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RC-16-29874 01/2/7 0.L 76 Scut ,l lug 1;)117 w'0 Sobs nth Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Permit NO. RC -11-16-2987 Permit Type: Residential Construction Work Classification: Alteration Permit Status: APPROVED Issue Date: 21312017 Expiration: 08/02/2017 Parcel Number Applicant 640 NE 98 Street Miami Shores, FL 33138- 1132060171820 Block: Lot: IAN & CORY ROSS Owner Information Address Phone Cell IAN & CORY ROSS 640 98 Street MIAMI SHORES FL 33138- (305)979-3879 640 98 Street MIAMI SHORES FL 33138- Contractor(s) WILCON CO Phone (786)399-8855 Cell Phone Valuation: Total Sq Feet: $ 19,600.00 238 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: MODIFY Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: Bond Return : EXISTING PERMITTED MA Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential Fees Due Bond Type - Contractors Bond CCF CO/CC Fee DBPR Fee DCA Fee Education Surcharge Permit Fee Plan Review Fee (Engineer) Scanning Fee Technology Fee Amount $500.00 $12.00 $50.00 $8.82 $8.82 $4.00 $588.00 $120.00 $30.00 $16.00 Total: $1,337.64 Pay Date Pay Type Invoice # RC -11-16-61881 11/02/2016 Credit Card 02/03/2017 Credit Card Bond #: 3304 Amt Paid Amt Due $ 50.00 $ 1,287.64 $ 1,287.64 $ 0.00 Available Inspections: Inspection Type: Final PE Certification Window Door Attachment Framing Insulation Drywall Screw Window and Door Buck Fill Cells Columns Review Electrical Review Electrical Review Electrical Review Building Review Building Review Plumbing Review Plumbing Review Planning Review Planning Review Planning Review Mechanical Review Structural 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 construction and zoning. Futhermore, I authorize the above-named contractor to do the work stated. February 03, 2017 Authorized Signature: Owner / Applicant / Contractor / Agent ate Building Department Copy February 03, 2017 1 Certificate of Completion Miami Shores Village 10050 NE 2 Ave, Miami Shores FL, 33138 Tel: 305-795-2204 Fax: 305-756-8972 Building Inspection Department This certificate issued pursuant to the requirements of the Florida Building Code 106.1.2 certifying that at the time of issuance this structure was in compliance with the various ordinances of the jurisdiction regulating building construction or use. For the following: Permit Type Owner RESIDENTIAL CONSTRUCTION Bldg. Permit No. RC-11-16-2987ft C �' IAN & CORY ROSS Contractor WILCON CO Subdivision/Project Construction Type NONE V- B Square Footage Description of Work Location 640 NE 98 ST INTERIOR RENOVATION Date Issued November 16, 2017 Occupancy Load N/A Occupancy Type R-3 Applicable 2014 FLORIDA BUILDING Code Miami Shores FL 33138 Building Officials Approval Not Transferable POST IN A CONSPICUOUS PLACE Ismael Naranjo, CBO ry_ •£y teil:' INSPECTION RECORD Miami Shores Village 10050 N.E. 2ind Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 • POST ON SITE Permit NO. RC -11-16-2987 'Permit Type: Residential Construction Worir,Classification:Alteration Issue Date: 2/3/2017 Expires: 08/02/2017 INSPECTION REQUESTS: (305)762-4949 or Log on at https://bldg.miamishoresvillage.comlcap REQUESTS ARE ACCEPTED DURING 8:30AM - 3:30PM FOR THE FOLLOWING BUSINESS DAY. Requests must be received by 3 pm for following day inspections. Residential Construction Parcel #:1132060171820 Owner's Name: IAN & CORY ROSS Job Address: 640 Nip, rptP: Miami �an'+v, L. Bond Number: 3304 , , ON •x r+• Owner's Phone: (305)979-3879 Total Square Feet: 238 Total Job Valuation: $ 19,600.00 Contractors) WILCON CO - r Phone rt,rimary Contractor (786)3Da ti es WORK IS ALLOWED: MONDAY THROUGH FRIDAY, 8:OOAM - 7:OOPM. SATURDAY 8:OOAM - 6:OOPM. NO WORK IS ALLOWED ON SUNDAY OR HOLIDAYS. BUILDING AND ROOFING INSPECTIONS ARE DONE MONDAY THROUGH FRIDAY. NO INSPECTION WILL BE MADE UNLESS THE PERMIT CARD IS DISPLAYED AND HAS BEEN APPROVED. PLANS ARE READLY AVAILABLE. IT IS THE PERMIT APPLICANTS RESPONSIBILITY TO ENSURE THAT WORK IS ACCESSIBLE AND EXPOSED FOR INSPECTION PURPOSES. NEITHER THE BUILDING OFFICIAL NOR THE CITY SHALL BE LIABLE FOR EXPENSE ENTAILED IN THE REMOVAL OR REPLACEMENT OF ANY MATERIAL REQUIRED TO ALLOW INSPECTION. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. 11111111111111111,711 INSPECTION RECORD STRUCTURAL INSPECTION DATE INSP Foundation Stemwall Slab Columns (1st Li Columns (2nd Lift Tie Beam Truss/Rafters Roof Sheathing Bucks Windows/Doors Interior Framing A Insulation Ceiling Grid Drywall Firewall Wire Lath Pool Steel e" Pool Deck Final Pool Final Fence Screen Enclosure Driveway Driveway Base Tin Cap Roof in Progress Mop in Progress Final Roof Shutters Attachment Final Shutters Rails and Guardrails ADA compliance FINAL DOCUMENTS Soil Bearing Cert Soil Treatment Cert Floor Elevation Survey Reinf Unit Mas Cert Insulation Certificate Spot Survey Final Survey Truss Certification .STRUCTURAL COMMENTS ZONING INSPECTION DATE INSP Zoning Final ZONING COMMENTS INSPECTION Temporary Pole 30 Day Temporary Pool Bonding Pool Deck Bonding Pool Wet Niche Underground Footer Ground Slab • Wall Rough Ceiling Rou Rough Telephone hough Telephone Final TV Rough TV Final Cable Rough Cable Final Intercom Rough Intercom Final Alarm Rough Alarm Final Fire Alarm Rough Fire Alarm Final Service Work With ELECTRICAL DATE INSP FINAL ELECTRICAL COMMENTS INSPECTION FIRE DATE INSP Final Sprinkler Final Alarm FINAL PLUMBING INSPECTION Rough asetai„i Water Service 2nd Rough Top Out Fire Sprinklers Septic Tank DATE 2 12.4 INSP Sewer Hook-up -27-/? Roof Drains Gas LP Tank Well Lawn Sprinklers Main Drain Pool Piping Backflow Preventor Interceptor Catch Basins Condensate Drains HRS Final FINAL PLUMBING 41-/7 COMMENTS MECHANICAL INSPECTION DATE INSP Underground Pipe Rough Ventilation Rough Hood Rough Pressure Test Final Hood Final Ventilation Final Pool Heater Final Vacuum FINAL 26)1 MECHANICAL COMMENTS 0/1(0 BUILDING PERMIT APPLICATION LBUILDING ❑ ELECTRIC PLUMBING ❑ MECHANICAL Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 ❑ ROOFING ❑PUBLIC WORKS JOB ADDRESS: 4o t4E c S ST RECEIVED titkor ID6 14 FBC200' Master Permit No.'C(6 - 2_.9E9 Sub Permit No. ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑ CHANGE OF ❑ CANCELLATION 0 SHOP CONTRACTOR DRAWINGS City: Miami Shores County: Miami Dade Zip: 3b15C3-' 24'1Z. Folio/Parcel#: 1 1- 3206 "e - 1320 Is the Building Historically Designated: Yes NO 1/ Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): Co e`( 4 A A QOSS Phone#: ?j65 -19cl 25S' Address: C, 40 NG 9f3 ST. City: M1AMt SHOeeS Tenant/Lessee Name: N ( A Email: State: FL Zip: 3`5138' 2412 CONTRACTOR: Company Name: W1 LCOi CO Phone#: Cos WS - 191- 2.55 /Phon #: �t e Address: Gi63C to Ste" ME. tap /1 I f\ Call S 'AV 111 10-Qr City: M IAII-tel SW t2 Qualifier Name: W t U- AAM Gf7-02_ State Certification or Registration #: GC C- 1 S C 26 42 Certificate of Competency #: DESIGNER: Architect/Engineer: eVCA.2 CD 0 ALT -6F SCO C AS1A521 s,t 1 Phone#: 5 4cta 65 (c1 City: t`11%/k \ I State: .FL. Zip: X31 �6 State: FL 50s. -q0-9 '99'IG 86 - c c 8855 Zip: V58 Phone#: Address: 6912 Sw • Value of Work for this Permit: $ Type of Work: ❑ Addition l "I Alteration ❑ New Description of Work: MO DI P-' EN -4-1S-1- I t.1 a (7EQ_M t1t� t's3) 6t . BOG Square/Linear Footage of Work: 25S Sat .FT. ❑ Repair/Replace ❑ Demolition ts/1/10CD'S ; P 2'« Gy Specify color of color thru the:' s ! 8 5 CCF $ r CO/CC $ . w • C� DBPR $ U • a. Z Notary $ N ia Submittal Fee $ '3 � • / Scanning Fee $ _ +�/0 Technology Fee $ ` Lis Permit Fee $ Radon Fee $ Training/Education Fee $ Double Fee $ t 1 Structural Reviews $ 1 Z Q (Revised02/24/2014) Bond$ £ - Cr TOTAL FEE NOW DUE $ S N I gR-•� Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip NIA Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and 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." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence pf such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature OWNER or AGENT The foregoing instrument was acknowledged before me this 2 *.10 day of 1-io'J —1BE12 , 20 , by CO'j 2CS- , who is personally known to me or who has produced DI- identification t - identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: A L•l. -o ¢© A S ALVARO ROJAS c MY COMMISSION # FF?29202 EXPIRES May 11. 2019 F•h'hdaNANYratNw .4 CACI (Oh 3AR-01S3 as Signature TRACTOR The foregoing instrument was acknowledged before me this 2lat> day of 1.404 D 1E2 , 20 It , by IL_f,-)A -% GQtjZ , who is personally known to me or who has produced FL ( L as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Seal: AL�tnCR1i ‘24.1A -S_ j4" I ALVARO ROJAS MY COMMISSION # FF229202 40,,1; EXPIRES May 11.2019 tint 3AR•0153 F,nlarecc" daNntarySer ********************************rk * ******************************************$**************** ***********• APPROVED BY (Revised02/24/2014) M(1 Plans Examiner J /7 Zoning Structural Review Clerk co Z QZ N Oco u) 0 Zg c C7) O tjtsm W l ' Q Ce 0 Z 01— (I) Lij ,u— s"� <W� N11.1 U) CL ocsi ma° 5 j0J 0 0 LL a e$ o J 0 c 0 0 0 0. 0 r cal o � LU LL m zg II• 0, CO 0 006139 Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOT A BILL — DO NOT PAY 5953626 BUSINESS NAME/LOCATION WILCON CO 9636 NE 5 AVE RD MIAMI SHORES FL 33138 OWNER WILCON CO Worker(s) 4 RECEIPT NO. RENEWAL 6210769 LBT EXPIRES SEPTEMBER 30, 2017 Must be displayed at place of business Pursuant to County Code 'Chapter 8A — Art. 9 & 10 SBC. TYPE OF BUSINESS 198 GENERAL BUILDING CONTRACTOR CGC1512842 PAYMENT RECEIVED BY TAX COLLECTOR $45.00 09/28/2016 CREDITCARD-16-058605 This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license, permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental or nongovernmental regulatory laws and requirements which apply to the business. The RECEIPT NO. above must be displayed on all commercial vehicles — Miami—Dade Code Sec 60-276. For more information, visit www.miamidade.aov/taxcollector A� iI CERTIFICATE OF LIABILITY INSURANCE °A09 �'°o° s"Y' 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 POUCIES 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(ies) must be endorsed. If SUBROGATION 15 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 Equiinsurance 6839 Main Street Miami Lakes FL 33014 CONTACT NAME: Priscilla ChRlno FAX � NNo. EA: (305) 557-5578 , No): (305) 557-5197 ADS: ffemandez@equiinsurance.com INSURER(S) AFFORDING COVERAGE NAZCA INSURERA : FEDERATED NATIONAL 10790 INSURED WIICon Co. 9636 NE 5th Ave Road Miami FL 33138 INSURER B GL -0000030371-01 INSURER C : 09/03/2017 INSURER D : $ 1,000,000 INSURER E : INSURER F : LLIABILnY /� 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 INSR LIR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF IMMIDDIYWY) POLICY EXP (MWDO/YYYY) OMITS A X COMMERCIAL GENERAL GL -0000030371-01 09/03/2016 09/03/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE LLIABILnY /� OCCUR DAMAGE TO RENTED PREMISES (Ea ocaarence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENT X AGGREGATE POLICY OTHER: LIMIT APPLIES JECOT- PER: LOC GENERAL AGGREGATE S 2,000,000 PRODUCTS - COMP/OP AGG E 2,000,000 E AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED NON -O AOT -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB EXCESS UAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE E AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY IA ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CGC 1512642 CERTIFICATE HOLDER CANCELLATION Miami Shores Village BUILDING DEPARTMENT 10050 NE 2nd Ave. MIAMI SHORES FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORED REPRESENTATIVE ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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: 9/28/2016 EXPIRATION DATE: 9/28/2018 PERSON: CRUZ WILLIAM FEIN: 562609254 BUSINESS NAME AND ADDRESS: WILCON CO 9636 NE 5TH AVE. RD MIAMI SHORES , FL 33138 SCOPES OF BUSINESS OR TRADE: UCENSED GENERAL CONTRACTOR Pursuant tD Chapter 440.05(14), F.S., an officer of a corporation who elects exemption from this chapter by filing a certfficate of election under this section may not recover benefits or compensation under this chapter. Pursuant to Chapter 410.05(12), F.S., Cin of election to be exempt... apply only within the scope of the buss ass or trade rated on the notice of election to be exempt. Pursuant to Chapter 410.05(13), F.S., Notices of election to be exempt and certificates of election 10 be exempt shall be subject to revocation if, at any time after the llkng 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 -DVC -252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS? (850)413-1609 Date: l p/ 0 State of WILCON CO. GENERAL CONTRACTOR CONSTRUCTION MANAGEMENT LICENSED & INSURED CGC# 1512642 WILLIAM CRUZ 9636 NE STH AVE Ro. MIAMI SHORES FL, 33138 WCRUZ23@HOTMAIL.COM DESIGN -BUILD CELL 7B6-399-8855 OFFICE 305-456-99B2 County of Dade Before me this day personally appeared Oji //i olii (Art_ who, being duly sworn, deposes and says: That he or she will be the only person woi King on the project at 6 i 9fr Sworn to ( or affirmed) and subscribed before me this l s' 'day of C> - .. ;20 1C., by Personally Know/ Or produced Identification f Type of identification produced y�q��.•; ALVARO ROJAS MY COMMISSION # FF229 202P nt. type or stamp of Notary_ w. `EXPIRES May 11. 2019 • .0150 F,n!IAaN:AAry&Wwca tarn • C[17 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the build- ing or other structure herein described. This application is made in compliance and conformity with the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regulations of the Building Division of Miami Shores Village shall be complied with, whether herein Tecified or• not. A copy of approved plans and specifications must he kept at building during progress of the work. • • • . • • /� Date I 3J •• • • 19t�7 ••••�• Owner's Name and Address C 11 0-15, !J- D T e , �� Str • • •.', • •1 i ( • Registered Architect and/or Engineer •_••.• • • • • ••.• •.•••• •••••• • • • Name and address of licensed contractor cTilia. C 4 oVi T U No 6 Y Location and legal description of lot to be built on: Lot Block Subdivision Street and Number where work is to be done go /V --f--� State work to be done nd purpose of building (by floo ) r .. N -r e five O AS lel 41-R Ahs -F ••••.. • . •• •• •• • • . . . . R . • • T..a;w,t''" :01A.Of , :• • . •• • •••• •00000 • • . . • •• • • •• • • •• ••.•• • • ••••• •.••.• %4 and for no other purpose. New Building Remodeling ' 10 Addition Repairs No. of Stories To be constructed of • Kind of foundation Roof Covering Estimated Total cost of improvements $ 1 p V Amount of F _ ©et Zone cubage required Plan Cubage Distance to next nearest building Maximum live load to be borne by each floor I hereby submita the plans and specifications for said building. All notices be sent to cT ii'a- C c, N S 1 L' 0 , Size of Building Lot v o� p c with reference to the building and its construction 4 -nay The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Sup k mint, and has complied with the provisions thereof, and will require similar compliance from all contractors or sub -contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this permit, as. are licensed by Miami Shores Village. Remarks STATE OF FLORII)A, COUNTY OF DADE. ss. Before me, the undersigned authority, a notary pub duly authorized to administer oaths and take acknowledgments, personally ap- peared (Signed) S to me well known, and who, being by me first duly sworn, upon oat •eposes and says lilt he is the. of the above descr' . ed construction, that he has % arefully read the f egoing application, and that he did sign the same, and that all facts therein by him sta'-d ire rue. Permit No._ Disapproved (Signed) -50 ate Building rispector PLANNING BOA ead, Sworn to and Subscribed before me. Notary Public, State of Florida My Commission Expires DATE ChairMember Member I Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has hecn obtained from the Planning Board. A re -inspection fee of 51.00 will be charged when such re -inspection materials and/or workmanship. de necessary by improper n9tice for inspection or faulty Qi 7dVt'Z ) clea g Xiej fed • 000000 00000 • • 00000 . • 000000 . • . • • • • • • • • • • • • • • • • • • • 000000 • o • 000000 • • 000000 • 000000 • • • • • 000000 ••••• 000000 • • 000000 4 •• V cro • ?s. 110 NE Z2 i (Y G.MSS JA -Li Dt, 9r" uuffi.LS t4TeeP * PLP rer T1 t'lgln. VOLLS S tri P�Lr TILE ?Sinn' E xirr'N-- ?eitnNs R R99 •f w�" �g W 61.14,04<r M/4U..%! a . • ty ..•• • • ' ei •••• '• ..... •• . . • • • • • •• • • • ...... • • TILE Bow WALLS EXISTING- t o' X ZL GI�RR6-E ...... • •••... . . . • RE PLACe eXuc'yG... L.OJvRx w&i•t TVer 1,..)1Ncvu� k. 6-14RF1'&.E t"- ere rdTIo& 4)a_ M t2. �- Mt2r . G tt . &OLDTtPV Goo M . 4 8 ST• i• ALAN t SH-oReS, 1=t RSL ri oo NES 2J r GLASS jr L• De, t-•rdQ .w3:7LLS F\ S t C +71 1 CL \I v4fLLS rl C ►'I -H L T TIL E •LJi)12_S • l'/)INT ${17IA, ( Ce, l+Ivo k' • ,1 )• .4,` wAt `• N 7?za •• Vy (•(r • ••.••• 000000 1:16:1(:1:1•614104.c: o 11 X1 C 14'''9€1e." --- ...i: r" • • • isye•;L•• ••..4. 00000 �—•• '•. . • • „ ••••. • .. •• • • • • • • •• • • • ••••.• ••••.• • • • • • • • • ••• • • • • •• • •.•••• • 000000 7gC �h.r1Ce t KICTiNG— L ;, J v 12 C W i -r +-1 114-004+nlv4m AwNi416— T/et Lk) iso Duui E i S T I N C— 1 0 X ZL GAIRf 1= r1R LT -et -dim) A) -Vu2 V\ I:. Li- Mks, cFi c. G0LpSVe-IAd 6L4 o N t= �� g ST. /t11�M1 S1+oReS/ it -A.. PHONE 82.4803 "SERVING SOUTH FLORIDA LIKE THE SUN" SANITARY LINEN SERVICE CO. ulfjeite- IAA Jte / fr 251 N. W. 22ND LANE MAILING ADDRESS: P. 0. BOX 528 MIAMI. FLORIDA t�. adeLa. 30.) :..... .• • • • ....••. .. . . • • •..... • • • ••..• •....: • •• .• • • • •d• •..• • • •• Ai '1— Lccif• Qt4 kA&L CDT Lx;4ii _Jr wuci 6"f&x' AA"? r1-1 etaA11-2 "LOCALLY OWNED AND OPERATED" 000000 • • • ...... .•..,, ..... • .•••. •...•. •• • • Miami 8-4-16 All Data from ASHRAE Residential System Sizing Calculation Existing Address: MIAMI SHORES FI Owner: Zone: South Summer Design Temperature 90 F Summer Set point 75 F Summer Temperature Difference 15 F Winter Design Temperature 50 F Winter Set Point 70 F Winter Temperature Difference 20 F 1 Rooms / 2 persons At Miami Latitude 25 ; Altitude 11 ft Humidity data Interior RH 50%. Outdoor wet Bulb 77 F Humidity difference 58 gr System Sizing Calculation -SUMMER- Floors. Slab on Grade . R= 0.0 ; HTM = 0 Total Perimeter : 66 ft area..264 sqf total... 1,188 BTU/H Roof+Ceiling. Main area under existing Unit= 264 sqf R=19. HTM= 3.6 Pitch : GABLE Roof Q= 264*3.6= 951 Btu/h Infiltration Sensible CFM = 75 Q= 1.1*75*25= 2,063 Btu/h Infiltration Latent = Q=0.7*75*58=3,045 Btu/h • . • . . . . • . . . . . .... .... • . • . .... .... . • .. . . • .. • . . • . • • • . •. • .. . 264*1.5*'3 1,188 btu/h Internal gain= 2 occupant*230 +1200= 1,660 Btu/h Sensible Internal gain= 2 occupant*200 Btu/h/person = 400 Btu/h Latent Duct No No attic. R=0, Max Oft. (DGM of 0.064) = 0 BTU/h/ Sensible Or 10% of total sensible/which is the worst case Walls. = N= 96 sqf; CLTD = 15 , R =5 , Q= 0.20*15*96= 288 Btu/h S= 96sgf; CLTD = 15, R= 5, Q= 0.20*15*96 =288 Btu/h E= 176 sqf ; CLTD= 26, R=5 , Q= 0.20*26*176=915 Btu/h 288 btu/h 288 btu/h 915 btu/h •••• . • • • • • • • • W= 176 sqf; CLTD= 10, R=5, Q= 0.20*10*176= 352 Btu/h 352 btu/h Windows. Shading Coeff =0.30 U glass Coeff (clear) = 0.65 Direct an Diffuse Solar Radiation N S E W 11.6 73.5 17.4 52.3 Convec and Rad Heat gain N S E W 16.5 18 16.6 17.5 0= A*GLF Windows South Q= 56*((73.5*0.30)+(18*0.65))= 4,894 Btu/h Windows West Q= 185*((17.4*0.30)+(16.6*0.55))= 1,004.5 Btu/h Windows North Q= 9*(60*0.30) +(15*0.65)= 250 Btu/h Q East=0 Total Sensible for Summer = 13,853 Btu/hr Total Latent for Summer= 3,445 Btu/h Total Summer = 17,298 Btu/h 1.44 tons , use 1.5 tons WINTER Calculations Difference temperature 20 F HTM 25.4 Windows Q= ( 56+185+9)*25.4= 6,350 Btu/h Walls Total Area (effective ) = 544 sqf HTM = 0.20 *20= 4 Q= 544*4 = 2,176 Btu/h • • • • •• • • •••• •••• • • • • •••• • •••• ••• •• •• •• • •• •• • • • • • ▪ •• •• • •••• •• • • • • • • • i Ceiling Area = 264 sqf HTM = 1.05 Q= 264*1.05= 273 Btu/h Floor Perimeter 68 Ft, HTM = 23.6 Q= 68*23.6= 1,605 Btu/h Infiltration Q= 1.1*50*20 =1,100 Btu/h total= 11,504 Btu/hr Total Winter Loss Q= 11,504 Btu/h or 3.44 Kw Use 3.5 Kw • • • • •• • • • • • • • .... .... • . • .... •..• . •• •• • •• •• • .. • • • • • • . . • • • • • • •• • .... • . q-/2_ 20/,‘ of ec-r CPS(‘ CS: 14n, cy doss 10 0 5- qg s+ �f�-F-►'� IZ Cry-L.G % �oc- rer/// 4 / d � Zd 43 D (Di) - /. 2 (l i} _ r1d� l'U.'1'rcsfi J9 71(2 /) • ,f4 (/ y/ 2- -- /2, cv (.7 (e\t ft r ie 2 • • • • • •• • 721?6) 1 • • • • • • • • • •• •. ��A--✓.�•�! � Z •••• •••• r ••...•, • -...r2 • • ••• • • • • • • • •• • • • • •••• • • • .• • • • • • • • • 1 ld. g1n�z /77,6411.7 - /2 /iz 36e r u ‘o (/ 2/ 7 ), /d 6) ( 1 r2/ PI /Z ( /rid( (# 2 (Z,�l �� FEDERAL EMERGENCY MANAGEMENT AGENCY NtationaltFlood Insurance Program SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name KENNETH AND JENNIFER KAY A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 640 N.E. 98TH STREET. City VILLAGE OF MIAMI SHORES State FL ZIP Code 33138 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOTS 7&8,BLOCK 101, OF "MIAMI SHORES SEC.4 AMD", ACCORDING TO PB15, PG 14, MIAMI-DADE COUNTY. Policy Number: Company NAIC Number: A4. Building Use (e.g., Residential, Non -Residential, Addition, Accessory, etc.) Residential A5. Latitude/Longitude: Lat 25°51'56 03" Long f30°11'04 29" Horizontal Datum: NAD 1927 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. A7. Building Diagram Number 8 A8. For a building with a crawlspace or enclosure(s): A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(s) 3067 sq ft a) Square footage of attached garage N/A sq ft b) Number of permanent flood openings in the crawlspace b) Number of permanent flood openings in the attached garage or enclosure(s) within 1.0 foot above adjacent grade c) Total net area of flood openings in A8.b d) Engineered flood openings? Yes No la 1780 sq in within 1.0 foot above adjacent grade N/A c) Total net area of flood openings in A9.b NLA sq in d) Engineered flood openings? Yes No SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Community Number VILLAGE OF MIAMI SHORES/120652 B2. County Name MIAMI-DADE COUNTY B3. State I FL B4. Map/Panel Number 1 B5. Suffix B6. FIRM Index Date 12086/0306 L ; 09/11/2009 B7. FIRM Panel Effective/ Revised Date 09/11/2009 B8. Flood Zone(s) X B9. Base Flood Elevation(s) (Zone AO, use base flood depth) N/A B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in Item B9. FIS Profile FIRM Community Determined Other/Source: B11. Indicate elevation datum used for BFE in Item B9: NGVD 1929 NAVD 1988 Other/Source: B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Yes No Designation Date: N/A CBRS OPA SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: Construction Drawings* Building Under Construction* Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations — Zones A1—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, AR/AO. Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Rico only, enter meters. Benchmark Utilized. N -603-R Vertical Datum: NGVD 1929 Indicate elevation datum used for the elevations in items a) through h) below. NGVD 1929 NAVD 1988 Other/Source: Datum used for building elevations must be the same as that used for the BFE. • • • • • • • • •• • • • • •••• • • •••• • • •• •• • • • • • • • • • • •• • • •••• • • •••• •• • • • • • •• • • • • •. • • • • •• • • •••• • • • • • FEMA Form 086-0-33 (7/12) See reverse side for continuation. Replaces all previous editions. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) b) Top of the next higher floor c) Bottom of the lowest horizontal structural member (V Zones only) d) Attached garage (top of slab) e) Lowest elevation of machinery or equipment servicing the building (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) g) Highest adjacent (finished) grade next to building (HAG) h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support • .• • • • .• • • • . . • • • • •• • • •••• • • •••• • •• • • • •• • • • • • • • •••• • • • •••• • • •••• • • •• • • • • • • • • • • • •• NLA. N/A. N/A. 9.41 9.22 9.36 N/A. Check the measurement used. feet feet feet feet feet feet feet feet meters meters meters meters meters meters meters meters FEMA Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions IMPdRTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 640 N.E 98TH STREET Policy Number: City VILLAGE OF MIAMI SHORES State FL ZIP Code 33138 Company NAIC Number: SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION (CONTINUED) Copy both sides of this Elevation Certificate for (1) community official, (2) insurance agent/company, and (3) building owner. Comments CROW OF THE ROAD ELEVATION= 9.64' , BENCHMARK MIAMI-DADE COUNTY #N -603-R , ELEVATION =8.06" DATUM N.G.V.D. 1929 C2e.) LOWEST ELEVATION OF EQUITMENT/MACHINERY SERVICING THE BUILDING(AIR CONDITIONER)= 9.41' ATTACHMENTS: BUILDING PHOTOGRAPHS. Signature Date 12/02/2013 SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B, and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. E1. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is feet meters above or below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is feet meters above or below the LAG. E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or 9 (see pages 8-9 of Instructions), the next higher floor (elevation C2.b in the diagrams) of the building is feet meters above or below the HAG. E3. Attached garage (top of slab) is feet meters above or below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is feet meters above or below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's floodplain management ordinance? Yes No Unknown. The local official must certify this information in Section G. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner's or Owner's Authorized Representative's Name Address City State ZIP Code Signature Date Telephone Comments • • • • • • check here if atIMPIeh is • SECTION G — COMMUNITY INFORMATION (OPTIONAL) • The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can oorr+piete Sectio i A,•B•, C (or E), and of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G1 8.,)4 j; ygrto Rico orgy enter meie+l • • G1. The information in Section C was taken from other documentation that has been signed and sealed by a licensed:ernyor, er>ptlipelP, pr archife !diRo is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Commis area below.$ • • G2. A community official completed Section E for a building located in Zone A (without a FEMA -issued or communiti.i9sued BFE) or Zone AO. • • G3. The following information (Items G4—G10) is provided for community floodplain management purposes. • • • • • • • . • G4. Permit Number I G5. Date Permit Issued I G6. Date Certificate Of Compti2Ince?OccuP3rfc'3s'sjied • • i •• • G7. This permit has been issued for: New Construction Substantial Improvement G8. Elevation of as -built lowest floor (including basement) of the building: feet meters Datum G9. BFE or (in Zone AO) depth of flooding at the building site: feet meters Datum G10. Community's design flood elevation: feet meters Datum FEMA Form 086-0-33 (7/12) Replaces all previous editions. SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that the information on this Certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Check here if comments are provided on back of form. Were latitude and longitude in Section A provided by a Check here if attachments. licensed land surveyor? Yes No Certifier's Name EFRAIN LOPEZ License Number 6792 Title P.SURVEYOR AND MAP. Company Name N/A Address 13801 S.W. 10 TERRACE Signature • • • • • • • • • . • • • • • •• •••• • • •••• • •• • • • .• • • • • • • •••. • • • • • • • • • •• • •••• • • •••• • • •• •• • • • • • • • • • • • •• City MIAMI DADE Date 12/02/2013 State FL ZIP Code 33184 Telephone (786) 416 - 4026 FEMA Form 81-31, January 2003 See reverse side for continuation. Replaces all previous editions ELEVATION CERTIFICATE, page 3 Building Photographs See Instructions for Item A6. IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 640 N.E. 98TH STREET City VILLAGE OF MIAMI SHORES Policy Number: State FL ZIP Code 33138 Company NAIC Number: If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. . • . . •. . .... • • .• •• • • • • .... • • •••• .. • • • • • •• • .• • .. • . • • • • • • . . •. • • •••• • • • FEMA Form 086-0-33 (7/12) Replaces all previous editions. Local Official's Name Title Community Name Telephone Signature Date Comments Check here if attachments • •� • • • • • • • • • • . •. • • • • • • •••• •... • • • • •••• •.•• • • • •� • •• • • • •• • •• • • •••• • • • • • •• • • • • • • • • • .• FEMA Form 086-0-33 (7/12) Replaces all previous editions. FRONT VIEW DATE TAKEN 12/02/2013 REAR VIEW DATE TAKEN 12/02/2013 • • • • • •• • • •••• • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • •••• • • •••• • • • • • • •• • • • • • • • • • • • • • •• • • •••• • • • • •• • Instructions — Page 2 RIGHT VIEW DATE TAKEN 12/02/2013 LEFT VIEW DATE TAKEN 12/02/2013 • • • • • .• • • •••• • • •••• • • •• •• • • • • • • • • • • •• • • • • • •• . • ••.i• __....• • • • •••• •• • • • • • •• • • • • •••• • • • • • • •• • • • • FEMA Form 086-0-33 (7/12) Replaces all previous editions. ELEVATION CERTIFICATE, page 4 Building Photographs Continuation Page IMPORTANT: In these spaces, copy the corresponding information from Section A. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. j 640 N.E. 98TH STREET City VILLAGE OF MIAMI SHORES State FL ZIP Code 33138 FOR INSURANCE COMPANY USE Policy Number: Company NAIC Number: If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. • •` • • • • •••• • • ••.• • •` • • •• • • . •• • • • • ••.. • • . • • • • • • •• • •••. • • •••• . • •• •• • • • • • • • • • • • •• FEMA Form 086-0-33 (7/12) Replaces all previous editions. SME LAND \Levi- ai 4e Proudly Serving !6+ ;y, the Florida Real Mt N�' Estate Community for Over 20 Years www-Mr.LANnsrRVICIS.COM • • •••• • • • • • • • •• • • • • •• • •• • • • • • • (• • �Qo.00'(N)•'• . •°i••• F.Mr J,PJ/2' 7t • 1t" •• N. E. 98th STREET /9' ASPHALT PAVEMENT t: 23.5' PARKWAY h • ••• • • •••• {t 5't lic.- wi1LX• uz. a 9.50 1461 0.1' ...,.-....., rZ.40' •h - • • • ' J2. A0' • • I'- H '1 I • •: • •• ••• • • h '' 'Y' . teei, ' •'- cavE. t+ --, ..A.4P4 • •ice=-„ , 11 00' k 0:1 U d • 0.59' CO 54.01' BRICK PAVERS PA no. / I / !8 i 81 2 Jr a "" klI • Lal' a Bl CiCM IC11 0.15' _.... FOUND NAIL 7.00' 1.. • 1.60' �_..........409:00TR -M) 9' ASPHALT PAVEMENT Accepted By: 0. 5. P1P.5/4' Property Address: 640 N.E. 98 Street Miami Shores, FLORIDA 33138 Notes: NO NOTES SURVEYOR'S CERTIFICATION: I HERBY��,;�, F•Y THAT THIS BOUNDARY SURVEY ISA TRUE AND CORRECT WrTH HE MINMUEMTECHNICALOF A�1 �"�t `lDORTHH BYDER Y DIRECTION. THIS COMPUES THE HE STATE OF FLORIDA BOARD OF PROFESSIONAL LAND SUR CY $ THROUGH 51-I7-os4 FLORIDA ADMINISTRATIVE CODE PI1RSTATUES SIGNED EFRAIN LOP STATE OF FL FOR THE FIRM P.S.M. No. 6792 NOT VALID WITHOUT AND AUHENIC SIGNATURE AND AUTHENTICATED ELECTRONIC SEAL AND/OR HIS MAP IS WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A LICENSED SURVEYOR AND MAPPER. M.E. Land Surveying, Inc. 10665 SW 190th Street Suite 3110 Miami, FL 33157 Phone: (305) 740-3319 Fax: (305) 669-3190 LB#: 7989 ME LAND_ v. Survey #:B-23297 Client File #: Page I of 2 Not valid without all pages PROPERTY UNE Surveyor's Legend B.R. BEARING REFERENCE TEL, TELEPHONE FAL'arnts FNO MAO IRON PIPE J PHI AS WED ON PLA? � Cf.NTkAL ANGLE OR DELTA U.P. UMW/ POLE LER LICENSE 0 - BUSINESS R RADIUS OR RADIAL £A-B- ELECTRIC SESJTY 805 L50 UCEN5E 0 -- SURVEYOR RAO. RAW TIE SEP. SEPTIC TANK CALL CALCULATED POINT N,R, NON RADIAL 8.8. ORARIFIELO SET SET PIN TVP. TYPICAL AFC ANI CONDITIONER • CONTROL POINT LR. IRON 000 5/0/ 5Nt[WAik a CONCRETE MONUMENT LP. IRON PIP£ ow/ 80NE.WA5 0. BENCHMARK NATO NAN. Y TRS% SCR. SCREEN EEE5 ELEVATION Al: HAIL PARKER-KALON NAY. OAR GARAGE P.T. POINT OF TANO£NC7 D.N. MU.HOLE (mot_ENCLOSURE P.C. P01111 OF CURVATURE. 0 WELL N,T.S- NOT TO SCALE P.R.N. PERMANENT REFERENCE MONUMENT , nos HYDRANT F,F- FINNISHEO FLOOR P.C.C. POINT OF CONP0050 CURVATURE TOP OF BANK R.C. POINT CT CURVATURE ON.L. OVERHEAD LINES , CODE OF WATER P,1Cj N.N. MANHOLE Low P.O.& POINT OE BEORINNNG Tx TRANSFORMER cow EDGE OF PAVEMENT P.O.C. POINT Of COMMENCEMENT CAN CABLE TV RICER C-V-O, CONCRETE VALLEY GUTTER P.C.P. PERMANENT CONTROL POINT IYAM. WATER METER ILIA_ •mnD,b SMACK UNE 8 8,ELD MEASURE0 s/E POOL EO5MMENt SURVEY TN: LINE S,T.L- 0 PLATTED MEASUREMENT CONE, CONCRETE SLAB Pi 5E14150 UNE 0 0500 E.SHT EASEMENT RJW 11101.1-0E-WAY C CALCULATED .£. T#4ANsCE EA$EtiEN" F,,E_, PAWIC U1I1,1 54T?IIA545 . 3kr- LY_ ..,f.NOSCAP5 k'al.N'. EWE -D.E. LANEIR APE s.?YER EAREARIWE o ga. CANAL MTHITIsANCE EASEMENT' T RA, ROOT s...,. E, EA Eos-s L,.AE, UNITER ACCESS EAREWEHE A.L. ANRHOP TAREmENT STRUCTURE YtY^'".,-,-", CONC, BLOCK WALL —Y-5— CHAIN-UNK FENCE OR WIRE FENCE --0,--ii— WOOD FENCE ---44--45.-- - IWON FENCE ............. ._... _-_ EA5£MENr — - -- CENTER UNE YY- .-•x'1/)/,�'77 '7E.«./!_1 W000 DECK _—] CONCRETE � :.L/..IL.L.;I ASPHALT •041.$4' 14 BRICK / TILE �J'"' E7.27:4 WATER APPROXIMATE EDGE OF WATER 7._,'m•+'..-� COVERED AREA C11TREE • 54 PO=WER POLE CATCH BARN C1x?555 INILITE 50.;"i 055Y 1.:/}E_ 50515 E 5555 LAREVE555 .R;,.IT: FA„E uo Property Address: 640 N.E. 98 Street Miami Shores, FLORIDA 33138 General Notes: 1.) The Legal Description used to perform this survey was supplied by others. This survey does not determine or is not to imply ownership 2.) This survey only shows above ground improvements. Underground utilities, footings, or encroachments are not located on this survey map 3.) If there is a septic tank, well, or drain field on this survey, the location of such items was shown to us by others and the information was not verified. 4.) Examination of the abstract of title will have to be made to determine recorded instruments, if any, effect this prop erty.The lands shown herein were not abstracted for easement or other recorded encumbrances not shown on the pl at 5.) Wall ties are done to the face of the wall. 6.) Fence ownership is not determined. 7.) Bearings referenced to line noted B.R 8.) Dimensions shown are platted and measured unless otherwise shown. 9.) No identification found on property comers unless noted. 10.) Not valid unless sealed with the signing surveyors embossed seal. 11.) Boundary survey means a drawing and/or graphic representation of the survey work performed in the field, coul d be drawn at a shown scale and/or not to scale 12.) Elevations if shown are based upon NGVD 1929 unless otherwise noted 13.) This is a BOUNDARY SURVEY unless otherwise noted. 14.) This survey is exclusive for the use of the parties to whom it is certified. The certifications do not extend to any u nnamed parties. 15.) This survey shall not be used for construction/permitting purposes without written consent from the land surveyor who has signed and sealed this survey. Flood Information: Community Number: 120652 Panel Number: 12086C0306 SUFFIX: L Date of Firm Index: 09/11/2009 Flood Zone: X Base Flood Elevation: N/A Date of Field Work: 12/12/2016 Date of Completion: 12/13/2016 • Legal Description: E • • • LOTS 7 AND 8, BLOCK 101, OF AMENDED PLAT OF MIAMI SHORES SECTION NO. 4 ACOORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 15,PAGE 14, OF THE PUBLIC RECORDS O MIAMI-DAM. • I COUNTY, FLORIDA • • •. • Printing Instructions: While viewing the survey in any PDF Reader, select the File Drop-down and select "Print". Select a color printer, if available; or at least one with 8.5" x 14" (legal) paper. Select ALL for Print Range, and the # of copies you would like to print out. Under the "Page Scaling" please make sure you have selected "None". Do not check the "Auto-rotate and Center" box. Check the "Choose Paper size by PDF" checkbox, then click OK to print. •••• •• • • Certified To: • • •• ••4 Carlos Cuartas • • • • • • • Self • • its successors and/or assigns as their inteast opq appea t • • • • • • • • _ Please copybelow for policyre aration purposes only: p p p This policy does not insure against loss or damage byeason %the following. • • exceptions: Any rights, easements, interests. or claims which may exist b.reasan • of, or reflected by, the following facts shown on the survey prepared by _ • • • EFRAIN LOPEZ dated 12/13/2016 bearing Job # B-23297 : a. NO NOTES M.E. Land Surveying, Inc. 10665 SW 190th Street, Suite 3110 Miami, FL 33157 w " "— ME LAND ME LAND Phone: (305) 740-3319. - - Fax: (305) 669-3190 \...L.1. * ••' LB#: 7989 Survey 1r'.13-23297 Client File #. Page 2 of 2 Not valid without all pages This instrument was prepared by: Name: C0e.DSS Address: 104,:, e 8 . *Li 0..044 S (13. 111111111Ii11111111 Il II1iI 1I1ll s (F=N 2E1l- R0.7;> -, - 7R r_.K. 30347 Fss 3492. .:49' -Pq—' (Space reserved for Clerk) DECLARATION OF USE In consideration of the issuance of a building permit/Certificate of Use and Occupancy, as hereinafter described, the undersigned, as Owner(s) of the property herein legally described, hereby agree and bind myself, or ourselves, and my, or our, heirs, successors and assigns as follows: Coe -,4 A t. 1 P tit iZr�55 The property herein described shall be used for: (15IM. 1 StvrA. On Lot- 5Block to of Witi 51n.6 SCG I km.b P.B. IS — [I Pg. of the Public Records of Miami -Dade County, Florida. .a . . . • .t A AM . •• • . 640 pit✓ '3T. IM cuva Ski) rR s Also known • as Miami-DadQggtinty, Fjotj a. • This agreement is hereby made and accepted as a condition of the issuarfcebf a btailding permit/Certificate of Use and Occupancy for: 011 F4 '&rD ¢- a- • ; • • • • • • . • .. • • •..• • . • Covenant Running with the Land. It is further understood and agreed that this agreement shall be deemed a covenant running with the land and shall remain in full force and effect and be binding upon the owner, their heirs, successors and assigns until such, time as the same may be released in writing by the Director of the Miami -Dade County Department of Regulatory and Economic Resources, or the executive officer of the successor of such department or, in the absence of such director or executive officer, by his assistant in charge of the office in his absence. [f./forms/declaration-general (12/12/12)] Section -Township -Range: Folio number: ti -���.. Ot l — 1r2) • • • • OR BK 730a:47 4 c_s LAST PAGE G Declaration of Use Building Permit/Certificate of Use and Occupancy Page 2 County Inspection. As further part of this agreement, it is hereby understood and agreed that any official inspector of the Miami -Dade County or its agents duly authorized, may have the privilege at any time during normal working hours of entering and investigating the use of the premises, to determine whether or not the requirements of the Building and Zoning Regulations and the conditions herein agreed to are being complied with. Enforcement. Enforcement shall be by action against any parties or person violating, or attempting to violate, any covenants. The prevailing party in any action or suit, pertaining to or arising out of this declaration, shall be entitled to recover, in addition to costs and disbursements allowed by law, such sum as the Court may adjudge to be reasonable for the services of his attorney. This enforcement provision shall be in addition to any other remedies available at law or in equity or both. Recording. This Declaration shall be filed of record in the public records of Miam2,patle County, Florida at the cost to the Owner following the adoption by the Mkrptlade cpuq,ty Board of County Commissioners or Zoning Appeals Board of a resolutioc••approvigg%t e Application. $ D • • •••• •• OD z • •< ( •••• • • • I •77 (11 •••• • •••<W t z a I� -0 SS (3o/ZO(L [EXECUTION PAGES FOLLOW] HORTENSIA V. MONTEL Notary Public - State o1 Florida Cow* j 240653 n 16.2019 [f./forms/declaration-general (12/12/12)] Section -Township -Range: Folio number: (l_ 3 2.06_ Q(? - ( Y 2 0 • .• • a - �. •,• .r •s 1, a •t4.m •a ts•-i e•?•D n -. • •�•) F.,• 1 Z 0 -n D 0 rn R�1 NCIGi t\tcrr 131r[ e NA Aa: no A4 sZo 3 S Pp---00C-0)t o l >`7 no r ors/ Drdered By. N. E. 98th STREET 19' ASPHALT PAVEMENT ' "20o.00:0.0 . I/2" F.10 5s 9AOC% CORNER WAYX 0.7I'— 0.89' • • r caNc,, •: 0.u.:',Off o ""."rzsd- °a c, m o: • • • • • • • -",.•• • • • • o • • ik cn •r • I—Y • • • CZ) ° o •••• •••• • • CSm • • M •••. •••• .., •. • • • • • • •• •• • •• • • . • • • • • • • • • . . .• • • • • .... • • • •. • • • romp Nato 0.. ' 10/.001RXM /4* 9' ASPHALT PAVEMENT L Accepted By: Property Address: 640 N.E. 98 STREET MIAMI, FL 33138 TES: NC) NOTES WfAVFVDN(iPeAl SURVEY El Prtr-Y' -IRECTEONUTH SURVEY IS ATRi1110 lINIMUM ';.aa REPRESENTATION OFA SURVEY AR 7 UNDER MY DIRECTION THIS COMPLIES WITH THE MINIMUM LECHNICAL STANDARDS. 140/7. FORTH BY THE STATE OF FLORIDA BOARD OF PROFESSIONAL LAND .3URVEYORS IN CHAPTER 141. 7. FLORIDA ADMINISTRATIVE CODE PURSUANT TO 472.027, FLORIDA STATUTES. SIGNED MIGUEL ,40T VALST.AITZIOE ELECTRONI CHIS MAP IS NOT VALID WITHOUT T11E SIGNA0AJ8 IND MAPPER. FOR THE FIRM P.S.M. No. 5101 ATURE AND AUTHENTICATED ELECTRONIC SEAL AND/OR 0 THE ORIGINAL RAISED SEAL OF A LICENSED SURVEYOR Survey:A-43524 Client File #: ROSS P/F KAY ME Land Services, Inc. 10665 SW 190TH STREET SUITE 3110 3 MIAMI, FL 33157 PHONE: (305) 740-3319 FAX: (305) 669-3190 LB#: 6463 Page 1 of 2 Not valid without all pages. PROPERTY UNE STRUCTURE 022220" ;_e CONC. BLOCK WALL --%--%— CHAIN—LINK FENCE OR WIRE FENCE —//—:/— WOOD FENCE 0 o IRON FENCE ......................... ::AS EME Nr CENTER UNE %1l ,A WOOD DECK 1 CONCRETE rL!_/./22 ASPHALT BRICK / TILE WATER APPROXIMATE EDGE OF WATER COVERED AREA FTz�k � I 1 C.;1... TREE POWER POLE CATCH BASIN E'idR� S ! F,0001 EASY.Mi'?ii V: t;.5iNEN7 Property Address: 640 N.E. 98 STREET MIAMI, FL 33138 END 181 1.01 CALL SET E1EV P.T. P.C. p.8 M. P.C.C. P.R.C. P.0.8. P.O.C. P.C.P. M .H.E. Surveyor's Legend FOUND IRON PIPE / PIN AS NOTED ON PLAT LICENSE 1 — 8051NE55 LICENSE 1 — SURVEYOR CALCULATED POINT SET PIN CONTROL POINT CONCRETE MONUMENT BENCHMARK ELEVAT1O8 POINT OF TANGENCY POINT OF CURVATURE PERMANENT REFERENCE MONUMENT POINT OF COMPOUND CURVATURE POINT OF REVERSE CURVATURE POINT OF BEGINNING POINT OF COMMENCEMENT PERMANENT CONTROL POINT F!ELO MEASURED PLATTED MEASUREMENT DEED CALCULATED it 11-?*lCSf P k' 100', _tx.r 1)0.;,y34AN'd P....Fk" Flood Information: Community Number: Panel Number: Suffix: Date of Firm Index: Flood Zone: Base Flood Elevation: Date of Field Work: Date of Completion: 120652 12086C0306 L 9/11/2009 X N/A 10/22/2013 10/24/2013 B.R. BEARING REFERENCE TEL. • CENTRAL ANGLE OR DELTA U.P. R RADIUS OR RADIAL E.U.B. RAD. RADIAL TIE SEP. N.R. NON RADIAL O.F. TYP. TYPICAL A/C 1.8. IRON ROD s/W I.P. IRON PIPE 0Wy N*D NAIL & DISK SCR. PK NAIL PARKER—KALON NAIL GAR O.H. DRILL HOLE SNCL • WELL N.T.S. FIRE HYDRANT F.F. ® M.H. MANHOLE T.O.B. 0.1.1.L. OVERHEAD LINES E.O.W. TX TRANSFORMER E.O.P CATV CABLE TV RISER W.M. WATER METER P/E POOL EQUIPMENT CONC. CONCRETE SLAB MUT t.=100::0 EAS 01150' 000180 EA1001::<T L'Mr1 ACC005 E:011)00 General Notes: TELEPHONE FACILITIES UTILITY POLE ELECTRIC UTILITY 80X SEPTIC TANK DRAINFIELD AIR CONDITIONER SIDEWALK DRIVEWAY SCREEN GARAGE ENCLOSURE NOT TO SCALE FINNISHED FLOOR TOP OF BANK EDGE OF WATER EDGE OF PAVEMENT C.V.G. CONCRETE VALLEY CUTTER B.S.L. BUILDING SETBACK LINE 5.T.L, SURVEY TIE LINE CE CENTER UNE R/W RIGHT—OF—WAY P.ti.£. 01)0)15 0 ?LITI' i;?5t#EE .4P. r:NA0::.. A0C;"OR 1. The Legal Description used to perform this survey was supplied by others This survey does not determine or is not to imply ownership. 2. This survey only shows above ground improvements. Underground utilities, footings, or encroachments are not located on this survey map. 3. If there is a septic tank, well, or drain field on this survey, the location of such items was shown to us by others and the information was not verified. 4. Examination of the abstract of title will have to be made to determine recorded instruments, if any, effect this property. The lands shown herein wer not abstracted for easement or other recorded encumbrances not shd/✓n on • the plat. • • • 5. Wall ties are done to the face of the wail. • • • 6. Fence ownership is not determined. • es • • 7. Bearings referenced to line noted B.R. • 8. Dimensions shown are platted and measured unless otherwise shown. 9. No identification found on property corners urr?eedpnElAs. • 10. Not valid unless sealed with the signing surveyQrr er,bossed seal.... • 11. Boundary survey means a drawing and/or graphic repr•sentationof the • survey work performed in the field, could be drawn 9t ehttiwn scale ane/drnet to scale. • • • 12. Elevations if shown are based upon NGVD 1929•Inles• otherwise noted. • 13. This is a BOUNDARY SURVEY unless other*ise rletEd. • • • 14. This survey is exclusive for the use of the paraiwilvatiem it is certified• The certifications do not extend to any unnamed perties• • • Legal Description: • • • • • • LOTS 7 AND 8, BLOCK 101, OF SUBDIVISION AMENDED PLAT OF MIAMI SHORES SECTION NO. 4, ARCORDING j0• • •' ii THE PLAT THEREOF AS RECORDED IN PLAT BOOK 15, PAGE 14, OF THE PUBLIC RECORDS OF MIAMI-DADE • • •• COUNTY, FLORIDA PRINTING INSTRUCTIONS: While viewing the survey in any Acrobat Reader, select the File Drop-down and select "Print" Select a color printer, if available, or at least one with 8.5" x 14" paper. Select ALL for Print Range, and the # of copies you would like to print out. Under the "Page Scaling" please make sure you have selected "None." Do not check the "AutoRotate and Center" button. Check the "Choose Paper size by PDF"checkbox. Click OK to Print. Survey:A-43524 Certi ted o: CORNO AY -•S, fA tFIDELITY NATIONAL TITLE INSURANCE COMPANY; WELLS ARGO, N.A.; . Its'successors and/or assigns as their interest nay appear. M.E. LAND SURVEYING, INC. 10665 SW 190TH Street, Suite 3110 MIAMI, FL 33157 PHONE:(305) 740-3319 FAX #:(305) 669-3190 LB # 6463 WWW.MELANDSURVEYING.COM Client File #: ROSS P/F KAY AFFILIATE MEMBERS Page 2 of 2 Not valid without all pages. M iami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Notice to Owner — Workers' Compensation Insurance Exemption pt Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 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 if: 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 toworkon 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: State of Florida County of Miami -Dade The foregoing was acknowledge before me this 2''t° day of fa. By Co 2'4 Q.&65 SEAL: ,20 t7' . who is personally known to me or has produced as identification. : .J1: 84 S3 ALVARO ROJAS MY COMMISSION # FF229202 EXPIRES May 11. 2019 1 .R1dA14.4ehraO.Mr,401 • NATIONAL FLOOD INSURANCE PROGRAM ELEVATION CERTIFICATE AND INSTRUCTIONS 2015 EDITION •• . • •• ••• ...... • ...... • • 000000 • •• • • • • . •• • ••• • •• • • • •• ...... • • •• •• ...... .t • • • • • • • •• • .• ...... • • • • •..... • .•.• • • • ...•l • • .•.• • • • ..•• • .•.. • ..... ...... . • • • 1. ••..• • • OMB No. 1660-0008 Expiration Date: November 30, 2018 U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE AND INSTRUCTIONS Paperwork Reduction Act Notice Public reporting burden for this data collection is estimated to average 3.75 hours per response. The burden estimate includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and submitting this form. You are not required to respond to this collection of information unless a valid OMB control number is displayed on this form. Send comments regarding the accuracy of the burden estimate and any suggestions for reducing the burden to: Information Collections Management, Department of Homeland Security, Federal Emergency Management Agency, 1800 South Bell Street, Arlington, VA 20598-3005, Paperwork Reduction Project (1660-0008). NOTE: Do not send your completed form to this address. Privacy Act Statement Authority: Title 44 CFR § 61.7 and 61.8. Principal Purpose(s): This information is being collected for the primary purpose of estimating the risk premium rates necessary to provide flood insurance for new or substantially improved structures in designated Special Flood Hazard Areas. Routine Use(s): The information on this form may be disclosed as generally permitted under 5 U.S.C. § 552a(b) of the Privacy Act of 1974, as amended. This includes using this information as necessary and authorized by the routine uses published in DHS/ FEMA -003 — National Flood Insurance Program Files System or Records Notice 73 Fed. Reg. 77747 (December 19, 2008); DHS/ FEMA/NFIP/LOMA-1 — National Flood Insurance Program (NFIP) Letter of Map Amendment (LOMA) System of Records Notice 71 Fed. Reg. 7990 (February 15, 2006); and upon written request, written consent, by agreement, or as required by law. Disclosure: The disclosure of information on this form is voluntary; however, failure to provide the information requested may result in the inability to obtain flood insurance through the National Flood Insurance Program or the applicant may be subject to higher premium rates for flood insurance. Information will only be released as permitted by law. Purpose of the Elevation Certificate The Elevation Certificate is an important administrative tool of the National Flood Insurance Program (NFIP). It is to be used to provide elevation information necessary to ensure compliance with community floodplain management ordinances, to determine the proper insurance premium rate, and to support a request for a Letter of Map Amendment (LOMA) or Letter of Map Revision based on fill (LOMR-F). The Elevation Certificate is required in order to properly rate Post -FIRM buildings, which are buildings constructed after publication of the Flood Insurance Rate Map (FIRM), located in flood insurance Zones A1—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, and AR/AO. The Elevation Certificate is not required for Pre -FIRM buildings unless the building is being rated under the optional Post -FIRM flood insurance rules. • • •••••• •••••• As part of the agreement for making flood insurance available in a community, the NFIP requires theicorrimity td adopt floodplain•• management regulations that specify minimum requirements for reducing flood losses. One such regaitement is fVthe oommul jty•:. to obtain the elevation of the lowest floor (including basement) of all new and substantially imprcwed.buildings' anti'maintain a • record of such information. The Elevation Certificate provides a way for a community to document compiieriee with the'communi +s • • oodplain •management ordinance. • • • • .• • • •• •• ..... Use of this certificate does not provide a waiver of the flood insurance purchase requirement. Only a• t. 1A or LOMR-.F from the :••• Federal Emergency Management Agency (FEMA) can amend the FIRM and remove the Federal m8108:or a leading tnstitutipn. • • • to require the purchase of flood insurance. However, the lending institution has the option of requirfAg'Mod insurance even if a •• LOMA/LOMR-F has been issued by FEMA. The Elevation Certificate may be used to support a LOMAtitLIIMR-F request. Lowest..: • floor and lowest adjacent grade elevations certified by a surveyor or engineer will be required if the certificate is used&krsupport.a • LOMA or LOMR-F request. A LOMA or LOMR-F request must be submitted with either a completecVF MA PAT -EZ or MT-"": package, whichever is appropriate. • • • •" • • • .• • This certificate is used only to certify building elevations. A separate certificate is required for floodproofing. Under the NFIP, non- residential buildings can be floodproofed up to or above the Base Flood Elevation (BFE). A floodproofed building is a building that has been designed and constructed to be watertight (substantially impermeable to floodwaters) below the BFE. Floodproofing of residential buildings is not permitted under the NFIP unless FEMA has granted the community an exception for residential floodproofed basements. The community must adopt standards for design and construction of floodproofed basements before FEMA will grant a basement exception. For both floodproofed non-residential buildings and residential floodproofed basements in communities that have been granted an exception by FEMA, a floodproofing certificate is required. Additional guidance can be found in FEMA Publication 467-1, Floodplain Management Bulletin: Elevation Certificate, available on FEMA's website at https://www.fema.gov/media-library/assets/documents/3539?id=1727. rrnn r____ non n nn ice_..:_ --1,u r., r nr_n niN 1 wIL.l'l 1 vi 1 ivivlL.Lniw JwvIVI 1 I Federal Emergency Management Agency National Flood Insurance Program ELEVATION CERTIFICATE Important: Follow the instructions on pages 1-9. OMB No. 1660-0008 Expiration Date: November 30, 2018 Copy all pages of this Elevation Certificate and all attachments for (1) community official, (2) insurance agent/company, and (3) building owner. SECTION A — PROPERTY INFORMATION FOR INSURANCE COMPANY USE Al. Building Owner's Name IAN AND CORY ROSS Policy Number: A2. Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 640 N.E. 98TH STREET. Company NAIC Number: City State ZIP Code VILLAGE OF MIAMI SHORES Florida 33138 A3. Property Description (Lot and Block Numbers, Tax Parcel Number, Legal Description, etc.) LOTS 7 AND 8, BLOCK 101, OF "MIAMI SHORES SEC.4 AMD". ACCORDING TO PLAT B. 15, PAGE 14, MIAMI-DADE COUNTY. A4. Building Use (e.g., A5. Latitude/Longitude: A6. Attach at least A7. Building Diagram A8. For a building with a) Square footage b) Number of permanent c) Total net area d) Engineered A9. For a building with a) Square footage b) Number of permanent c) Total net area d) Engineered Residential, Non -Residential, Addition, Lat. 25°51'56.03"N Long. 80°11'04.29"W Accessory, etc.) RESIDENTIAL Horizontal Datum: obtain flood insurance. 1.0 foot above above adjacent adjacent grade 0 NAD 1927 grade ;O; NAD 1983 13 2 photographs of the building if the Number 8 Certificate is being used to 3,067 sq ft a crawlspace of crawlspace flood of flood openings flood openings? an attached of attached flood of flood openings flood openings? or enclosure(s): or enclosure(s) openings in the crawlspace in A8.b 1,780 sq or enclosure(s) within in sq ft within 1.0 foot sq in 0 • Yes O No garage: garage 0 openings in the attached garage in A9.b 0 • • • • • •..• • • ... •• •• .• • • • Yes ;O, No SECTION B—FLOOD INSURANCE RATE MAP (FIRM) INFORMATION•;•• 'le• , • B1. NFIP Community Name & Community Number VILLAGE OF MIAMI SHORES/120652 •••• B2. County Name ..... MIAMI-DADE •• •••• B3, State •• •••• •"" Florida•.;.. B4. Map/Panel Number 12086C/0306 B5. Suffix L B6. FIRM Index Date 09/11/2009 B7. FIRM Panel Effective/..ogpne Revised Date 09/11/2009 B8. Flood Zone(s) X .Q9,Base Floud Elevations) • AO, use Base ' • . iFl1od Depth) • ..... • N/A : ..... • • • ••••I • •••• • B10. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth •• • 1 • • •• • entered in Item B9: FIS Profile B11. Indicate elevation B12. Is the building Designation Date: 0 FIRM datum used located in a • Community Determined for BFE in Item B9: Coastal Barrier Resources • Other/Source: O NGVD System 1929 • NAVD (CBRS) area 1988 • Other/Source: or Otherwise Protected Area (OPA)? • Yes ;O; No • CBRS Q OPA ELEVATION CERTIFICATE UMti NO. 1bbU-000tS Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 640 N.E. 98TH STREET. Policy Number: City State ZIP Code VILLAGE OF MIAMI SHORES Florida 33138 Company NAIC Number SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Building elevations are based on: • Construction Drawings* • Building Under Construction* ;O Finished Construction *A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations — Zones A1—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/A, AR/AE, Complete Items C2.a—h below according to the building diagram specified in Item A7. In Puerto Benchmark Utilized: N -603-R Vertical Datum: N.G.V.D 1929 AR/A1—A30, AR/AH, AR/AO. Rico only, enter meters. Indicate elevation datum used for the elevations in items a) through h) below. O NGVD 1929 • NAVD 1988 • Other/Source: Datum used for building elevations must be the same as that used for the BFE. a) Top of bottom floor (including basement, crawlspace, or enclosure floor) 12. 8 Check the measurement used. O feet • meters b) Top of the next higher floor N/A O feet • meters c) Bottom of the lowest horizontal structural member (V Zones only) N/A O feet • meters d) Attached garage (top of slab) N/A O feet • meters e) Lowest elevation of machinery or equipment servicing the building 9 41 C feet • meters (Describe type of equipment and location in Comments) f) Lowest adjacent (finished) grade next to building (LAG) 9. 22 p feet • meters g) Highest adjacent (finished) grade next to building (HAG) 9. 36 ;O; feet meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including NSA. ;O; feet • meters structural support SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer, or architect authorized by I certify that the information on this Certificate represents my best efforts to interpret the data available. statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. law to certify elevation information. I understand that any false Were latitude and longitude in Section A provided by a licensed land surveyor? 0. Yes S No 1 Check here if attachments. Certifier's Name License Number EFRAIN LOPEZ • • • • • • • ••• • • • • •••••, • • • •••••• ••••• • • • • • ••••• .••. •• • ••••• •••••• .• •• •••• ; ELEVATION CERTIFICATE UMti NO. ititiU-000tS Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 640 N.E. 98TH STREET. Policy Number: City State ZIP Code VILLAGE OF MIAMI SHORES Florida 33138 Company NAIC Number SECTION E — BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) For Zones AO and A (without BFE), complete Items E1—E5. If the Certificate is intended to support a LOMA or LOMR-F request, complete Sections A, B,and C. For Items E1—E4, use natural grade, if available. Check the measurement used. In Puerto Rico only, enter meters. El. Provide elevation information for the following and check the appropriate boxes to show whether the elevation is above or below the highest adjacent grade (HAG) and the lowest adjacent grade (LAG). a) Top of bottom floor (including basement, crawlspace, or enclosure) is • feet • meters • above or • below the HAG. b) Top of bottom floor (including basement, crawlspace, or enclosure) is • feet • meters * above or • below the LAG. 9 (see pages 1-2 of Instructions), E2. For Building Diagrams 6-9 with permanent flood openings provided in Section A Items 8 and/or the next higher floor (elevation C2.b in the diagrams) of the building is • feet meters * above or • below the HAG. E3. Attached garage (top of slab) is • feet • meters above or • below the HAG. E4. Top of platform of machinery and/or equipment servicing the building is • feet • meters • above or below the HAG. E5. Zone AO only: If no flood depth number is available, is the top of the bottom floor elevated in accordance with the community's certify this information in Section G. floodplain management ordinance? • Yes • No • Unknown. The local official must SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION The property owner or owners authorized representative who completes Sections A, B, and E for Zone A (without a FEMA -issued or community -issued BFE) or Zone AO must sign here. The statements in Sections A, B, and E are correct to the best of my knowledge. Property Owner or Owner's Authorized Representative's Name Address City State ZIP Code Si. nature Date Telephone • • Comments • • : `•� • • • • • • • • • • •• • •• •• • •• • •••••• • • • • •••••• •••••• •••• •• • • • . • • • • •••• • ••• • •••• ••• •••••• •• •• • • • • • • • • • • ••••• • • • • • ••••• • •• •••• • •• • • • • ❑ Check here if attachments. ELEVATION CERTIFICATE UMIzi NO. 1titiU-0001 Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. _ FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 640 N.E. 98TH STREET. Policy Number: City State ZIP Code VILLAGE OF MIAMI SHORES Florida 33138 Company NAIC Number SECTION G — COMMUNITY INFORMATION (OPTIONAL) The local official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Complete the applicable item(s) and sign below. Check the measurement used in Items G8—G10. In Puerto Rico only, enter meters. G1. ❑ The information in Section C was taken from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. (Indicate the source and date of the elevation data in the Comments area below.) G2 ❑ A community official completed Section E for a building located in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. G3. ❑ The following information (Items G4—G10) is provided for community floodplain management purposes. G4. Permit Number G5. Date Permit Issued G6. Date Certificate of Compliance/Occupancy Issued G7. This permit has been issued for: • New Construction 1 Substantial Improvement G8. Elevation of as -built lowest floor (including of the building: G9. BFE or (in Zone AO) depth of flooding at the G10. Community's design flood elevation: basement) 1 feet 1 meters Datum building site: • feet • meters Datum • feet • meters Datum Local Official's Name Title Community Name Telephone Si. nature Date • • •••••• •••••• • • • •• •••- • •• •• • • •••••• ••• Comments (including tYPe of equipment and location, per C2 e , if applicable) •••••• . •• •• • • • •••• • • • •••• • ••J • • ••••• • ••••••• •••••• • •• •• • • • • • • • •••••1 ••••• • •• • • • •••• • •• • • •• • ❑ Check here if attachments. ELEVATION CERTIFICATE See Instructions for Item A6. UMti NO. ltitiU-000ti Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 640 N.E. 98TH STREET. Policy Number: City State ZIP Code VILLAGE OF MIAMI SHORES Florida 33138 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least 2 building photographs below according to the instructions for Item A6. Identify all photographs with date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. If submitting more photographs than will fit on this page, use the Continuation Page. Photo One Photo One Caption FRONT VIEW 12/19/2016 • • . • . • .. . .. . . • • • • .. . . .... •• . . • . • . .... • .. • • • . . •• . • . • . • • • . • • • •• • •••• • • • • Photo Two . . • . • • . Photo Two Caption REAR VIEW 12/19/2016 ELEVATION CERTIFICATE Continuation Page UMti NO. ltitiU-UUUti Expiration Date: November 30, 2018 IMPORTANT: In these spaces, copy the corresponding information from Section A. FOR INSURANCE COMPANY USE Building Street Address (including Apt., Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. 640 N.E. 98TH STREET. Policy Number: City State ZIP Code VILLAGE OF MIAMI SHORES Florida 33138 Company NAIC Number If submitting more photographs than will fit on the preceding page, affix the additional photographs below. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." When applicable, photographs must show the foundation with representative examples of the flood openings or vents, as indicated in Section A8. Photo One Photo One Caption RIGHT VIEW 12/19/2016 • • . • • . .. . .. • . • . • • .• • • • .... .. • • • • . . • .... . .. . • • . • .. •. . • . • . . • • • • • • • .. • .... • • • • Photo Two • • • . . . . • • Photo Two Caption LEFT VIEW 12/19/2016 U.S. DEPARTMENT OF HOMELAND SECURITY Federal Emergency Management Agency • National Flood Insurance Program OMB No. 1660-0008 Expiration Date: November 30, 2018 Instructions for Completing the Elevation Certificate The Elevation Certificate is to be completed by a land surveyor, engineer, or architect who is authorized by law to certify elevation information when elevation information is required for Zones A1 -A30, AE, AH, A (with BFE), VE, V1 -V30, V (with BFE), AR, AR/A, AR/AE, AR/A1-A30, AR/AH, or AR/AO. Community officials who are authorized by law or ordinance to provide floodplain management information may also complete this form. For Zones AO and A (without BFE), a community official, a property owner, or an owner's representative may provide information on this certificate, unless the elevations are intended for use in supporting a request for a LOMA or LOMR-F. Certified elevations must be included if the purpose of completing the Elevation Certificate is to obtain a LOMA or LOMR-F. The property owner, the owners representative, or local official who is authorized by law to administer the community floodplain ordinance can complete Section A and Section B. The partially completed form can then be given to the land surveyor, engineer, or architect to complete Section C. The land surveyor, engineer, or architect should verify the information provided by the property owner or owner's representative to ensure that this certificate is complete. In Puerto Rico only, elevations for building information and flood hazard information may be entered in meters. SECTION A - PROPERTY INFORMATION Items Al -A4. This section identifies the building, its location, and its owner. Enter the name(s) of the building owner(s), the building's complete street address, and the lot and block numbers. If the building's address is different from the owner's address, enter the address of the building being certified. If the address is a rural route or a Post Office box number, enter the lot and block numbers, the tax parcel number, the legal description, or an abbreviated location description based on distance and direction from a fixed point of reference. For the purposes of this certificate, "building" means both a building and a manufactured (mobile) home. A map may be attached to this certificate to show the location of the building on the property. A tax map, FIRM, or detailed community map is appropriate. If no map is available, provide a sketch of the property location, and the location of the building on the property. Include appropriate landmarks such as nearby roads, intersections, and bodies of water. For building use, indicate whether the building is residential, non-residential, an addition to an existing residential or non- residential building, an accessory building (e.g., garage), or other type of structure. Use the Comments area of the appropriate section if needed, or attach additional comments. Item A5. Provide latitude and longitude coordinates for the center of the front of the building. Use either decimal degrees (e.g., 39.5043°, -110.7585°) or degrees, minutes, seconds (e.g., 39° 30' 15.5", -110° 45' 30.7") format. If decimal degrees are used, provide coordinates to at least 5 decimal places or better. When using degrees, minutes, seconds, provide seconds to at least 1 decimal place or better. The latitude and longitude coordinates must be accurate within 66 feet. When the latitude and longitude are provided by a surveyor, check the "Yes" box in Section D and indicate the method used to determine the latitude and longitude in the Comments area of Section D. If the Elevati5c.Certificate is being certified by other than a licensed surveyor, engineer, or architect, this information is net r.egtiired. l5rovide the type•• of datum used to obtain the latitude and longitude. FEMA prefers the use of NAD 1983. • •• • • •• Item A6. If the Elevation Certificate is being used to obtain flood insurance through the NFIP','Die tgrtifier must providLat..: least 2 photographs showing the front and rear of the building taken within 90 days from the da4e of oerlification. the • photographs must be taken with views confirming the building description and diagram numlnr,Qcgvided sin Section A•J ••' the extent possible, these photographs should show the entire building including foundation..lf tt1e t uildir'f 11Mplit-I4v44• • • or multi-level areas, provide at least 2 additional photographs showing side views of the•builtling. In addition, when.' applicable, provide a photograph of the foundation showing a representative example of thaflood openim ary ents.AA.:. photographs must be in color and measure at least 3" x 3". Digital photographs are acceptable. • • • • • • • Item A7. Select the diagram on pages 7-9 that best represents the building. Then enter the diagram rfumbet and use the diagram to identify and determine the appropriate elevations requested in Items C2.a-h. If you are unsure of the correct diagram, select the diagram that most closely resembles the building being certified. Item A8.a. Provide the square footage of the crawlspace or enclosure(s) below the lowest elevated floor of an elevated building with or without permanent flood openings. Take the measurement from the outside of the crawlspace or enclosure(s). Examples of elevated buildings constructed with crawlspace and enclosure(s) are shown in Diagrams 6-9 MID Cicuo+inn rer ifinn+c Ino+n v.+inno — on..., 1 ...co Instructions for Completing the Elevation Certificate (continued) on pages 8-9. Diagrams 2A, 2B, 4, and 9 should be used for a building constructed with a crawlspace floor that is below the exterior grade on all sides. Items A8.b—d. Enter in Item A8.b the number of permanent flood openings in the crawlspace or enclosure(s) that are no higher than 1.0 foot above the higher of the exterior or interior grade or floor immediately below the opening. (A permanent flood opening is a flood vent or other opening that allows the free passage of water automatically in both directions without human intervention.) If the interior grade elevation is used, note this in the Comments area of Section D. Estimate the total net area of all such permanent flood openings in square inches, excluding any bars, louvers, or other covers of the permanent flood openings, and enter the total in Item A8.c. If the net area cannot be reasonably estimated, provide the size of the flood openings without consideration of any covers and indicate in the Comments area the type of cover that exists in the flood openings. Indicate in Item A8.d whether the flood openings are engineered. If applicable, attach a copy of the Individual Engineered Flood Openings Certification or an Evaluation Report issued by the International Code Council Evaluation Service (ICC ES), if you have it. If the crawlspace or enclosure(s) have no permanent flood openings, or if the openings are not within 1.0 foot above adjacent grade, enter "0" (zero) in Items A8.b—c. Item A9.a. Provide the square footage of the attached garage with or without permanent flood openings. Take the measurement from the outside of the garage. Items A9.b—d. Enter in Item A9.b the number of permanent flood openings in the attached garage that are no higher than 1.0 foot above the higher of the exterior or interior grade or floor immediately below the opening. (A permanent flood opening is a flood vent or other opening that allows the free passage of water automatically in both directions without human intervention.) If the interior grade elevation is used, note this in the Comments area of Section D. This includes any openings that are in the garage door that are no higher than 1.0 foot above the adjacent grade. Estimate the total net area of all such permanent flood openings in square inches and enter the total in Item A9.c. If the net area cannot be reasonably estimated, provide the size of the flood openings without consideration of any covers and indicate in the Comments area the type of cover that exists in the flood openings. Indicate in Item A9.d whether the flood openings are engineered. If applicable, attach a copy of the Individual Engineered Flood Openings Certification or an Evaluation Report issued by the International Code Council Evaluation Service (ICC ES), if you have it. If the garage has no permanent flood openings, or if the openings are not within 1.0 foot above adjacent grade, enter "0" (zero) in ItemsA9.b—c. SECTION B — FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Complete the Elevation Certificate on the basis of the FIRM in effect at the time of the certification. The information for Section B is obtained by reviewing the FIRM panel that includes the building's location. Information about the current FIRM is available from the Federal Emergency Management Agency (FEMA) by calling 1-800-358-9616. If a Letter of Map Amendment (LOMA) or Letter of Map Revision (LOMR-F) has been issued by FEMA, please provide the letter date and case number in the Comments area of Section D or Section G, as appropriate. For a building in an area that has been annexed by one community but is shown on another community's FIRM, enter the community name and 6 -digit number of the annexing community in Item B1, the name of the countyor new county, if necessary, in Item B2, and the FIRM index date for the annexing community in Item BO. E tgr information front the;• actual FIRM panel that shows the building location, even if it is the FIRM for the previous jutisdlction„n.ltdrps B4, B5'. B7, B8, and B9. ••••• • • ••' • If the map in effect at the time of the building's construction was other than the current FIRM•aAelyou have tae pastdnap • information pertaining to the building, provide the information in the Comments area of Section 0. • • • . • Item 61. NFIP Community Name & Community Number. Enter the complete name of.tti2.cammupltrin•whictl41je.. building is located and the associated 6 -digit community number. For a newly incorporated.wromunity, use the name' and 6 -digit number of the new community. Under the NFIP, a "community” is any State Or area:or poetical:subdivisies:. thereof, or any Indian tribe or authorized native organization, that has authority to adopt•gnd eiVorce floodplain • management regulations for the areas within its jurisdiction. To determine the current cvmrounity nte,ber, see the • NFIP Community Status Book, available on FEMA's web site at https://www.fema.gov/national-fldod lnsurance- program/national-flood-insurance-program-community-status-book, or call 1-800-358-9616. Innf ienfirsnc _ Pana 9 of 9 Instructions for Completing the Elevation Certificate (continued) Item B2. County Name. Enter the name of the county or counties in which the community is located. For an unincorporated area of a county, enter "unincorporated area." For an independent city, enter "independent city." Item B3. State. Enter the 2 -letter state abbreviation (for example, VA, TX, CA). Items B4—B5. Map/Panel Number and Suffix. Enter the 10 -character "Map Number" or "Community Panel Number" shown on the FIRM where the building or manufactured (mobile) home is located. For maps in a county -wide format, the sixth character of the "Map Number" is the letter "C" followed by a 4 -digit map number. For maps not in a county- wide format, enter the "Community Panel Number" shown on the FIRM. Item B6. FIRM Index Date. Enter the effective date or the map revised date shown on the FIRM Index. Item B7. FIRM Panel Effective/Revised Date. Enter the map effective date or the map revised date shown on the FIRM panel. This will be the latest of all dates shown on the map. The current FIRM panel effective date can be determined by calling 1-800-358-9616. Item B8. Flood Zone(s). Enter the flood zone, or flood zones, in which the building is located. All flood zones containing the letter "A" or "V" are considered Special Flood Hazard Areas. The flood zones are A, AE, A1—A30, V, VE, V1—V30, AH, AO, AR, AR/A, AR/AE, AR/A1—A30, AR/AH, and AR/AO. Each flood zone is defined in the legend of the FIRM panel on which it appears. Item B9. Base Flood Elevation(s). Using the appropriate Flood Insurance Study (FIS) Profile, Floodway Data Table, or FIRM panel, locate the property and enter the BFE (or base flood depth) of the building site. If the building is located in more than 1 flood zone in Item B8, list all appropriate BFEs in Item B9. BFEs are shown on a FIRM or FIS Profile for Zones A1—A30, AE, AH, V1—V30, VE, AR, AR/A, AR/AE, AR/A1—A30, AR/AH, and AR/AO; flood depth numbers are shown for Zone AO. Use the AR BFE if the building is located in any of Zones AR/A, AR/AE, AR/A1—A30, AR/AH, or AR/AO. In A or V zones where BFEs are not provided on the FIRM, BFEs may be available from another source. For example, the community may have established BFEs or obtained BFE data from other sources for the building site. For subdivisions and other developments of more than 50 lots or 5 acres, establishment of BFEs is required by the community's floodplain management ordinance. If a BFE is obtained from another source, enter the BFE in Item B9. In an A Zone where BFEs are not available, complete Section E and enter N/A for Section B, Item B9. Enter the BFE to the nearest tenth of a foot (nearest tenth of a meter, in Puerto Rico). Item B10. Indicate the source of the BFE that you entered in Item B9. If the BFE is from a source other than FIS Profile, FIRM, or community, describe the source of the BFE. Item B11. Indicate the elevation datum to which the elevations on the applicable FIRM are referenced as shown on the map legend. The vertical datum is shown in the Map Legend and/or the Notes to Users on the FIRM. Item B12. Indicate whether the building is located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA). (OPAs are portions of coastal barriers that are owned by Federal, State, or local governments or by certain non-profit organizations and used primarily for natural resources protection.) Federal flood insurance is prohibited in designated CBRS areas or OPAs for buildings or manufactured (mobile) homes built or substantially improved after the date of the CBRS or OPA designation. For the first CBRS designations, that date is October 1, 1983. Information about CBRS areas and OPAs may be obtained on the FEMA web site at httpsiliza.fema.gov/ v.fema.gov/ national-flood-insurance-program/coastal-barrier-resources-system. • .. SECTION C — BUILDING ELEVATION INFORMATION (SURVEY REG7JIRE3) • Complete Section C if the building is located in any of Zones A1—A30, AE, AH, A (with B▪ P'P) VE, 1/1—V30, V NI1•. BFE), AR, AR/A, AR/AE, AR/A1—A30, AR/AH, or AR/AO, or if this certificate is being usean'Suppor2ariquest fdr'5' LOMA or LOMR-F. If the building is located in Zone AO or Zone A (without BFE), cornelei Section E instear1 ensure that all required elevations are obtained, it may be necessary to enter the building (gr stance, if the buildjrlg: has a basement or sunken living room, split-level construction, or machinery and equipment).•• • ▪ • Surveyors may not be able to gain access to some crawlspaces to shoot the elevation of the cra irsrace floor. If access to the crawlspace is limited or cannot be gained, follow one of these procedures. ' • Use a yardstick or tape measure to measure the height from the floor of the crawlspace to the "next higher floor," and then subtract the crawlspace height from the elevation of the "next higher floor." If there is no access to the romp Clo..oAnn (`o.fifino+e Inc+n in+innc — Dine Z of 0 Instructions for Completing the Elevation Certificate (continued) crawlspace, use the exterior grade next to the structure to measure the height of the crawlspace to the "next higher floor." • Contact the local floodplain administrator of the community in which the building is located. The community may have documentation of the elevation of the crawlspace floor as part of the permit issued for the building. • If the property owner has documentation or knows the height of the crawlspace floor to the next higher floor, try to verify this by looking inside the crawlspace through any openings or vents. In all 3 cases, use the Comments area of Section D to provide the elevation and a brief description of how the elevation was obtained. Item C1. Indicate whether the elevations to be entered in this section are based on construction drawings, a building under construction, or finished construction. For either of the first 2 choices, a post -construction Elevation Certificate will be required when construction is complete. If the building is under construction, include only those elevations that can be surveyed in Items C2.a—h. Use the Comments area of Section D to provide elevations obtained from the construction plans or drawings. Select "Finished Construction" only when all machinery and/or equipment such as furnaces, hot water heaters, heat pumps, air conditioners, and elevators and their associated equipment have been installed and the grading around the building is completed. Item C2. A field survey is required for Items C2.a—h. Most control networks will assign a unique identifier for each benchmark. For example, the National Geodetic Survey uses the Permanent Identifier (PID). For the benchmark utilized, provide the PID or other unique identifier assigned by the maintainer of the benchmark. For GPS survey, indicate the benchmark used for the base station, the Continuously Operating Reference Stations (CORS) sites used for an On-line Positioning User Service (OPUS) solution (also attach the OPUS report), or the name of the Real Time Network used. Also provide the vertical datum for the benchmark elevation. All elevations for the certificate, including the elevations for Items C2.a—h, must use the same datum on which the BFE is based. Show the conversion from the field survey datum used if it differs from the datum used for the BFE entered in Item B9 and indicate the conversion software used. Show the datum conversion, if applicable, in the Comments area of Section D. For property experiencing ground subsidence, the most recent reference mark elevations must be used for determining building elevations. However, when subsidence is involved, the BFE should not be adjusted. Enter elevations in Items C2.a—h to the nearest tenth of a foot (nearest tenth of a meter, in Puerto Rico). Items C2.a—d. Enter the building elevations (excluding the attached garage) indicated by the selected building diagram (Item A7) in Items C2.a—c. If there is an attached garage, enter the elevation for top of attached garage slab in Item C2.d. (Because elevation for top of attached garage slab is self-explanatory, attached garages are not illustrated in the diagrams.) If the building is located in a V zone on the FIRM, complete Item C2.c. If the flood zone cannot be determined, enter elevations for all of Items C2.a—h. For buildings in A zones, elevations a, b, d, and e should be measured at the top of the floor. For buildings in V zones, elevation c must be measured at the bottom of the lowest horizontal structural member of the floor (see drawing below). For buildings elevated on a crawlspace, Diagrams 8 and 9, enter the elevation BUILDING ON SLAB • • •• BLTIVitt *PILES, • • PIERS, OR COLUMNS• • •••••• • • BASE FLOOD ELEVATION ADJACENT GRADE BASE FLOOD ELEVATION •••• • • • •• • V ZOMES •• • • • • • •• ••• ••• • ••• • ••• • • • ••• • ••• ••• • •• •• • • ••• • •• ••• ••• • • • ••• ••• • 1\11D CIc„n+i,,., rse,-+is,.•s+e Ino+.,..+i...,e _ Pana 4 of Q Instructions for Completing the Elevation Certificate (continued) of the top of the crawlspace floor in Item C2.a, whether or not the crawlspace has permanent flood openings (flood vents). If any item does not apply to the building, enter "N/A" for not applicable. Item C2.e. Enter the lowest platform elevation of at least 1 of the following machinery and equipment items: elevators and their associated equipment, furnaces, hot water heaters, heat pumps, and air conditioners in an attached garage or enclosure or on an open utility platform that provides utility services for the building. Note that elevations for these specific machinery and equipment items are required in order to rate the building for flood insurance. Local floodplain management officials are required to ensure that all machinery and equipment servicing the building are protected from flooding. Thus, local officials may require that elevation information for all machinery and equipment, including ductwork, be documented on the Elevation Certificate. If the machinery and/or equipment is mounted to a wall, pile, etc., enter the platform elevation of the machinery and/or equipment. Indicate machinery/equipment type and its general location, e.g., on floor inside garage or on platform affixed to exterior wall, in the Comments area of Section D or Section G, as appropriate. If this item does not apply to the building, enter "N/A" for not applicable. Items C2.f—g. Enter the elevation of the ground, sidewalk, or patio slab immediately next to the building. For Zone AO, use the natural grade elevation, if available. This measurement must be to the nearest tenth of a foot (nearest tenth of a meter, in Puerto Rico) if this certificate is being used to support a request for a LOMA or LOMR-F. Item C2.h. Enter the lowest grade elevation at the deck support or stairs. For Zone AO, use the natural grade elevation, if available. This measurement must be to the nearest tenth of a foot (nearest tenth of a meter, in Puerto Rico) if this certificate is being used to support a request for a LOMA or LOMR-F. SECTION D — SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION Complete as indicated. This section of the Elevation Certificate may be signed by only a land surveyor, engineer, or architect who is authorized by law to certify elevation information. Place your license number, your seal (as allowed by the State licensing board), your signature, and the date in the box in Section D. You are certifying that the information on this certificate represents your best efforts to interpret the data available and that you understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. Use the Comments area of Section D to provide datum, elevation, openings, or other relevant information not specified elsewhere on the certificate. SECTION E - BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A (WITHOUT BFE) Complete Section E if the building is located in Zone AO or Zone A (without BFE). Otherwise, complete Section C instead. Explain in the Section F Comments area if the measurement provided under Items E1—E4 is based on the "natural grade." Items El .a and b. Enter in Item El .a the height to the nearest tenth of a foot (tenth of a meter in Puerto Rico) of the top of the bottom floor (as indicated in the applicable diagram) above or below the highest adjacent grade (HAG). Enter in Item El .b the height to the nearest tenth of a foot (tenth of a meter in Puerto Rico) of the top of the bottom floor (as indicated in the applicable diagram) above or below the lowest adjacent grade (LAG). For buildings in Zone AO, the community's floodplain management ordinance requires the lowest floor of the building be elevated abowebe highest adjacent grade at least as high as the depth number on the FIRM. Buildings in Zone A (w+ahoif 8FE) may qualify for a . lower insurance rate if an engineered BFE is developed at the site. •• • • • • Item E2. For Building Diagrams 6-9 with permanent flood openings (see pages 8-9), erftePtile height td the nedrjSt.; tenth of a foot (tenth of a meter in Puerto Rico) of the next higher floor or elevated floor (asindieated Sn theapplihble • diagram) above or below the highest adjacent grade (HAG). • • Item E3. Enter the height to the nearest tenth of a foot (tenth of a meter in Puerto Rick , trt relatid'h to the higflf?St; • adjacent grade next to the building, for the top of attached garage slab. (Because elevation Iv !op of attached garagd. slab is self-explanatory, attached garages are not illustrated in the diagrams.) If this item cjoes ,ot app t+o•& building, enter "N/A" for not applicable. • • •• •• • • Item E4. Enter the height to the nearest tenth of a foot (tenth of a meter in Puerto Rico), in relation io tPie highest adjacent grade next to the building, of the platform elevation that supports the machinery and/or equipment servicing the building. Indicate machinery/equipment type in the Comments area of Section F. If this item does not apply to the building, enter "N/A" for not applicable. !ICID Clc.ro+ic.. rc.+ifi,.' +c inficno — Dnnc I .,f 0 Instructions for Completing the Elevation Certificate (continued) Item E5. For those communities where this base flood depth is not available, the community will need to determine whether the top of the bottom floor is elevated in accordance with the community's floodplain management ordinance. SECTION F — PROPERTY OWNER (OR OWNER'S REPRESENTATIVE) CERTIFICATION Complete as indicated. This section is provided for certification of measurements taken by a property owner or property owners representative when responding to Sections A, B, and E. The address entered in this section must be the actual mailing address of the property owner or property owners representative who provided the information on the certificate. SECTION G — COMMUNITY INFORMATION (OPTIONAL) Complete as indicated. The community official who is authorized by law or ordinance to administer the community's floodplain management ordinance can complete Sections A, B, C (or E), and G of this Elevation Certificate. Section C may be filled in by the local official as provided in the instructions below for Item G1. If the authorized community official completes Sections C, E, or G, complete the appropriate item(s) and sign this section. Check Item G1 if Section C is completed with elevation data from other documentation that has been signed and sealed by a licensed surveyor, engineer, or architect who is authorized by law to certify elevation information. Indicate the source of the elevation data and the date obtained in the Comments area of Section G. If you are both a community official and a licensed land surveyor, engineer, or architect authorized by law to certify elevation information, and you performed the actual survey for a building in Zones A1—A30, AE, AH, A (with BFE), VE, V1—V30, V (with BFE), AR, AR/ A, AR/A1—A30, AR/AE, AR/AH, or AR/AO, you must also complete Section D. Check Item G2 if information is entered in Section E by the community for a building in Zone A (without a FEMA -issued or community -issued BFE) or Zone AO. Check Item G3 if the information in Items G4—G10 has been completed for community floodplain management purposes to document the as -built lowest floor elevation of the building. Section C of the Elevation Certificate records the elevation of various building components but does not determine the lowest floor of the building or whether the building, as constructed, complies with the community's floodplain management ordinance. This must be done by the community. Items G4—G10 provide a way to document these determinations. Item G4. Permit Number. Enter the permit number or other identifier to key the Elevation Certificate to the permit issued for the building. Item G5. Date Permit Issued. Enter the date the permit was issued for the building. Item G6. Date Certificate of Compliance/Occupancy Issued. Enter the date that the Certificate of Compliance or Occupancy or similar written official documentation of as -built lowest floor elevation was issued by the community as evidence that all work authorized by the floodplain development permit has been completed in accordance with the community's floodplain management laws or ordinances. • Item G7. New Construction or Substantial Improvement. Check the applicable box. "Sub§tantiial Improvem�rit" mu9N.. any reconstruction, rehabilitation, addition, or other improvement of a building, the cost of•wlifbK equal or exceeds 5Q • percent of the market value of the building before the start of construction of the imprcweinent. Teter includes:. buildings that have incurred substantial damage, regardless of the actual repair work performer .. • • Item G8. As -built lowest floor elevation. Enter the elevation of the lowest floor (inctudipg• baseMdritewhen the. construction of the building is completed and a final inspection has been made to confirm 411a0 the buildirzq is built ira. • accordance with the permit, the approved plans, and the community's floodplain management laws or ordinanoesi•• Indicate the elevation datum used.• • • •, • • Item G9. BFE. Using the appropriate FIRM panel, FIS Profile, or other data source, locate thepropeW'3rid enter the • BFE (or base flood depth) of the building site. Indicate the elevation datum used. • • • • •••• • •• • .. • Item G10. Community's design flood elevation. Enter the elevation (including freeboard above the BFE) to which the community requires the lowest floor to be elevated. Indicate the elevation datum used. Enter your name, title, and telephone number, and the name of the community. Sign and enter the date in the appropriate blanks. MID Clo.,o+inn !`or+if,'. +o Ino+n,..+inno — Don. 62 ..f 0 Building Diagrams The following diagrams illustrate various types of buildings. Compare the features of the building being certified with the features shown in the diagrams and select the diagram most applicable. Enter the diagram number in Item A7, the square footage of crawlspace or enclosure(s) and the area of flood openings in square inches in Items A8.a-c, the square footage of attached garage and the area of flood openings in square inches in Items A9.a-c, and the elevations in Items C2.a-h. In A zones, the floor elevation is taken at the top finished surface of the floor indicated; in V zones, the floor elevation is taken at the bottom of the lowest horizontal structural member (see drawing in instructions for Section C). DIAGRAM 1A All slab -on -grade single- and multiple -floor buildings (other than split-level) and high-rise buildings, either detached or row type (e.g., townhouses); with or without attached garage. Distinguishing Feature - The bottom floor is at or above ground level (grade) on at least 1 side.* NEXT HIGHER FLOOR GRADE ezistitig glade DIAGRAM 2A All single- and multiple -floor buildings with basement (other than split-level) and high-rise buildings with basement, either detached or row type (e.g., townhouses); with or without attached garage. Distinguishing Feature - The bottom floor (basement or underground garage) is below ground level (grade) on all sides.* NEXT HIGHER FLOOR BOTTOM FLOOR BASEMENT DIAGRAM 1B All raised -slab -on -grade or slab -on -stem -wall -with -fill single- and multiple -floor buildings (other than split- level), either detached or row type (e.g., townhouses); with or without attached garage. Distinguishing Feature - The bottom floor is at or above ground level (grade) on at least 1 side.* NEXT HIGHER FLOOR GRADE Bxi5t r 9i'a(II DIAGRAM 2B All single- and multiple -floor buildings with basement (other than split-level) and high-rise buildings with basement, either detached or row type (e.g., townhouses); with or without attached garage. Distinguishing Feature - The bottom floor (basement or underground garage) is below ground level (grade) on all sides; most of the height of the walls is belcw.grcund level on all sides; and the door anal area of egress are also •••• below ground level on all sides : Building Diagrams DIAGRAM 3 All split-level buildings that are slab -on -grade, either detached or row type (e.g., townhouses); with or without attached garage. Distinguishing Feature — The bottom floor (excluding garage) is at or above ground level (grade) on at least 1 side.* DIAGRAM 5 All buildings elevated on piers, posts, piles, columns, or parallel shear walls. No obstructions below the elevated floor. Distinguishing Feature — For all zones, the area below the elevated floor is open, with no obstruction to flow of floodwaters (open lattice work and/or insect screening is permissible). NEXT HIGHER FLOOR ELEVATED FLOOR GRADE / N7 N7 .� (detenilined'by existing grade) (For V zones only) DIAGRAM 4 All split-level buildings (other than slab -on -grade), either detached or row type (e.g., townhouses); with or without attached garage. Distinguishing Feature — The bottom floor (basement or underground garage) is below ground level (grade) on all sides.* DIAGRAM 6 All buildings elevated on piers, posts, piles, columns, or parallel shear walls with full or partial enclosure below the elevated floor. Distinguishing Feature — For all zones, the area below the elevated floor is enclosed, either partially or fully. In A Zones, the partially or fully enclosed area below the elevated floor is with or without openings** present in the walls of the enclosure. Indicate information about enclosure size and openings in Section A — Property Information. NEXT HIGHER FLOOR GRADE eterrr•ne •at•la:ar.size 8 •openings. if any. (de ecrriin'edby existing grade) •••• (For \(.zones only) • • •••• •• • • • • • • • • •••• • •• * A floor that is below ground level (grade) on all sides is considered a basement even if the floor is used for livipg, purposes, co' as an office, ' ' garage, workshop, etc. • •' • •' • ** An "opening" is a permanent opening that allows for the free passage of water automatically in both direction:! tDet;t human •intervention. • • Under the NFIP, a minimum of 2 openings is required for enclosures or crawlspaces. The openings shall provide a total net area of not lessitl,an: • 1 square inch for everysquare foot of area enclosed, excluding any bars, louvers, or other covers of the o e.ing. aternativ y, •a• •d ividuai • Engineered Flood Openings Certification or an Evaluation Report issued by the International Code Council EvalsIation Servica(JGC ES) mu'srI e': submitted to document that the design of the openings will allow for the automatic equalization of hydrostatic flood forces ori gxje%iotwalls. A window, a door, or a garage door is not considered an opening; openings may be installed in doors. Openings shall be on at least 2 sides of the enclosed area. If a building has more than 1 enclosed area, each area must have openings to allow floodwater to directly enter. The bottom of the openings must be no higher than 1.0 foot above the higher of the exterior or interior grade or floor immediately below the opening. For more guidance on openings, see NFIP Technical Bulletin 1. MIIIo Inc+rePana R of q Building Diagrams DIAGRAM 7 All buildings elevated on full -story foundation walls with a partially or fully enclosed area below the elevated floor. This includes walkout levels, where at least 1 side is at or above grade. The principal use of this building is located in the elevated floors of the building. Distinguishing Feature — For all zones, the area below the elevated floor is enclosed, either partially or fully. In A Zones, the partially or fully enclosed area below the elevated floor is with or without openings** present in the walls of the enclosure. Indicate information about enclosure size and openings in Section A — Property Information. DIAGRAM 8 All buildings elevated on a crawlspace with the floor of the crawlspace at or above grade on at least 1 side, with or without an attached garage. Distinguishing Feature — For all zones, the area below the first floor is enclosed by solid or partial perimeter walls. In all A zones, the crawlspace is with or without openings** present in the walls of the crawlspace. Indicate information about crawlspace size and openings in Section A — Property Information. DIAGRAM 9 All buildings (other than split-level) elevated on a sub - grade crawlspace, with or without attached garage. Distinguishing Feature — The bottom (crawlspace) floor is below ground level (grade) on all sides.* (If the distance from the crawlspace floor to the top of the next higher floor is more than 5 feet, or the crawlspace floor is more than 2 feet below the grade [LAG] on all sides, use Diagram 2A or 2B.) • • • • • • • • •• • •• • • • • • •• • • •••• •• • • • • • • •••• • •• • • • • • • •• • * A floor that is below ground level (grade) on all sides is considered a basement even if the floor is used for liM Odrroses, or as'an office, garage, workshop, etc. • • • • • • ** An "opening" is a permanent opening that allows for the free passage of water automatically in both directions without human intervention. • Under the NFIP, a minimum of 2 openings is required for enclosures or crawlspaces. The openings shall provide a total net areaJJaot lessihan 1 square inch for every square foot of area enclosed, excluding any bars, louvers, or other covers of the opening. Alternatively an Individual Engineered Flood Openings Certification or an Evaluation Report issued by the International Code Council Evaluation Service (ICC ES) must be submitted to document that the design of the openings will allow for the automatic equalization of hydrostatic flood forces on exterior walls. A window, a door, or a garage door is not considered an opening; openings may be installed in doors. Openings shall be on at least 2 sides of the enclosed area. If a building has more than 1 enclosed area, each area must have openings to allow floodwater to directly enter. The bottom of the openings must be no higher than 1.0 foot above the higher of the exterior or interior grade or floor immediately below the opening. For more guidance on openings, see NFIP Technical Bulletin 1. • • • • • • • • • • • • romp Ciato+ir.n r`.r+iF..o+. Ino+r,er•+i.,n*• — Dort. 0 r,+0 •