete Roof Tile [ ] Wood Shake / Shingle [ ] Tar & Gravel [ ] Modified Bitumen [ ] Other [Vf Product Approval required for all types of Roofing Material (2 Sets) [ ] All Commercial Roofing requires designs by an Engineer or Architect (2 Sets) with Product Approval attached Roof Mitigation per F.S. 553.844 will be required. 7. Owner Information8. Contractor Informattiionn Name: ) !�,• FL Reg/Cert #: �;(-,(�j S Address: County Cert #:aSC City: State: Wk Business Name• 71 Zip: Phone: 1 4A Phone• �bk-�o� 9. Value of Construction: $ Gd "Note Dry -in and Final Inspection Required. Additional inspection may be required per Product Approval. CONTRACTOR/OWNER'S AFFIDAVIT, 1 eert4 that all o L.- contained in this application is correct and that all work will be done in complianall applicable lows regulating construction and zoning. PRINT' Q ALIFIF,RS/OWNERS NAME SIGNATURE OF QIIALIFIER/OWNF,R STATE OF FLORIDA. COUNTY OF ! ACINNOW LEDCED t3EFORF. MF, THIS DAY OF 20_a, FIY WHO P9 'ONA KNOWN L TO ME OR HAS PRODUCED AS IDENTIFICATION NOTARY PUBLIC -STATE OF FLORIDA �'..., J Karen S, Nielsen SICNA OF NOTARY TYPE OR PRINT NAME OF NOTARY (scat) `COgltt7j55(Otl #Dpelsen 8 COMMISSION NUMBER DONDEpg� p ��' DUNE 12, 2014 TUVnC DONDInG CG., rjC. NOTICE TO OWNER: 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 YOUR LENDER OR ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Rcvigcd 4/2G�Ot0 2014-01-13 17:09 j.a.taylc^ I-oofing 772 468 8397 >>, P 5/7 11v11any rFIFnaIOPI-Jk.I-4V1%w VVYll"yl 1 L I 4irF1.11WWW.j1A.71M.V .7Rdj11M.C1Qw r lil w1U—J4VLVVLV4 I uVVVL Arlllul I. UeSalltis Kcrord; I ul' 1 Property Idenlilicnlinn Sitc Address; 651 HOWARD ST Scc/fown/Ronge: 11 :36S :40E Map ID: 34/1 IN Zoning: RS-3 01vilershlp and mallinl! Owner: Arthur L Wands Address: 69 Market St Northtnnpton MA 01060 PROPERTY RECORD CARD -:-:Prcv Ncxta: Spec.Assmnt Tascy FNewlitiuns llernlils Iliwiv Print ICI! Potec11D; 3402-602-0218.000.2 Al`� Account 11: 36575 ,.. Use Type: SP Res City/Cnty; Saint Lucie County 1. clsl 1111Yerip Boll INDIAN RIVER ESTATES -UNIT I. BLK7 E 1/2 Of LOTS l AND 2 (MAP 34/11N) (OR 3579.1596) S411•s In1'111npd11111 Assessmrn1 21113 Date Price Code Deed Bouk/Puge 2013 Final; 72400 11/7/2013 120000 0001 WD 3579 / 1596 Asscsscd; 72400 9/4/2013 100 0111 QC 3567 / 0291 Ag.Crcdit; 0 12/20/2012 100 0111 QC 3470 / 1831 Exrmpt; 8/12/1999 100 01 QC 124411185 Tilxablc; 1/17/1995 103000 00 WD 0937/2361 Taxes; 1466,28 7/1/1993 126500 01 WD 0848 12708 2/26/1993 16000 01 WD 0829/ 2875 3/1/1973 4800 00 CV 0211 / 2976 11111Al11111�11h3K1]lA]hV Y [1)►I Exinior Fuittlres Vices; - ltoolCovcr; ExYI ypc; HC- - HC- YMBlt: Grade: C- - C- EuYrolt; Storyl•lght: 0010-I Story No.Units: Interior F'rnulrls BedRnams; 3 Ocetric: I.,u11814h; 2 HeatType: 1/2BIrth: 0 I'leutFueI. %A/C:: 100 °/ Hated; Special i-natures and lard Itrim Type Y/S Qty, Units Qual. Cond. DWG - Dtiv-Concrct Y I 720 AV AV FEN4 - CHAINLINK 4' Y 1 180 AV AV Tofill I'luld null ISuittligl; Land Valu �32Q9Alecr; 0.45 Building —WI 59200 __-`, Finished Area: 77ti svr SO - Dim Shin& RoolStruct; GA - Goble r-�Ii99 Frame; - �y�/� primewalt; FS - Frm Stucco 1 Secwlll l: - MX - MAXIMUM PrmintWidl: DW • Drywall PHA . PrcdHotAir AvgHt/121: ELEC - Electric Prm. F Iorv: C11- Carpet 100 ^/otiprinklcd; 0 Land Inforulnlimi YrBlt, No, Use Typc 'Type Mo►= Depth 1993 1 0I00-SF Res 81-Front Ft 150 132 1999 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED, Page 1 of 1 2014-01-13 17:08 j.a.taylor roofing 772 468 8397 >>P 1/7 Ftesldentlal Commercial ja 0 ROOFING CONTRACTOR E-MAIL: karenfortaylor@aol.com FAX COVER SHEET DATE January 13, 2014 FAX # 462-1578 ATTN: Audrey FROM Karen Nielsen COMPANY SLC Permitting # PAGES Including Cover 7 Here are the Permit Apps (with Property Appraisers Sheets) that I will be bringing in. YOUNG / 2459 SWEETWATER DRIVE DESANTIS / 651 HOWARD STREET DESANTIS / 5615 BUCHANAN DRIVE Thanks for all your help! I Know I sent some in last week. Haven't been able to get out of the office. I will be in tomorrow to get them all. (6) 302 Melton Drive Fort Pierce, Florida 34982 Phone: 772.466.4040 Fax: 772.468,8397 REPAIRS, RE -ROOFS, NEW COMMERCIAL & RESIDENTAL ROOFING CONTRACTGORS SERVING FLORIDA SINCE 1965 LICENSE #CCC1325720 2014-01-17 13:38 j.a�------rlor roofing 772 468 87- '-. >> 7724626443 P 1/1 COUNTY F L Q R f D A + Re: Permit # i Planning & Development Services Building & Code Regulation Division 2300 Virginia Avenue Fort Pierce, FL 34982 772-462-2165 or 772-462-2172 Fax: 772-462-6443 ROOF INSPECTION AFFIDAVIT I, `> i Lk licensed as ontractor* Engineer/Architect (Please print name & circle license type) *FS4 ul InQ nspector *General, Building, Residential or Roofing Contractor or any Individual certified under 468 F.5. to make such an Inspection. On or about I did personally inspect the roof deck nailiniz (Date) work at: 'Ir (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 and Seal OjOL IS Z5 U License # SPATE OF FLORI PA. COUNTY OF Sworn o nd subscri�qd before me this l da f 20A by��, i.LS�ti't"�° Who Is pe nally k own to me o who has produced as Identification. Notary Public State of Flor a Signature of Commission Number: (Seal) NOTARY PUBLIC-STATF. OP FLORIDA En 01/19/2011 • "aren S. Nielsen CDm111ission#DD]000358 13DNI1$D THxu ATLPMIC IIUNDINr,CO, iNC RECEIVED JAN 171014 JOSEPH E . SMITH, Q -'-Z OF THE CIRCUIT COURT - SAIZ;�---' �XCIE COUNTY FILE # 3915162 OR _'.)OK 3595 PAGE 1099, Recorded' ?(14/2014 at 10:24 �/ NOTICE OF COMMENCEMENT TO BE COMPLETED WHEN CONSTRUCTION. VALUE EXCEEDS $2AW.00 OR WHEN HEATING OR AIR CONDITIONING REPAIR OR REPLACEMENT EXCEEDS $7,500A0 PERMIT IF: TAXFOLIOF, 2�01.60)- OZ,I$- CC©' 2 State of Ftodd% Coady of , the undersigned hereby gives notice that improvement will be made to certain red property, and In accordance with chapter 713, Florida statutes, the following information Is provided in this notice of Commencement. I. LEGAL DESCRIPTION OF PROPERTY (AND STREET ADDRESS IF AVAILABLEr 6 S 1 RO W,fR o Sr,, FT- PIE Ia eE FL IRE I)Nlr I, BLK YE IA OF LorS 14-4 (M4P 34f/iIN) 3A171a 2. GENERAL DESCRIPTION OF IMPROVEMENT: RE- Rooi= Vi-rH SHItt 6S 3. ®OWNER INFORMATION or []LESSEE INFORMATION (If Lessee contracted for fhe Improvement) a. Name: A RTNdR 4. DE 6A 1FIT(S Address: Gel M,)RKFr S-r, NORT HAPrPTOMI I11A0rG6C b. Interest in property: S vr'. E G W N£ R c. Name and addressof fee simple title holder (if other than owner): N/A 4. CONTRACIOIt a. Name: J.A. TAYLORFtOORNG, INC. Address 302 MELWN DRIVF, FORTPIEixF, R. 34982 b. Phone number. 772-4ee-4040 S. 9AWTYCOMPANY (IFApplbable,acopy ofthepayment bond Isallnchad): a. Name 8 Addrous_N/A b. Phone number. Bond amount: B. LENNDEWMORTGAGECOMPANY: a. Name 8 Addreaq_N/A b. Phone number. 7. PENBONSWI7HIN1HESMIEOFFLORIDA DESIGNATED BYOWNHtUPONWHOM NO11Ct$OR07H6NDOCUMENISMAYBE St381EDAS FWVIDEDBY SM1aON 717.13 (1) (a) 7., RDRDA 8TAN103 a. Name 8 Address _N/A b. Phone number fax number. 8. IN ADDITO N 10 HIMSE F O R HBNBEF, a. Ownerdeegnatea_NIA of to receive a copy of the flenor's notice as provided in section 713.13(I) (b), Florida statues. b. Phone number. 9. D(PIFAMON DAIEOFNOIICEOFCOMMENCBNENP (11HE EXPIRATION DATE ISONE (1) YEAR FROM THE DATEOF RECORDING UNLFBSA DIFFSBNTDAIE IS53MIRED). WAKING 10 OWNOe ANY FAYlFB:ISMADRNY 180WNERAFERINEXIVIAWN OFIENOVUOFCOMMMWMMTARECONSDEW NRORMPAYMUM UNDetCNAFBt711, INRr4 ND70N 713.13, ROFOA SKILI 6AND CAN RNLTN YOUtPAYNO WWAFORNROVMWM DYOU PMPWY, A NOIOEOPCOMMMNCURRIT MUSTFEPWORM ANDFOSW ON 1EJOeeiI00R31EPWNiCTON. RYOUN7a)10 ORIAN RNANCNO,CONaLTwnm OURLemONRORAN ATOMWWC MCOMM060M WOR(ORFFCOMM4 YOURNOICEOFCONNOXMIMIL UNDER PE3NAUI6OF PERJURY, I DE9CLAREIFIAT1 HAVE READ 11HE MIREGOING AND IHATlHE FiACTSIN rrARE7RUEIO THE 8ESrOFMY KNOWrEOGo�EC ANDBEUEF(S)1IION9925SS 25,FLORIDASTATUTE •rE.yn Js, r J0 Ii� 6 C 9GNA1=OFOVME RorIESSEE or OWNER'S AURIORIZED OFiiCBt/DIFIECTOR/PARfNER/MANAGER - SIGNAOORRPS TITLE / OFRCE 1HEFORE30INGINSIHLIMEN WASACI(NOWLFDGEDI$OREME'HIS//�DAYOF_d/?-o_, 20j,�,EK: III -., _F, . NAME OFPEREONTYPE OFAUTHORTY NAMEOFPARTYONBEHWLFOFWHOMINSTRUMENTINASEX(Ey UTED ��jj 401ARWY FERSID! HNONM OR XPRDOWEDIDENIRICA10N1YPEOFtMIFICAlIONPRODI1C® SS( 1aIUp� ' �r � (mil Zl �201'1 90NAILI E / NOTArdr ENIED NAME / NOTARY SEAL JEANNA MISISCHIA Ulf Notary MASS ublic COMMONWEALTH Co LTH Commission on Expires My Commission Exptree October 21, 2017 STATE OF FLORIDA ST. LUCIE COPTY V�I THIS ST CERTIFYTTRUE H CORRECT ORIGIN _ , A Dale' 'A1 2�14 A Property Appraiser- St.Lucie County, FL Arthur 1. DeSantis Record: 1 of I Property t(lentification Site Address: 651 HOWARD ST Sec/Town/Range: 11 :36S :40E Map ID: 34/11N Zoning: RS-3 http://www.pas °`-, g/paslc/prc.asp?prclid=340260202180002 PROPERTY RECORD CARD - «Prey Next» Spec.assmnt Taxes Exemptions Permits Home Print ParcellD: 3402-602-0218-000-2 2 Account #: 36575 Use Type: City/Cnty: SF Res Saint Lucie County Ownership and Mailing Owner: Arthur L DeSantis Address: 69 Market St Northampton MA 01060 Sales Information Date Price Code Deed Book/Page 11/7/2013 120000 0001 WD 3579 / 1596 9/4/2013 100 0111 QC 3567 / 0291 12/20/2012 100 0111 QC 3470 / 1831 8/12/1999 100 01 QC 1244 / 1185 1/17/1995 103000 00 WD 0937 / 2361 7/l/1993 126500 01 WD 0848 / 2708 2/26/1993 16000 01 WD 0829/2875 3/l/1973 4800 00 CV 0211 / 2976 u Il Pin 7 am 1! 11 ers u (nll7 se '4 Is (� OPM 31 M) Legal Description INDIAN RIVER ESTATES -UNIT I- BLK7 E 1/2 OF LOTS 1 AND 2 (MAP 34/11N) (OR 3579-1596) Assessment 2013 Total Land and Building 2013 Final: 72400 Land Value,;.-- - 13200Acres: 0.45 Assessed: 72400 Building ue: 59200 Ag.Credit: 0 Finished Area: q Exempt: Taxable: Taxes: 1466.28 BUILDING INFORNIA Exterior Features View: RooiCover: ExtType: HC- - HC- YearBlt: Grade: C- - C- EIJYrBlt: Storyllght: 0010 - 1 Story No.Units: Interior Features BedRooms: 3 Electric: FullBath: 2 Heat'rype: 1/213ath: 0 I IeatFuel: °/QVC: 100 %Heated: Special Features and Yard Items Type Y/S Qty. Units Qual. Cond. DWC — Driv-Concret Y 1 720 AV AV FEN4 — CHAINLINK 4' Y 1 180 AV AV SD - Dim Shingle RooiStruct: GA - Gable 1993 Frame: - PrimcWall: FS - Frm Stucco 1 SecWall: - MX - MAXIMUM PrmintW all: DW - Drywall FHA - FrcdHotAir AvgHt/Fl: ELEC - Electric Prm.Flors: CU - Carpet 100 %Sprinkled: 0 Land Information YrBlt. No. Use Type Type Measure Depth 1993 1 0100-SF Res BI-Front Ft 150 132 1999 THIS INFORMATION IS BELIEVED TO BE CORRECT AT THIS TIME BUT IT IS SUBJECT TO CHANGE AND IS NOT WARRANTED. Page 1 of 1 Florida Building Code Online Page 1 of 2 g' k wO t,. QM ^•-»-r•«,.-:. i. BCIS Home Log In ° User Registration : Hot Topics Submit Surcharge i Stats &Fads Busines'i P_ rofessiorial --^ ►U ERd"`t Approval User 4uc `;'��GIIVn C. 12 Publications FBC Staff BCIS Site Map Links Search Product Aap�ovaI Menu > Product or Application Seara•n > Anaticahoc list > AppUwtion Detail 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 Florida Engineer or Architect Name who developed the Evaluation Report Florida License Quality Assurance Entity Quality Assurance Contract Expiration Date Validated By Certificate of Independence FL6785-R5 Revision Approved Carlisle Coatings & Waterproofing 900 Hensley Lane Wylie, TX 75098 (717) 245-7000 Ext 7456 wert@syntec.cariisle.com Chad Wert Overt@syntec.carlisle.com FIL.E Copy 7URoofing I I C) 0 d LOPr erlayments Evaluation Report from a Florida Registered Architect or a Licensed Florida Professional Engineer Ewl Evaluation Report - Hardcopy Received Referenced Standard and Year (of Standard) Equivalence of Product Standards Certified By Sections from the Code Robert Nieminen PE-59166 UL LLC 11/08/2013 John W. Knezevich, PE .21 Validation Checklist - Hardcopy Received FL6785 R5 COI Trinity ERD CI - Nieminen.pdf Standard Year ASTM D1970 2001 http://floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDgvkdyKrmfaLgB2sB%... 7/ 17/2013 Florida Building Code Online Page 2 of 2 Product Approval Method Date Submitted Date Validated Date Pending FBC Approval Date Approved Method 1 Option D 10/12/2012 10/15/2012 10/22/2012 12/04/2012 FL # Model, Number or Name Description 6785.1 CCW Roof Underlayments Self -Adhesive Roofing Underlayments Limits of Use Approved for use in HVHZ: No Approved for use outside HVHZ: Yes Impact Resistant: N/A Design Pressure: N/A Other: 1.) Refer to ER Section 5 for Limits of Use 2.) Refer to ER Section 6 for Installation Instructions FL6785 R5 11 er101212FINAL CAR ISLE UNDERLAYMENTS 1-L.6785_ R5.adf Verified By: Robert Nieminen 59166 Created by Independent Third Party: Yes Evaluation Reports FL6785 R5 AE er101212FINAL CARLISLE UNDERLAYMENTS FL6785_: RS.pdf Created by Independent Third Party: Yes Installation. Batk Next Contact Us :: 1940 North Monroe Street, Tallahassee FL 32399 Phone: 850-487-1824 The State of Florida is an AA/EEO employer. Copyright 2007-2010 State of Florida.:: Privacy Statement :: Accessibility Statement :: Refund Statement Under Florida 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 to this entity. instead, contact the office by phone or by traditional mail. If you have any questions, please contact 650.487.1395. 'Pursuant to Section 455.275(1), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee. However email 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 click here . Product Approval Accepts: `Cr«] M re it E http://floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDgvkdyKrmfaLgB2sB%... 7/ 17/2013 EXTERIOR RESEARCH & DESIGN, LLC. Certificate of Authorization #9503 tfJ 353 CHRISTIAN STREET, UNIT #13 P TRINITY ! ERD OXFORD, CT 06478 PHONE: (203) 262-9245 FAX: (203) 262-9243 EVALUATION REPORT Carlisle Coatings & Waterproofing Evaluation Report C39180.12.11-R2 900 Hensley Lane FL6785-RS Wylie, TX 7SO98 Date of Issuance: 12/09/2011 Revision 2: 10/12/2012 SCOPE: This Evaluation Report is issued under Rule 9N-3 and the applicable rules and regulations governing the use of construction materials in the State of Florida. The documentation submitted has been reviewed by Robert Nieminen, P.E. for use of the product under the Florida Building Code and Florida Building Code, Residential Volume. The products described herein have been designed to comply with the 2010. Florida Building Code sections noted herein. DESCRIPTION: CCW Roof Underlayments LABELING: Each unit shall bear labeling in accordance with the requirements the Accredited Quality Assurance Agency noted herein. CONTINUED COMPLIANCE: This Evaluation Report is valid until such time as the named product(s) changes, the referenced Quality Assurance documentation changes, or provisions of the Code that relate to the product change. Acceptance of this Evaluation Report by the named client constitutes agreement to notify Robert Nieminen, P.E. if the product changes or the referenced Quality Assurance documentation changes. TrinityJERD requires a complete review of this Evaluation Report relative to updated Code requirements with each Code Cycle. ADVERTISEMENT: The Evaluation Report number preceded by the words "TrinitylERD Evaluated" may be displayed in advertising literature. If any portion of the Evaluation Report is displayed, then it shall be done in its entirety. INSPECTION: Upon request, a copy of this entire Evaluation Report 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 Evaluation Report consists of pages 1 through 4. Prepared by: ow - - The facsimile seal appearing was authorized =— by Robert Nieminen, P.E. on 10/12/2012 This does not serve as an electronically signed •�%,,�'; hardcopies have been Robert 3.M. Nieminen P.E. , document. Signed, sealed s�. s.;,.• ���_���, transmitted to the Product Approval Administrator and Florida Registration No. 59166, Florida DCA ANE1983 ;����� ��� to the named client CERTIFICATION OF INDEPENDENCE: 1. TrinitylERD does not have, nor does it intend to acquire or will it acquire, a financial interest in any company manufacturing or distributing products it evaluates. 2. TrinitylERD is not owned, operated or controlled by any company manufacturing or distributing products it evaluates. 3. Robert Nieminen, P.E. does not have nor will acquire, a financial interest in any company manufacturing or distributing products for which the evaluation reports are being issued. does have, nor will acquire, process of the a financial interest in any other entity involved in the approvalp 4. Robert Nieminen, P.E. not product. � TRINITY , ERD ROOFING COMPONENT EVALUATION: 1. SCOPE: Product Category: Roofing Sub -Category: Underlayment Compliance Statement: CCW Roof Underlayments, as produced by Carlisle Coatings & Waterproofing, have demonstrated compliance with the following sections of the Florida Building Code through testing in accordance with the -following Standards. Compliance is subject to -the -Installation Requirements and Limitations / Conditions of Use set forth herein. 2. STANDARDS: Section Property Standard Year 1507.2.4, 1507.2.9.2, Physical Properties ASTM D1970 2001 1507.5.3 3. REFERENCES: Entity Examination Reference Date ERD (TST6049) Physical Properties C41280.10.12 10/05/2012 MTI (TST2508) Physical Properties PX02MOA 01/17/2011 MTI (TST2508) Physical Properties PXI6MOA 01/18/2011 MTI (TST2508) Physical Properties PXI3MOB 01/18/2011 M-D (CER1592) HVHZ Compliance 09-0630.13 08/12/2009 ICC-ES (EVL2396) 2009 IBC Compliance ESR-1556 03/01/2012 ICC-ES (EVL2396) 2006 IBC Compliance ESR-2206 03/01/2012 UL, LLC. (QUA9625) Quality Control TGDY.R18678 Listing 10/18/2010 UL, LLC. (QUA9625) Quality Control Inspection Report, R18678 02/20/2012 4. PRODUCT DESCRIPTION: 4.1 CCW WIP 100 is a self -adhering, fiberglass reinforced, granule surfaced, rubberized asphalt roof underlayment. 4.2 CCW WIP 250 is a self -adhering, fiberglass reinforced, film surfaced, rubberized asphalt roof underlayment. 4.3 CCW WIP 300HT is a self -adhering, coated-polyolefin-composite film surfaced, rubberized asphalt roof underlayment. 5. LIMITATIONS: 5.1 This Evaluation Report is not for use in the HVHZ. 5.2 Fire Classification is not part of this report; refer to current Approved Roofing Materials Directory for fire ratings of this product. 5.3 CCW Roof Underlayments may be used with any prepared roof cover where the product is specifically referenced within FBC approval documents. If not listed, a request may be made to the AHJ for approval based on this evaluation combined with supporting data for the prepared roof covering. Exterior Research and Design, LLC. Evaluation Report C39180.12.11-R2 Certificate of Authorization #9503 FL6785-R5 Revision 2: 10/12/2012 Page 2 of 4 TRfNITY'� ERD 5.4 Allowable roof covers applied atop the underlayments are follows: Table 1: Roof Cover Options Underlayment Asphalt Shingles Nail -On Tile Foam -On Tile Metal Wood Shakes & Shingles Slate & Synthetic Slate/Shake CCW WIP 100 Yes No No No No No CCW WIP 250 Yes No No Yes No No CCW WIP 300HT Yes No No Yes No Yes 5.5 Allowable substrates are noted below: 5.5.1 Direct -Bond to Deck: Self -adhering membranes applied to: New untreated plywood; Primed new untreated plywood; e Existing plywood; Primed existing plywood; Note: While not required, CCW-702 or CAV-GRIP primer may be used when deemed appropriate or when temperatures are below 40°F. 5.5.2 Bond to Mechanically Attached Base Laver: Self -adhering membranes applied to: ASTM D226, Type I or II felt; For installations under mechanically attached prepared roof coverings, base layer shall be attached per minimum codified requirements. 5.6 Exposure Limitations: 5.6.1 CCW WIP 100, CCW WIP 250 and CCW WIP 300HT shall not be left exposed for longer than 30-days after installation. 6. INSTALLATION: 6.1 CCW Roof Underlayments shall be installed in accordance with Carlisle Coatings & Waterproofing published installation requirements subject to the Limitations set forth in Section 5 herein and the specifics noted below. 6.2 Re -fasten any loose decking panels, and check for protruding nail heads. Sweep the substrate thoroughly to remove any dust and debris prior to application. Prime the substrate (if applicable) with CCW-702 or CAV-GRIP Primer. 6.3 CCW WIP 100, CCW WIP 250 and CCW WIP 300HT: 6.3.1 Shall be installed in compliance with the requirements for ASTM D1970 underlayment in FBC Sections 1507 for the type of prepared roof covering to be installed. 6.3.2 While not required, CCW-702 or CAV-GRIP primer may be used when deemed appropriate. Priming is required when temperatures are below 400F. 6.3.3 Cut WIP roofing underlayment into 10 to 15 ft lengths. Remove 2 to 3 ft of release film and align the edge of the membrane, sticky -side down, so it overhangs the drip edge by 3/8-inch. Continue to remove release film and press as you move across the roof. Use a hand roller and/or hand pressure to press into place. Exterior Research and Design, LLC. Evaluation Report C39180.12.11-R2 Certificate of Authorization #9S03 FL6785-R5 Revision 2: 10/12/2012 Page 3 of 4 j TRIi�IIIY ERD 6.3.4 Horizontal seams should be minimum 3.5-inches, configured to shed water. Vertical seams should be 6-inches and staggered not less than 2-ft from vertical seams in the course below. 6.3.5 Consult Carlisle Coatings & Waterproofing for steep slope & back nailing requirements. 6.3.6 For Valleys and Ridges: Cut WIP roofing underlayment into manageable lengths. Align over the center of the valley, hip or ridge. Remove release film. Press the middle of the membrane first before working toward the edges. For open valleys, cover roofing underlayment with metal valley liners. 7. LABELING: Each unit shall bear a permanent label with the manufacturer's name, logo, city, state and logo of the Accredited Quality Assurance Agency noted herein. S. BUILDING PERMIT REQUIREMENTS: As required by the Building Official or Authority Having Jurisdiction in order to properly evaluate the installation of this product. 9. MANUFACTURING PLANTS: Contact the manufacturer or the named QA entity for plants covered under Rule 9N-3 QA requirements. 10. QUALITY ASSURANCE ENTITY: UL, LLC- QUA9625; (847) 664-3281 - END OF EVALUATION REPORT - Exterior Research and Design, LLC. Evaluation Report C39180.12.11-R2 Certificate of Authorization #9503 FL6785-R5 Revision 2: 10/12/2012 Page 4 of 4 Florida Building Code Online Page 1 of 2 t .6 Y BCIS Home Log In User Registration ; Hot Topics Submit Surcharge Stats &Facts s Pul Busines �� Professional �a Approval P ERdu ict User y Regulation Product Approval Menu > Product or Application Search > Fpplicaticn List > Application Detail WAM FL # FL10674-RS y Application Type _ --Revl5jOn Code Version Application Status Approved Comments Archived El Product Manufacturer Address/Phone/Email Authorized Signature Technical Representative Address/Phone/Email Quality Assurance Representative Address/Phone/Email Category Subcategory Compliance Method I p Cations ; FBC Stall ; BCIS Site Map ;Links i Search Owens Corning One Owens Corning Parkway Toledo, OH 43659 (740)404-7829 greg.keeler@owenscorn i ing.com Greg Keeler greg. keel er@owens orrt� Mel Sancrant i Owens Corning PKWY',' Toledo, OH 43659 (419)376-8360 mel.sancra nt@owenscornig -com C®py I Roofing` Asphalt Shingil } Evaluation Report from°a Florida Registered Architect or a Licensed Florida Professional Engineer 2 Evaluation Report;Hardcopy Received Florida Engineer or Architect Name who developed the Evaluation Report Florida License Quality Assurance Entity Quality Assurance Contract Expiration Date Validated By Certificate of Independence Referenced Standard and Year (of Standard) Equivalence of Product Standards Certified By Robert J.M. Nieminen ; PE-59166 UL LLC 09/26/2014 John W. Knezevich, PE,' Validation Checklist - Hardcopy Received FL10674 R8 COI Trinity ERD CI - Nieminen.odf Standard ASTM D3161, Class F ASTM D3462 ASTM D7158, Class H Year 2006 2007 2007 http://floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDgtBNbEY5 V%2boQT... 6/ 19/2013 Florida Building Code Online Page 2 of 2 Sections from the Code Product Approval Method Method 1 Option D Date Submitted 12/19/2012 Date Validated 12/20/2012 Date Pending FBC Approval 12/25/2012 Date Approved 02/04/2013 Sum am ry of Products FL # Model, Number or Name Description 10674.1 Owens Corning Asphalt Roofing 3-tab, laminated, starter, and hip & ridge I Shingles and Starters Limits of Use Approved for use in HVHZ: No Installation Instructions FL10674 R8 II er121912FINAL OC Asphalt Approved for use outside HVHZ: Yes Shingles FL10674-RS.pdf Impact Resistant: N/A Verified By: Robert 3. M. Nieminen PE - 59166 Design Pressure: N/A Created by Independent Third Party: Yes other: Refer to ER, Section S. Evaluation Reports FL10674 R8 AE er121912FINAL OC Asphalt Shingles FL16674-RS.Pdf Created by Independent Third Party: Yes Back Next Contact Us :: 1940 North Monroe Street Tallahassee FL 32399 Phone: 850-487.1824 The State of Florida is an WEED employer. Copyright 2007-2010 State of Florida.:: Privacy Statement :: Accessibility Statement :: Refund Statement Under Florida 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 to this entity. Instead, contact the office by phone or by traditional mail. If you have any questions, please contact 850.487.1395. •Pursuant to Section 455.275(S), Florida Statutes, effective October 1, 2012, licensees licensed under Chapter 455, F.S. must provide the Department with an email address if they have one. The emails provided may be used for official communication with the licensee, However email 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 click here . Product Approval Accepts: a M s�Yvrity+trnurs http://floridabuilding.org/pr/pr_app_dtl.aspx?param=wGEVXQwtDgtBNbEY5 V%2boQT... 6/ 19/2013 EXTERIOR RESEARCH & DESIGN, LLC. (—)o Certificate of Authorization #9503 353 CHRISTIAN STREET, UNIT #13 TRINITY ERD OXFORD, CT 06478 PHONE: (203) 262-9245 FAX: (203) 262-9243 EVALUATION REPORT Owens Corning Evaluation Report 037940.02.12-112 One Owens Corning Parkway FL10674-RS Toledo, OH 43659 Date of Issuance: 02/06/2012 Revision 2: 12/19/2012 SCOPE: This Evaluation Report is issued under Rule 9N-3 and the applicable rules and regulations governing the use of construction materials in the State of Florida. The documentation submitted has been reviewed by Robert Nieminen, P.E. for use of the product under the Florida Building Code and Florida Building Code, Residential Volume. The products described herein have been designed to comply with the 2010 FBC and 2010 FBC Residential Volume sections noted herein. DESCRIPTION: Owens Corning Asphalt Roof Shingles LABELING: Each unit shall bear labeling in accordance with the requirements the Accredited Quality Assurance Agency noted herein. CONTINUED COMPLIANCE: This Evaluation Report is valid until such time as the named product(s) changes, the referenced Quality Assurance documentation changes, or provisions of the Code that relate to the product change. Acceptance of this Evaluation Report by the named client constitutes agreement to notify Robert Nieminen, P.E. if the product changes or the referenced Quality Assurance documentation changes. TrinityJERD requires a complete review of this Evaluation Report relative to updated Code requirements with each Code Cycle. ADVERTISEMENT: The Evaluation Report number preceded by the words "TrinitylERD Evaluated" may be displayed in advertising literature. If any portion of the Evaluation Report is displayed, then it shall be done in its entirety. INSPECTION: Upon request, a copy of this entire Evaluation Report 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 Evaluation Report consists of pages 1 through 6. Prepared by: tt,r.,,_- ��,ttt,, �,., Robert J.M. Nieminen P.E. Florida Registration No. 59166, Florida DCA ANE1983 The facsimile seal appearing was authorized by Robert Nieminen, P.E. on 12119/2012 This does not serve as an electronically signed document. signed, sealed hardcopies have been transmitted to the Product Approval Administrator and to the named client CERTIFICATION OF INDEPENDENCE: 1. TrinitylERD does not have, nor does it intend to acquire or will it acquire, a financial, interest in any company manufacturing or distributing products it evaluates. 2. TrinitylERD is not owned, operated or controlled by any company manufacturing or distributing products it evaluates. 3. Robert Nieminen, P.E. does not have nor will acquire, a financial interest in any company manufacturing or distributing products for which the evaluation reports are tieing issued. 4. Robert Nieminen, P.E. does not have, nor will acquire, a financial interest in any other entity involved in the approval process of the product. \l TRINITY I ERD ROOFING SYSTEMS EVALUATION: 1. SCOPE: Product Category: Roofing Sub -Category: Asphalt Shingles Compliance Statement: Owens Corning Asphalt Roof Shingles, as produced by Owens Corning, have demonstrated compliance with the following sections of the Florida Building Code and Florida Building Code, Residential Volume through testing in accordance with the following Standards. Compliance is subject to the Installation Requirements and Limitations / Conditions of Use set forth herein. 2. STANDARDS: Section Proi2erty StandardYear 2007 1507.2.5, R905.2.4 Physical Properties ASTM D3462 1507.2.7.1, R905.2.6.1 Wind Resistance ASTM D3161, Class F 2006 1507.2.7.1, R905.2.6.1 Wind Resistance ASTM D7158, Class H 2O07 3. REFERENCES: En i Examination Reference Date UL LLC (CER9626) Physicals & Wind Resistance File R2453, Vol. 3 UL LLC (CER9626) Physicals & Wind Resistance 20120516-R2453 0 07 O5/1/16/20/2012 UL LLC (TST9628) Physical Properties 06CA20263 11CA34308 04/18/2006 02/18/2012 UL LLC (TST9628) Wind Resistance Miami -Dade (CER1592) FBC HVHZ Compliance 07-1116.12 02/14/2008 Miami -Dade (CER1592) FBC HVHZ Compliance o9-0915.12 10-0817.09 12/16/2009 10/27/2010 Miami -Dade (CER1592) FBC HVHZ Compliance Miami -Dade (CER1592) FBC HVHZ Compliance 10-0817.10 10/27/2010 Miami -Dade (CER1592) FBC HVHZ Compliance 10-0817.08 10/27/2010 10/27/2010 Miami -Dade (CER1592) FBC HVHZ Compliance 10-0817.07 11-0411.03 06/16/2011 Miami -Dade (CER1592) FBC HVHZ Compliance Miami -Dade (CER1592) FBC HVHZ Compliance 12-0309.01 07/19/2012 UL LLC (QUA9625) Quality Control Service Confirmation R2453 Exp. 09/26/2014 4. PRODUCT DESCRIPTION: 4.1 Asphalt Shingles: 4.1.1 Classic® and Supreme° are fiberglass reinforced, 3-tab asphalt roof shingles. 4.1.2 Berkshires are fiberglass reinforced, 4-tab asphalt roof shingles. 4.1.3 Duration', TruDefinition° Duration`"', Duration° Premium Cool, TruDefinition� Duration@ Designer Color Collection, TruDefinition° OakridgeO, Oakridge° and WeatherGuard� HP are fiberglass reinforced, laminated asphalt roof shingles. 4.2 BerkshireO Hip & Ridge Shingles, High Ridge, Hip & Ridge with Sealant, WeatherGuard° HP Hip & Ridge Shingles and ProEdge Hip & Ridge Shingles are fiberglass reinforced, hip and ridge asphalt roof shingles. 4.3 Starter Strip Pius and Starter Shingle Roll are starter strips for asphalt roof shingles. S. LIMITATIONS: 5.1 This Evaluation Report is not for use in the HVHZ. 5.2 Fire Classification is not part of this Evaluation Report; refer to current Approved Roofing Materials Directory for fire ratings of this product. 5.3 Wind Classification: Exterior Research and Design, LLC. Evaluation Report 037940.02.12-R2 Certificate of Authorization #9503 FL10674-RS Revision 2: 12/19/2012 Page 2 of 6 TRINITY � ERD 5.3.1 All Owens Corning shingles noted herein are Classified in accordance with FBC Tables 1507.2.7.1 and R905.2.6.1 to ASTM D3161, Class F and/or ASTM D7158, Class H, indicating the shingles are acceptable for us in all wind zones up to Vasa = 150 mph (V,,,t = 194 mph). Refer to Section 6 for installation requirements to meet this wind rating. 5.3.2 All Owens Corning hip & ridge shingles and Starter Strip Pius noted herein are Classified in accordance with FBC Tables 1507.2.7.1 and R905.2.6.1 to ASTM D3161, Class F, indicating the shingles are acceptable for us in all wind zones up to Vasd = 150 mph (Vu,t = 194 mph). Refer to Section 6 for installation requirements to meet this wind rating. 5.3.3 Classification by ASTM D7158 applies to exposure category B or C and a building height of 60 feet or less. Calculations by a qualified design professional are required for conditions outside these limitations. Contact the shingle manufacturer for data,specific to each shingle. 5.3.4 Refer to Owens Corning published information on wind resistance and installation limitations. 5.4 All products in the roof assembly shall have quality assurance audit in accordance with the Florida Building Code and F.A.C. Rule 9N-3. 6. INSTALLATION: 6.1 Underlayment: 6.1.1 Underlayment shall be acceptable to Owens Corning and shall hold current Florida Statewide Product Approval, or be Locally Approved per Rule 9N-3, per FBC Sections 1507.2.3, 1507.2.4 or R905.2.3. 6.2 Asphalt Shingles: 6.2.1 Installation of asphalt shingles shall comply with the manufacturer's current published instructions, using minimum four (4) nails per shingle in accordance with FBC Sections 1507.2 or R905.2, with the following exceptions: > Berkshire° shingles require minimum five (5) nails per shingle. > WeatherGuard� HP shingles require minimum six (6) nails per shingle. > Starter Strip Plus requires minimum five (5) nails per strip. Refer to Owens Corning published information on wind resistance and installation limitations. 6.2.2 Fasteners shall be in accordance with the manufacturer's published requirementsr but not less than FBC 1507.2.6 or R905.2.5. Staples are not permitted. 6.2.4 Where the roof slope exceeds 21 units vertical in 12 units horizontal, special methods of fastening are required. Contact the shingle manufacturer for details. 6.2.5 Minimum Nailing - Classic@ & Supreme: Mansard or Area pars VAnd Amis High VAnd dssysnaa r Area pan visatos nomu/u Areas vlsntos hrrsds W 1' Y 2' (® i' �• I s Espowr. 8.poskmn Exterior Research and Design, LLC. Certificate of Authorization #9503 Nomrsi Msnssrd or Aras psra VWndAmas High VAnd dssysnss y Area pan vismoa nornol" Areas viontoa /urns rt' t {� Y 1• 2• {g 2• 1' t 6 6!>S' Fsposun Esposictdn Evaluation Report 037940.02.12-112 FL10674-RS Revision 2: 12/19/2012 Page 3of6 6.2.6 Minimum Nailing - Berkshire@: anbro strip La lia do saU* '' g v:� • j ' y yf ' i ~vim i A v� \.l I RINITY I ERD s abn strip to t&a & sdbdtr ��r. .-.. .. 8--••-84Y+•t - �= J t ' � 2' AsFlaat ro*ftVa!oaenl Zaraentadaleefiodeaatatm 6.2,7 Minimum Nailing - Duration@, TruDefinition@ Duration, Duration@ Premium Cool & TruDefinition� Duration3 Designer Color Collection: 4 Na8 Pattam Esquma d14 davos sunfuipbatn ba awe wM Awdedaaos6uwWP V — SW Exposuse Nail ban° Expasue PApul4,daaspotiddn crane 64pnl4.daavoskidn 6 Nai tuna aaro4n.p 4mor ear.+aat.nmaar.wa° Pattern soaarazaonev,u�i. 4P'llaeao7eicmNax 27= — ,gcaaaµ7+msse da Cd • sniSurtbi>r+lam ra,�armtranraa 8�irt%ri�' � \ Sa�Calo^o In oo r Aram two Rlu—✓iY�P sa m r 4r nails SW Exposm dares Mpadg•desar"am 6.2.8 Minimum Nailing - TruDefinitions Oakridge@, Oakridge@: 4 NJI Mtm ESW— car 4 dews is— 4r - ►i {�-- ff —1i1 55Ai Fxpowr+ 6 5Ai" EaPos�aw Erpodddadab5J6P&4 Cum EvpWdmdo66l8put4. 6 Nall PAM Esomta con 6 dews i. r EBIT rapmulei¢osi 6wptA¢ Cbr�os Ea 55'dabn ww do 65/49D+dfc Exterior Research and Design, LLC. Evaluation Report 037940.02.12-112 Certificate of Authorization #9503 FL10674-R8 Revision 2: 12/19/2012 Page 4of6 6.2.9 6.3 6.3.1 6.3.2 6.3.3 6.3.4 TRINITY ERD Minimum Nailing - WeatherGuard@ HP: :•...+ Hip & Ridge Shingles: Installation of Berkshire@ Hip and Ridge Shingles, High Ridge, Hip & Ridge with Sealant, WeatherGuard'" HP Hip and Ridge Shingles and ProEdge Hip & Ridge Shingles shall comply with the manufacturer's current published instructions, using four (4) nails per shingle. Refer to Owens Corning published information on wind resistance and installation limitations, including the use of hand -sealing for wind warranties. Fasteners shall be in accordance with the manufacturer's published requirements, but not less than FBC 1507.2.6 or R905.2.5. Staples are not permitted. Minimum Nailing - Berkshire® Hip & Ridge and High Ridge: Fig.1 4 ,41, PrerdWlgWnd �'�. Oiteabn %' A . walls v 4 I t i i A i I i I �EXMo Minimum Nailing - Hip & Ridge with Sealant: wn F'g. 2 - WighWind FaStOWN9 PatWm R Naibj rim Shingliea2"2 nd DiscardExcessalant " StripFas,benirg Distance 12" Fig. 2 TopNew sweiAm wais w ails 1- r Top LmlMnateC T • �- r 1 1 l i i �I t 1 I i I I i �-- I Exterior Research and Design, LLC. Evaluation Report 037940.02.12-112 Certificate of Authorization #9503 FL10674-RS Revision 2: 12/19/2012 Page 5 of 6 6.3.5 Minimum Nailing - WeatherGuard® HP Hip and Ridge: Fig. A arovarbywna / f"_ pt0tibn A A Nails 4 4 i r �S A i i i 1 ERD �! I KINIIY I Fig. C Hip & Ridge Shingle Fastening TopVbw _-r Kalb Naln T, r I s� octmsnn I 6.3.6 Minimum Nailing - ProEdge Hip & Ridge Shingles: PnvaRing Wind Di bon Saiont A/ 6- EV.— Faun 7'h- atr with Roof C~ . 7. LABELING: Standard t f'--• Fastening �` 4 Pattern u. s.:i.:l: (tom `- 8' Falposu» 7.1 Each unit shall bear a permanent label with the manufacturer's name, logo, city, state and logo of the Accredited Quality Assurance Agency noted herein. 7,2 Asphalt shingle wrappers shall indicate compliance with one of the required classifications detailed in FBC Table 1507.2.7.1 / R905.2.6.I. B. BUILDING PERMIT REQUIREMENTS: As required by the Building Official or Authority Having Jurisdiction in order to properly evaluate the installation of this product. 9. MANUFACTURING PLANTS: Contact the named QA entity for information on which plants produce products covered by Florida Rule 9N-3 QA requirements. 10. QUALITY ASSURANCE ENTITY: UL LLC- QUA9625 ; (414) 248-6409; karen.buchmann@ul.com - END OF EVALUATION REPORT - Exterior Research and Design, LLC- Evaluation Report 037940.02.12-112 Certificate of Authorization #9503 FL10674-R8 Revision 2: 12/19/2012 Page 6 of 6 f ��,�� 1. of Om + a �