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RC-14-1686 (3) Permit No. RC-8-14-1686 `SIRES►, Miami Shores Village Permit Type:Residential Construction 10050 N.E.2nd Avenue NW ' Work Classification:Alteration Miami Shores,FL 33138-0000 Per Permit Status: APPROVED Phone: (305)795-2204 �'GORI�P Issue Date:9/1812015 Expiration: 03/16/2016 Project Address Parcel Number Applicant 10616 NW 2 Avenue 1121360020060 Miami Shores, FL 33150- Block: Lot: CRISTINA CRUZ ESCALONA Owner Information Address Phone Cell CRISTINA CRUZ ESCALONA 619 E CROSBY Avenue EL PASO TX 79902- 619 E CROSBY Avenue EL PASO TX 79902- Contractor(s) Phone Cell Phone Valuation: $ 80,000.00 APOLO BUILDERS INC (954)445-5046 Total Sq Feet: 00 Approved:In Review Available Inspections: Comments: Inspection Type: Date Approved: :In Review Final PE Certification Date Denied: Window Door Attachment Type of Construction: INTERIOR RENOVATION TO KITCH Occupancy:Single Family Framing Stories: 1 Exterior: Insulation Front Setback: Rear Setback: Drywall Screw Left Setback: Right Setback: Window and Door Buck Bedrooms:3 Bathrooms:2 Fill Cells Columns Plans Submitted:Yes Certificate Status: Review Electrical Certificate Date: Additional Info: Review Electrical Review Electrical Bond Return: Classification:Residential Review Structural Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Building CCF $48.00 Review Building CO/CC Fee $50.00 Invoice# RC-8-14-52489 Review Building DBPR Fee $36.00 08/04/2014 Credit Card $50.00 $3,452.00 Review Building DCA Fee $36.00 09/18/2015 Credit Card $3,452.00 $0.00 Review Building Education Surcharge $16.00 Review Mechanical Permit Fee $2,400.00 Review Mechanical Plan Review Fee(Engineer) $160.00 Review Plumbing Plan Review Fee(Engineer) $40.00 Review Plumbing Plan Review Fee(Engineer) $80.00 Review Planning Plan Review Fee(Engineer) $40.00 Review Structural Plan Review Fee(Engineer) $160.00 Review Structural Plan Review Fee(Engineer) $80.00 Review Structural Plan Review Fee(Engineer) $40.00 Review Structural Plan Review Fee(Engineer) $80.00 Review Structural Plan Review Fee(Engineer) $120.00 Plan Review Fee(Engineer) $40.00 Scanning Fee $12.00 Technology Fee $64.00 Total: $3,502.00 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 September 18,2015 1 Permit NO. RC-8-14-1686 `5Y REs L� Miami Shores Village Permit Type;Residential COnstructiOn 10050 N.E.2nd Avenue NW ' Work Classification:Alteration Miami Shores,FL 33138-0000 Perill Phone: (305)795-2204 Permit status:APPROVED FES` �ORtDp' Issue Date:9/18/2015 Expiration: 03/16/2016 Project Address Parcel Number Applicant 10616 NW 2 Avenue 1121360020060 Miami Shores, FL 33150- Block: Lot: CRISTINA CRUZ ESCALONA Owner Information Address Phone Cell CRISTINA CRUZ ESCALONA 619 E CROSBY Avenue EL PASO TX 79902- 619 E CROSBY Avenue EL PASO TX 79902- Contractor(s) Phone Cell Phone APOLO BUILDERS INC (954)445-5046 Valuation: $ $0,000.00 Total Scl Feet: 00 Approved: In Review Available Inspections: Comments: Inspection Type: Date Approved::In Review Final PE Certification Date Denied: Window Door Attachment Type of Construction: INTERIOR RENOVATION TO KITCH Occupancy:Single Family Framing Stories: 1 Exterior: Insulation Front Setback: Rear Setback: Drywall Screw Left Setback: Right Setback: Window and Door Buck Bedrooms:3 Bathrooms:2 Fill Cells Columns Plans Submitted:Yes Certificate Status: Review Electrical Certificate Date: Additional Info: Review Electrical Review Electrical Bond Return: Classification:Residential Review Structural Fees Due Amount Pay Date Pay Type Amt Paid Amt Due Review Building CCF $48.00 Review Building CO/CC FeeInvoice# RC-8-14-52489 Review Building $ .00 08/04/2014 Credit Card $50.00 $3,452.00 DBPR Fee $3366.00 Review Building DCA Fee $36.00 09/18/2015 Credit Card $3,452.00 $0.00 Review Building Education Surcharge $16.00 Review Mechanical Permit Fee $2,400.00 Review Mechanical Plan Review Fee(Engineer) $160.00 Review Plumbing Plan Review Fee(Engineer) $40.00 Review Plumbing Plan Review Fee(Engineer) $80.00 Review Planning Plan Review Fee(Engineer) $40.00 Review Structural Plan Review Fee(Engineer) $160.00 Review Structural Plan Review Fee(Engineer) $80.00 Review Structural Plan Review Fee(Engineer) $40.00 Review Structural Plan Review Fee(Engineer) $80.00 Review Structural Plan Review Fee(Engineer) $120.00 Plan Review Fee(Engineer) $40.00 Scanning Fee $12.00 Technology Fee $64.00 Total: $3,502.00 construction and zoning. Futhermore, I authorize the aboye_na,medconte t�o`to the work stated. lceptember 18, 2015 Authorized Signature:Owner / Applicant / Contractor / Age r ate Building Department Copy September 18,2015 2 �-c V Miami Shores Village CErvFD Itq� AUG 01 2014 a Building Department 3 �� BY 10050 N.E.2nd Avenue,Miami Shotes,Florida 3 1:33 " rel: (305)7955 2241 Fax: (:305)756.997' INSPECT I'llt:)NE Nt..'lB R: 130 5)762.4949 HIC _10)0 BUILDING Permit No. ___ _.. ....___........... ..___ _ .. PERMIT APPLICATION Master Permit No.he_&.:_ _ 16_16.. Permit Type: BUILDING ROOFING ;JOB ADDRESS: 10616 NW 2nd Ave. (;6 Miami Shote? _ _ Comity:.—____..... Miami Dade _..__ hi): 33,138._......._.. lioho/R rceftt:__ll_21 fiQ02046.0 --.._......._............ Is the'Building Historically Designated: Yeti_ NO _ ._Flood'Lone: OR'\F R: Name ttFe-e Simple'l'itletictlder):mmCrlS 1Yla. Cr, _ES.C2.1ona Grost. I'hone#:.9.5-X3,3 001 .....___ Address: 619 E. Crosby Ave. __-state:...__.._.._-TX_.._.._..................____.._...._...._._._..__.._.__._.___..__________.__..___/ip. .._.7. ____-............. Tenant/Lessee:.(Name:_._ __--- ______ ..._..____.__..................._..._.._........................._.._.._._Phtnrc#:__ _..........._. lmail; CONTRACTOR:Company Name: �1 / dprS __._.___.._.._. theme#:,y�, /-yS�S:3vy/G �//_o.....P.............&,,!"/ ...................._�_.........._..._ _. �. Addre,s:- c y/ �C 1 L/ '4ve —__.............._._................—._......_..__...._._.. __.._._.._..._ _ __. _.............. Citv: ..-_,.,Q�,rk'"A^ Ael State: rL %*1D: .1,7.7`� _. (�uali tier Name: tJiT L� 7; ____..._...Phone tt: State Certification or Kegistt iturn#: C 6 S�a�y CTerQtiicate of comintenc v Contact Phone#: 9f %00/0..iu.;40 ---........_......... lhSltiFt: lrchtCccUnirtecr . _ '0 '.4 W< _._. _.._t'hnnc# ..___..__ .__.._._..------ Value of Work for this Perntlt:� Q..0 wo Square/Linear Footage of Work:. _ _-- Type of Work: JAddition Xmienation Ll New ;repair/Replace JDemolition Description of Work: Ph 0 /�P✓�O✓._ P[�J i r�n ✓ ,n ✓��f Color thru tile: .#.z:�:a�-,-..-r t.za,,.,z-:�.'�-;-:�<;��5`•--L-,i-,-h,- �eL 4'S'.:rx::x::k:...o-. Submittal Fee$ & Permit Fee$ CCF S CO/CC$ lJ Scanning Fe �... _. _....._...Radon Fee's_. Dlil'R$....... Bond t+................... Notary$_____-------........... Training/Education Fee$ _.._......_Technology Fee Double tree k Structural Review$ TOTAL FEE NOW DUE$3�. (4 S Bondinjg Company's Name(it'applicable) tj� Bon('1inz C'ra]npany'�:�ddress— City State ------ Lip Mont agge Larder's Name(i f'applicahlo)Z,# 1.1ort��ai:c: I,c•ndel-'s Address City State Zip Application is hereby made it, obtain a permit to kh) the work and instrdlations as indicated. I certify (hat no work iw installation has conlincrk•ed prior to the ISStiance UI a pCrtn]t and that all work skill he ivi-101-111cd to mCel the Stan(Iat'd5 01 all JdXkSS re Mating. 09) r1ctioII in(his jurisdiction, I understand that a soparate permit must be S%N:Alred lir, 11-EMICAL WORK. PLUMBING. SIt_;NS, WFL.IS.P{)OI.S. FURNACE S.BOILERS,HFATERS.TANKS wicl.AIR CONIATI{)NI RS ETC.—, ONVNEWS AFFIDAVIT: 1 c°crtil'y that all the f6regoint,=inl rrm,,ttion is accurate curd that all work will be done in complial),ce with alf applicable law,regulating consu•uction turd zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." ?Vorice to Applicemr: As a condition to the issuance of a frudding permit with an estirrur ed volare exceeding 52500, the applicant must prorruise in good faith that ca corm of the notice of czrnnncr:reruerst and crrnstructku: lien late broc-hure will Ix delirewd to the person: u lro.ce proper,} is subject to crttcrclurrrra. Also. a terrified cope of the recorded notice of conunenceuaent nutrst Ix posted tit the jol)site for tile: ,nest inspection which ot-curs seven (7) cla}'s after the building permit is issued In tilt, absence of sut-h posted notice, tilt, inspection still not!�e approved and a rehispection Jae will be charged. S tL ntrt n rt', Owner or.Agent C�>ntractt+r The fore;!oing instrument w 15 acknntsslcdged hel6re ntc this�b The f>reiioins in tttunent was.t knowhd ed tlef'ote me this dayof D -ro1 et,( (3 ,b}CIZISTtt$ -t�4-kosT , day of 20&.by 9—ue t 11? J ; r-'J a sk`ho is personally known to Inc or who has produced who is lex-7nally known to inn or who has produced As idenlificaticM°said ww110 did take,an oath. 66�2�227,ojas idcntiticaticsn snd who did take.ttnoz1h. NOTARY PUBLIC: NC)TARA'PUBLIC: l n: St tl: St T l ----- P]'tnt: 11'IyC`<em 714 v LEMAMORENO 111yC >nl i=o >,f,_�ptr d1bry Public State ofFlorida Joanna MFeliciano NAY PubifC. My Commission FF 082753 �f S1C7f@ of Tex=t OF r. Expires 01/12/2018 'S..:S. .- :$:.. `"VNT1lL•'' ,.,+V-2&1: i:X:• .i-'a': M.",'.y::.. ::%::i:%F :! .<.,., .`g yb:�:i .,rt. ':Y 'rt:',:P,. NM\ APPROVED BY �� !Tans F;kttnlitwr Zoning Strtmural Review Clerk tRe�ried�;I?''_{)1?1{RLtitied±3'++I(}?(11h:Rivixcl{)6r10i={%99riF2c i5.:7+?l ,'i?9t KEN LAWSON, SECRETARY RICK SCOTT, GOVERNOR _...._._ w.. _..,.. STATE OF FLORIDA DEPARTMENT OF BUSINESS AND,PROFESSIONAL REGULATION � . CONSTRUCTION IN LICENSING BOARD ' jj CGC1512484 i TOR- The The GENERAL..CONTRAC ou s -N£amed below IS'CERTIFIED ; ., - y. Under the provisions of Chapter 489F&- = Expicafion dater AU,G X31 , 201`6 } ' -BURT EDWARD AP(OLINARIO, ` 'APOLOtr'BU.ILDERS INC G - = r .' , Y` ;`s, • 8041NE14-AVENUE OAKLAND PARK FL 33334 km ISSUED: 08/12/2014 DISPLAY AS REQUIRED BY LAW SEQ# L1408120002023 BROWARD COUNTY LOCAL BUSINESS TAX RECEIPT 115 S. Andrews Ave., Rm. A-100, Ft. Lauderdale, FL 33301-1895 — 954-831-4000 VALID OCTOBER 1,2014 THROUGH SEPTEMBER 30,2015 pgq; Receipt#:GENERALOCONTRACTOR (CERTIFIED Business Name:APOLO BUILDERS INC Business Type:GENERAL CONTRACTOR) Owner Name:BURT E APOLINARIO/QUAL Business Opened:lo/01/1994 Business Location: 3041 NE 14 AVE State/County/Cert/Reg:CGC1512484 OAKLAND PARK Exemption Code: Business Phone: Rooms Seats Employees Machines Professionals 10 For Vending Business Only Number of Machines: Vending Type: Tax Amount Transfer Fee NSF Fee Penalty Prior Years Collection Cost Total Paid 27.00 0.00 0.00 0.00 0.00 0.00 27.00 THIS RECEIPT MUST BE POSTED CONSPICUOUSLY IN YOUR PLACE OF BUSINESS THIS BECOMES A TAX RECEIPT This tax is levied for the privilege of doing business within Broward County and is non-regulatory in nature. You must meet all County and/or Municipality planning WHEN VALIDATED and zoning requirements. This Business Tax Receipt must be transferred when the business is sold, business name has changed or you have moved the business location. This receipt does not indicate that the business is legal or that it is in compliance with State or local laws and regulations. Mailing Address: APOLO BUILDERS INC Receipt #JCP-13-00018956 3041 NE 14 AVE Paid 09/17/2014 27.00 OAKLAND PARK, FL 33334 2014 - 2015 w w f�r� w w w w ■�,�.7!a,�„-1, w w � ■__..m.�7.• ■id.IL1 w w w T.!,,.L.-w/.-JLC w w_�=�, ' -, - ,,.._.__.�.._._.. APOLBUI-01 TTOWER ACORO" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/2/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Tina Tower Charles L.Crane Agency Co. PHONE FAX 100 N Broadway,Ste 900 A/C No Ext:(561)746-4514 104 A/C No:(561)746-6566 Saint Louis, MO 63102 E-MAIL DRESS:ttower@craneagency.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Ohio Casualty Insurance Co. 24074 INSURED INSURER B: Apolo Builders Inc. INSURER C: 3041 NE 14th AV INSURER D: Oakland Park,FL 33334 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INADDLSUSR POLIY EFF LTR TYPE OF INSURANCE POLICY NUMBER MIWDDNYY MWDDNYYP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE T OCCUR BLS56579609 03/06/2015 03/06/2016 pREMISEs Ea occurrence $ 300,000 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY 1 PRO JECT F—] LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION 1PER OTH- ANDEMPLOYERS'LIABILITY y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatary In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) MASONRY-RESIDENTIAL ONLY "THE FOLLOWING LICENSE INFORMATION WAS PROVIDED TO US AND REQUESTED SHOWN ON THIS CERTIFICATE BY THE NAMED INSURED ON THE ABOVE MENTIONED INSURANCE POLICY.THE INSURANCE COMPANY,CARRIER,BROKER,AGENCY NOR AGENT WARRANTY ANY INFORMATION ABOUT THIS LICENSE#CGC 1512484" CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE BUILDING DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2ND AVE MIAMI SHORES,FL 33138 AUTHORIZED REPRESENTATIVE C tiro f-;Jt,,14 4 @ 19988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD L I r JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION **CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 5/20/2015 EXPIRATION DATE: 5/19/2017 PERSON: APOLINARIO BURT E FEIN: 592522898 BUSINESS NAME AND ADDRESS: APOLO BUILDERS INC 3041 NE 14 AVENUE OAKLAND PARK FL 33334 SCOPES OF BUSINESS OR TRADE: LICENSED GENERAL CONTRACTOR Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter b filing a certificate of election under(his section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt...apply only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440.05(13),F.S.,Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any bme after the filing of the notice or the issuance of the certificate, the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 APOLO BUILDERS INC. Date: September 11, 2015 State of Florida County of Mtc'� Before me this day personally appeared Who, being duly sworn, deposes and says: That he or she will be the only person working on the project located at: l00/i&/ /U(t/ a`O ke A 6",; fL Sworn to (or affirmed) and subscribed beYore me this V� day of S 2015 by Personally know OR Produced Identification Type of Identification Produced =btoa A Print,Type or Stamp Name of Notary state of Floridares Nov 16,2017# FF 05026pssn.F�;,;,`,�' ational Ndary gt�ORFs �,,,, m Miami shores Village Building Department ORiD 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner - Workers' Compensation Insurance Exemption Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. S 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees,including the owner,must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt i£ 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC,a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State,Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State,Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor,part-time employees or subcontractors for your project.The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances,Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor,part-time employees or subcontractors. BY SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. Signature: 0_214�_Aoe Owner State of Florida County of Miami-Dade The foregoing was acknowledge before me this V) day of 20 By Cmc �5 + +.c.��,,2 C�-O5-V who is ersonally known me or has produced as identification. Notary V •�- ��+..�� SEAL: �; �'� �''��'• DEBBIE APOLINARIO left o s, opo My Comm.Expires May 27.2017 Commission#FF 021536 FORM 405-10 FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION Florida Department of Busje_ss and Professional Regulation - Residential Performance Method Project Name: MIAMI SHORES Builder Name: Street: 10616 NW 2ND AVE Permit Office: MIAMI SHORES City,State,Zip: MIAMI SHORES,FL, Permit Number: Owner: MIAMI SHORES Jurisdiction: Design Location: FL,Miami 1. New construction or existing New(From Plans) 9. Wall Types(1293.3 sqft.) Insulation Area 2. Single family or multiple family Single-family a.Concrete Block-Int Insul,Exterior R=4.1 1293.30 ft' b.N/A R= ft' 3. Number of units,if multiple family 1 c.N/A R= ft' 4. Number of Bedrooms 2 d.N/A R= ft' 5. Is this a worst case? No 10.Ceiling Types (1480.0 sqft.) Insulation Area a.Under Attic(Vented) R=30.0 1480.00 ft 6. Conditioned floor area above grade(ft2) 1480 b.N/A R= r� ' XII% ' Conditioned floor area below grade(ft2) 0 c.N/A R= ft'. 11.Ducts R ft2 7. Windows(186.0 sqft.) Description Area a.Sup:Attic,Ret:Main,AH:Main 6 200 a. U-Factor: Sgl,U=1.07 186.00 ft2 SHGC: SHGC=0.48 b. U-Factor: N/A ft2 12.Cooling systems kBtu/hr Efficiency SHGC: a.Central Unit 35.0 SEER:14.00 c. U-Factor: N/A ft2 SHGC: 13.Heating systems kBtu/hr Efficiency d. U-Factor: N/A ft2 a.Electric Strip Heat 25.0 COP:1.00 SHGC: Area Weighted Average Overhang Depth: 1.500 ft. Area Weighted Average SHGC: 0.480 14.Hot water systems 8. Floor Types (1480.0 sqft.) Insulation Area a. Electric Cap:40 gallonsEF:0.920 a.Crawlspace R=19.0 1480.00 ft2 b. Conservation features b. N/A R= ft2 None c.N/A R= ft2 15.Credits Pstat Glass/Floor Area: 0.126 Total Proposed Modified Loads: 40.07 PASS Total Standard Reference Loads: 52.51 1 hereby certify that the plans and specifications covered by Review of the plans and "SIAE Sr,1� this calculation are in compliance with the Florida Energy specifications covered by this Code. calculation indicates compliance vj 4, ' z with the Florida Energy Code. ttfit PREPARED?.Y' � Before construction is completed DATE: this building will be inspected for 0 compliance with Section 553.908 ; I hereby certify that this building, as designed, is in compliance Florida Statutes. ✓,, �� with the Florida Energy Code. Cfl2 �yE t�` OWNER/AGENT: BUILDING OFFICIAL: DATE: DATE: Compliance requires certification by the air handler unit manufacturer that the air handler enclosure qualifies as certified factory-sealed in accordance with 403.2.2.1.1. - Compliance requires completion of a Florida Air Barrier and Insulation Inspection Checklist 4/3/2014 10:26 AM EnergyGauge®USA-FlaRes2010 Sectio 4. o Ii t`3o a Page 1 of 5 PROJECT Title: MIAMI SHORES Bedrooms: 2 Address Type: Street Address Building Type: User Conditioned Area: 1480 Lot# Owner: MIAMI SHORES Total Stories: 1 Block/SubDivision: #of Units: 1 Worst Case: No PlatBook: Builder Name: Rotate Angle: 0 Street: 10616 NW 2ND AVE Permit Office: MIAMI SHORES Cross Ventilation: County: DADE Jurisdiction: Whole House Fan: City,State,Zip: MIAMI SHORES, Family Type: Single-family FL, New/Existing: New(From Plans) Comment: CLIMATE IECC Design Temp Int Design Temp Heating Design Daily Temp Design Location TMY Site Zone 97.5% 2.5% Winter Summer Degree Days Moisture Range FL,Miami FL_MIAMI_INTL_AP 1 51 90 70 75 149.5 56 Low BLOCKS Number Name Area Volume 1 Block1 1480 13320 SPACES Number Name Area Volume Kitchen Occupants Bedrooms InfilID Finished Cooled Heated 1 Main 1480 13320 Yes 1 2 1 Yes Yes Yes FLOORS # Floor Type Space Exposed PerlVVall Ins.R-Value Area Floor Joist R-Value Tile Wood Carpet 1 Crawlspace Main 159 ft 0 1480 ft' 19 0 0 1 ROOF / Roof Gable Roof Solar SA Emitt Emitt Deck Pitch V # Type Materials Area Area Color Absor. Tested Tested Insul. (deg) 1 Hip Composition shingles 1603 ft' 0 ft' Medium 0.96 No 0.9 No 0 22.6 ATTIC V # Type Ventilation Vent Ratio(1 in) Area RBS IRCC 1 Full attic Vented 300 1480 ft' N N CEILING # Ceiling Type Space R-Value Area Framing Frac Truss Type 1 Under Attic(Vented) Main 30 1480 ft' 0.11 Wood 4/3/2014 10:26 AM EnergyGauge®USA-FlaRes2010 Section 405.4.1 Compliant Software Page 2 of 5 WALLS Adjacent Cavity Width Height Sheathing Framing Solar Below # Omt To Wall Type Space P--Val-le Ft In Ft In Area R-Valu ° 1 N Exterior Concrete Block-Int Insul Main 4.0999 32 4 10 323.3 ft2 0 0.144999 0 2 S Exterior Concrete Block-Int Insul Main 4.0999 32 4 10 323.3 ft2 0 0.144999 0 3 E Exterior Concrete Block-Int Insul Main 4.0999 32 4 10 323.3 ft2 0 0.144999 0 4 W Exterior Concrete Block-Int Insul Main 4.0999 32 4 10 323.3 ft2 0 0.144999 0 DOORS # Ornt Door Type Space Storms U-Value Width Height Area Ft In Ft In 1 N Insulated Main None .46 3 6 8 20 ft2 2 E Insulated Main None .46 3 6 8 20 ft2 WINDOWS Orientation shown is the entered,Proposed orientation. Wall Overhang V # Omt ID Frame Panes NFRC U-Factor SHGC Area Depth Separation Int Shade Screening 1 N 1 Metal Single(Tinted) Yes 1.07 0.48 30.0 ft2 1 ft 6 in 1 ft 6 in Drapes/blinds None 2 S 2 Metal Single(Tinted) Yes 1.07 0.48 15.0 ft2 1 ft 6 in 1 ft 6 in Drapes/blinds None 3 S 2 Metal Single(Tinted) Yes 1.07 0.48 30.0 ft2 1 ft 6 in 1 ft 6 in Drapes/blinds None 4 S 2 Metal Single(Tinted) Yes 1.07 0.48 5.0 ft2 1 ft 6 in 1 ft 6 in Drapes/blinds None 5 E 3 Metal Single(Tinted) Yes 1.07 0.48 9.0 ft2 1 ft 6 in 1 ft 6 in Drapes/blinds None 6 E 3 Metal Single(Tinted) Yes 1.07 0.48 18.0 ft2 1 ft 6 in 1 ft 6 in Drapes/blinds None 7 E 3 Metal Single(Tinted) Yes 1.07 0.48 15.0 ft2 1 ft 6 in 1 ft 6 in Drapes/blinds None 8 W 4 Metal Single(Tinted) Yes 1.07 0.48 55.0 ft2 1 ft 6 in 1 ft 6 in Drapes/blinds None 9 W 4 Metal Single(Tinted) Yes 1.07 0.48 9.0 ft2 1 ft 6 in 1 ft 6 in Drapes/blinds None INFILTRATION # Scope Method SLA CFM 50 ELA EgLA ACH ACH 50 1 Wholehouse Best Guess .0003 1164.6 63.94 120.24 .207 5.246 HEATING SYSTEM # System Type Subtype Efficiency Capacity Block Ducts 1 Electric Strip Heat None COP:1 25 kBtu/hr 1 sys#1 COOLING SYSTEM # System Type Subtype Efficiency Capacity Air Flow SHR Block Ducts 1 Central Unit None SEER:14 35 kBtu/hr 1050 cfm 0.75 1 sys#1 4/3/2014 10:26 AM EnergyGauge®USA-FlaRes2010 Section 405.4.1 Compliant Software Page 3 of 5 HOT WATER SYSTEM # System Type SubType Location EF Cap Use SetPnt Conservation 1 Electric None Main 0.92 40 gal 50 gal 120 deg None SOLAR HOT WATER SYSTEM FSEC Collector Storage Cert # Company Name System Model# Collector Model# Area Volume FEF None None ft' DUCTS ---Supply---- ----Return-- Air CFM 25 CFM25 HVAC# # Location R-Value Area Location Area Leakage Type Handler TOT OUT QN RLF Heat Cool 1 Attic 6 200 ft' Main 10 ft' Default Leakage Main (Default) (Default) 1 1 TEMPERATURES Programable Thermostat:Y Ceiling Fans: CoolingJan Feb [[ ]]Mar A r May X]Jun Jul AugX]Se [ ]Oct Nov Dec HeatinHJan Feb [X]Mar f Apr f May E ]Jun f Jul f Au [ ]Sep [ ]Oct Nov Dec Vent in Jan Feb [X]Mar [X]Apr [ May [ ]Jun [ Jul [ Aug [ ]Se [X]Oct Nov Dec Thermostat Schedule: HERS 2006 Reference Hours Schedule Type 1 2 3 4 5 6 7 8 9 10 11 12 Cooling(WD) AM 78 78 78 78 78 78 78 78 80 80 80 80 PM 80 80 78 78 78 78 78 78 78 78 78 78 Cooling(WEH) AM 78 78 78 78 78 78 78 78 78 78 78 78 PM 78 78 78 78 78 78 78 78 78 78 78 78 Heating(WD) AM 66 66 66 66 66 68 68 68 68 68 68 68 PM 68 68 68 68 68 68 68 68 68 68 66 66 Heating(WEH) AM 66 66 66 66 66 68 68 68 68 68 68 68 PM 68 68 68 68 68 68 68 68 68 68 66 66 4/3/2014 10:26 AM EnergyGauge®USA-FlaRes2010 Section 405.4.1 Compliant Software Page 4 of 5 FORM 405-10 Florida Code Compliance Checklist Florida Department of Business and Professional Regulations Residential Whole Building Performance Method ADDRESS: 10616 NW 2ND AVE PERMIT#: MIAMI SHORES, FL, MANDATORY REQUIREMENTS SUMMARY-See individual code sections for full details. COMPONENT SECTION SUMMARY OF REQUIREMENT(S) CHECK Air leakage 402.4 To be caulked, gasketed,weatherstripped or otherwise sealed. Recessed lighting IC-rated as meeting ASTM E 283.Windows and doors=0.30 cfm/sq.ft. Testing or visual inspection required. Fireplaces: gasketed doors&outdoor combustion air. Must complete envelope leakage report or visually verify Table 402.4.2. Thermostat& 403.1 At least one thermostat shall be provided for each separate heating and controls cooling system. Where forced-air furnace is primary system, programmable thermostat is required. Heat pumps with supplemental electric heat must prevent supplemental heat when compressor can meet the load. Ducts 403.2.2 All ducts,air handlers,filter boxes and building cavities which form the primary air containment passageways for air distribution systems shall be considered ducts or plenum chambers, shall be constructed and sealed in accordance with Section 503.2.7.2 of this code. 403.3.3 Building framing cavities shall not be used as supply ducts. Water heaters 403.4 Heat trap required for vertical pipe risers. Comply with efficiencies in Table 403.4.3.2. Provide switch or clearly marked circuit breaker (electric)or shutoff(gas). Circulating system pipes insulated to= R-2 +accessible manual OFF switch. Mechanical 403.5 Homes designed to operate at positive pressure or with mechanical ventilation ventilation systems shall not exceed the minimum ASHRAE 62 level. No make-up air from attics, crawlspaces, garages or outdoors adjacent to pools or spas. Swimming Pools 403.9 Pool pumps and pool pump motors with a total horsepower(HP)of= 1 &Spas HP shall have the capability of operating at two or more speeds. Spas and heated pools must have vapor-retardant covers or a liquid cover or other means proven to reduce heat loss except if 70%of heat from site-recovered energy. Off/timer switch required. Gas heaters minimum thermal efficiency=78% (82%after 4/16/13). Heat pump pool heaters minimum COP=4.0. Cooling/heating 403.6 Sizing calculation performed &attached. Minimum efficiencies per Tables 503.2.3. Equipment efficiency verification required. Special equipment occasion cooling or heating capacity requires separate system or variable capacity system. Electric heat>10kW must be divided into two or more stages. Ceilings/knee walls 405.2.1 R-19 space permitting. 4/3/2014 10:26 AM EnergyGauge®USA-FlaRes2010 Section 405.4.1 Compliant Software Page 5 of 5 ENERGY PERFORMANCE LEVEL (EPL) DISPLAY CARD ESTIMATED ENERGY PERFORMANCE INDEX* = 76 The lower the EnergyPerformance Index,the more efficient the home. 10616 NW 2ND AVE, MIAMI SHORES, FL, 1. New construction or existing New(From Plans) 9. Wall Types Insulation Area 2. Single family or multiple family Single-family a.Concrete Block-Int Insul,Exterior R=4.1 1293.30 ft2 b.N/A R= ft 3. Number of units,if multiple family 1 c.N/A R= ft' 4. Number of Bedrooms 2 d.N/A R= ft2 10.Ceiling Types Insulation Area 5. Is this a worst case? No a.Under Attic(Vented) R=30.0 1480.00 ft2 6. Conditioned floor area(W) 1480 b.N/A R= ft2 7. Windows" Description Area c.N/A R= ft2 a. U-Factor: Sgl,U=1.07 186.00 ft2 11.Ducts R ft SHGC: SHGC=0.48 a.Sup:Attic,Ret:Main,AH:Main 6 200 b. U-Factor: N/A ft2 SHGC: 12.Cooling systems kBtu/hr Efficiency c. U-Factor: N/A ft2 a.Central Unit 35.0 SEER:14.00 SHGC: d. U-Factor: N/A ft2 13.Heating systems kBtu/hr Efficiency SHGC: a.Electric Strip Heat 25.0 COP:1.00 Area Weighted Average Overhang Depth: 1.500 ft. Area Weighted Average SHGC: 0.480 8. Floor Types Insulation Area 14.Hot water systems Cap:40 gallons a.Crawlspace R=19.0 1480.00 ft2 a.Electric EF:0.92 b.N/A R= ft2 c.N/A R= ft2 b. Conservation features None 15.Credits Pstat I certify that this home has complied with the Florida Energy Efficiency Code for Building x.114 S, Construction through the above energy saving features which will be installed (or exceeded) o in this home before final inspection. Otherwise, a new EPL Display Card will be completed ,,,�'�� based on installed Code compliant features. Builder Signature: Date: k- * * Address of New Home: City/FL Zip: �ob ,� WE *Note: This is not a Building Energy Rating. If your Index is below 70,your home may qualify for energy efficient mortgage(EEM)incentives if you obtain a Florida EnergyGauge Rating. Contact the EnergyGauge Hotline at(321) 638-1492 or see the EnergyGauge web site at energygauge.com for information and a list of certified Raters. For information about the Florida Building Code, Energy Conservation,contact the Florida Building Commission's support staff. **Label required by Section 303.1.3 of the Florida Building Code, Energy Conservation, if not DEFAULT. EnergyGauge®USA-FlaRes2010 Section 405.4.1 Compliant Software a,� Load Short Form Job: MIAMISHORES wei htso C Date: 4/1/14 Entire House By: MIKEL ABBOTT ENERGY CALCS 4920 N DIXIE HWY,FT LAUDERDALE,FL 33334 Phone:954776-2003 License:ENERGY RATER#37 Project • • For: MIAMI SHORES 10616 NW 2ND AVE, MIAMI SHORES, FL Design Information Htg Clg Infiltration Outside db(°F) 52 91 Method Simplified Inside db(°F) 70 75 Construction quality Average Design TD(°F) 18 16 Fireplaces 0 Daily range - L Inside humidity(%) 30 50 Moisture difference(gr/Ib) -13 57 HEATING EQUIPMENT COOLING EQUIPMENT Make RHEEM OR EQUAL Make RHEEM OR EQUAL Trade Trade Model RHLL-HM3617JA Cond 13AJN36A01 AHRI ref Coil AHRI ref Efficiency 100 AFUE Efficiency 11.0 EER, 14 SEER Heating input 7.5 kW Sensible cooling 24500 Btuh Heating output 25000 Btuh Latent cooling 10500 Btuh Temperature rise 19 °F Total cooling 35000 Btuh Actual air flow 1200 cfm Actual air flow 1200 cfm Air flow factor 0.081 cfm/Btuh Air flow factor 0.049 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat Load sensible heat ratio 0.73 ROOM NAME Area Htg load Clg load Htg AVF Clg AVF (ftz) (Btuh) (Btuh) (cfm) (cfm) WHOLE HOUSE 1480 14805 24464 1200 1200 Entire House d 1480 14805 24464 1200 1200 Other equip loads 0 0 Equip. @ 1.00 RSM 24464 Latent cooling 8845 TOTALS I 1480 I 14805 I 33309 I 1200 I 1200 Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. 2014-Apr-03 10:23:43 wrlghtsOft' Right-Suite®Universal 2013 13.0.08 RSU18185 page 1 C:%Users10wner%Desktop\Heat Loads\MIAMISHORES.rup Calc=MJ8 Front Door faces: N Job: MIAMISHORES . .. wrightsoft Project Summary Date: 4/1/14 Entire House By: MIKEL ABBOTT ENERGY CALCS 4920 N DIXIE HWY,FT LAUDERDALE,FL 33334 Phone:954-776-2003 License:ENERGY RATER#37 • Project Information For: MIAMI SHORES 10616 NW 2ND AVE, MIAMI SHORES, FL Notes: WHOLE HOUSE Design Information Weather: Miami Intl AP, FL, US Winter Design Conditions Summer Design Conditions Outside db 52 °F Outside db 91 °F Inside db 70 °F Inside db 75 °F Design TD 18 °F Design TD 16 °F Daily range L Relative humidity 50 % Moisture difference 57 gr/Ib Heating Summary Sensible Cooling Equipment Load Sizing Structure 13460 Btuh Structure 21273 Btuh Ducts 1346 Btuh Ducts 3191 Btuh Central vent(0 cfm) 0 Btuh Central vent(0 cfm) 0 Btuh Humidification 0 Btuh Blower 0 Btuh Piping 0 Btuh Equipment load 14805 Btuh Use manufacturer's data y Rate/swing multiplier 1.00 Infiltration Equipment sensible load 24464 Btuh Method Simplified Latent Cooling Equipment Load Sizing Construction quality Average Fireplaces 0 Structure 7014 Btuh Ducts 1832 Btuh Heating Cooling Central vent(0 cfm) 0 Btuh Area(ftp 1480 1480 Equipment latent load 8845 Btuh Volume(fF) 13320 13320 Air changes/hour 0.81 0.68 Equipment total load 33309 Btuh Equiv.AVF(cfm) 180 150 Req.total capacity at 0.70 SHR 2.9 ton Heating Equipment Summary Cooling Equipment Summary Make RHEEM OR EQUAL Make RHEEM OR EQUAL Trade Trade Model RHLL-HM3617JA Cond 13AJN36A01 AHRI ref Coil AHRI ref Efficiency 100 AFUE Efficiency 11.0 EER, 14 SEER Heating input 7.5 kW Sensible cooling 24500 Btuh Heating output 25000 Btuh Latent cooling 10500 Btuh Temperature rise 19 °F Total cooling 35000 Btuh Actual air flow 1200 cfm Actual air flow 1200 cfm Air flow factor 0.081 cfm/Btuh Air flow factor 0.049 cfm/Btuh Static pressure 0 in H2O Static pressure 0 in H2O Space thermostat Load sensible heat ratio 0.73 BoldRtalic values have been manually overridden Calculations approved by ACCA to meet all requirements of Manual J 8th Ed. 2014-Apr-0310:23:43 wrilghtsoft" Right-Suite® universal 2013 13.0.08 RSU18185 a 9 AM C:\Users\Owner\Desktop\Heat Loads\MIAMISHORES.rup Calc=MJ8 Front Door faces: N AL. wrightsof' Right-J® Worksheet Job: MIAMISHORES Entire House Date: 4/1/14 MIKEL ABBOTT ENERGY CALCS By: 4920 N DIXIE HWY,FT LAUDERDALE,FL 33334 Phone:954-776-2003 License:ENERGY RATER#37 1 Room name Entire House WHOLE HOUSE 2 Exposed wall 159.0 ft 159.0 ft 3 Room height 9.0 ft d 9.0 ft heat/cool 4 Room dimensions 1480.0 x 1.0 ft 5 Room area 1480.0 ft' 1480.0 ft' Ty Construction U-value Or I HTM I Area (ft') I Load I Area (ft') I Load number (Btuh/f t'-°F (Btuh/ft2) or perimeter (ft) (Btuh) or perimeter (ft) (Btuh) Heat Cool Gross N/P/S Heat Cool Gross N/P/S Heat Cool 6 13A-4ocs 0.143n4 -212 J 2.85 -324 274 717 A82 924 274 717 782 �-G 1A-h1om 1.270 n 23.24 30.84 30 0 697925 30 0 697 925 111---------ODD 11,10 0.600 _n 10.98 18.69 20 20_ 220 374 20 20 220 374 13A-4ocs 0.143 a 2.62 2.85 324 252 659 719 324 252 659 719 11 1A-h1om 1.270 a 23.24 69.91 52 0 1209 3635 52 0 1209 3635 ILL_�-9 11.10 0.600 _e,, 10.98 18.69 20 20 220 374 _ 20_ y,20 _220 374 13A-flocs T'0.143 s 2.62 2.85 324 274 717 782 324 274 717 782 to-h10m 1.270 s 23.24 32,98 50 0 1162 1650 50 0 1162 1650 11.10 0.600 s 0.00 0.00. _0 ,0 _ ,0 0. 0 0 .0 0 13A4ocs 0.143 w 2.62 2.85 324 252 659 719 324 252 659 719 1A-hlom 1.270 w 23.24 53.69 72 45 1673 3866 72 30 1673 3866 111,10 0.600 w„ 0.00 0.00 0 0 0 0 0 0 0 0 F{ 12B-Osw 0.097 0.00 0.00 0 0 0 0 0 0 0 0 11DO _ ,:0.390 -.n.. ,0.00 0.00 0 . 0. A . .0 0._ .0 -0 .0 P, 13A-4ocs 0.143 - 0.00 0.00 0 0 0 0 0 0 0 0 1-D 11 DO 0.390 n 0.00 - , ,0.00, - _.-,0,, _ 0 0 _ 0 m0_ 0 __ ,e 0,_ _0 C_ 168-308d 0.032 0.59 1.75 1460 1480' 867 2588 1480 1480 667 2588 F 19A-19cvcp 0.049 ,0.70 0.60_ .1480 1480 _1040 892 1480_ 1,480 1040 892 61 c)AED excursion 01 1 0 Envelope loss/gain 1 9840 17305 1 1 9840 17305 12 a) Infiltration 3619 2588 3619 2588 b) Room ventilation 0 0 0 0 13 Internal gains: Occupants(81 230 6 1380 6 1380 Appliancestother 0 0 Subtotal(lines 6 to 13) 13460 21273 13460 21273 Less external load 0 0 0 0 Less transfer 0 0 0 0 Redistribution 0 0 0 0 14 Subtotal 13460 21273 13460 21273 15 Dud loads 10% 15% 1346 3191 10% 15% 1346 3191 1 1 Total room I I I 148051 2 I I 141051 244641 Air 1200201200 _.L200 Calculations approved by ACCA to meet all reauirements of Manual J 8th Ed. wrightsc>ft- 2014-Apr-03 10:23:43 Right-Suite®Universal 2013 13.0.08 RSU18185 Page 1 C:\Users\Owner\Desktop\feat Loads\MIAMISHORES.rup Calc=MJ8 Front Door faces: N