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CC-08-22-2162Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 1700 NE 105TH ST 207, Miami Shores, FL 33138 Contacts Issue Date: 09/23/2022 Parcel Number 1122300500260 Permit No.: CC-08-22-2162 Permit Type: Building (Commercial) Work Classification: Alteration Permit Status: Approved Expiration: 09/25/2023 JOSE JORGE ARIAS SR REV TR Owner DON BAILEY CARPETS INC Contractor 1700 NE 105 ST 207 ALBERT HINSON 14831 NW 7 AVE, MIAMI, FL 33168 Business: 30S7571568 karen.waite@donbaileynooring.com Description: INSTALL WHISPER MAT LVT AND LUXUARY VINYL [Vatlu ation: $ 1,000.00 Inspection Re nests: PLANKS IN BEDROOM CLOSETLIVING DINING HALL KITCHEN, 305-762-4949 NO BATH, NO BALCONY al Sq Feet: 900.00 Fees Amount Application Fee - Other $50.00 CCF $0.60 DBPR Fee $2.00 DCA Fee $2.00 Education Surcharge $0.30 Permit Fee $50.00 Planning and Zoning Review Fee $70.00 Scanning Fee $12.00 rechnology Fee $10.00 Total: $196.90 Building Department Copy Payments Date Paid Amt Paid Total Fees $196.90 Credit Card 08/26/2022 $50.00 Credit Card 09/23/2022 $146.90 Amount Due: $0.00 i consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations I:ertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Ilage. 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. AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws acinstructiort-2nd zoning., Futhl authorize the above named contractor to do the work stated. It//�/►� Signature: Owner / Applicant / Contractor / Agent ate September 23, 2022 Page 2 of 2 Miami Shores Village RECEIVED BUILDING PERMIT APPLICATION UfBBUILDING ❑PLUMBING ELECTRIC ❑ MECHANICAL Building Department AUG 26Z022 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY:—M& Tel: (305) 795-2204 Fax: (305) 756-8972 INSPECTION LINE PHONE NUMBER: (305) 762-4949 T FBC 20AI? Master Permit No. Sub Permit No. ❑ ROOFING ❑ REVISION EXTENSION ❑RENEWAL ❑ CHANGE OF ❑ CANCELLATION SHOP CONTRACTOR DRAWINGS JOB ADDRESS: I70© 64g /OS _s 4 AtgZ the Building Historically Designated: Yes NO Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): 'Osr 74/2.l S2 Phone# Of_) 77.ZT c ,) Address: 1-700 A)G 1,DK— ;6L .?07 , City: lylp,44r S,SDAd�, State: `ftyp raA Zip: 3 Tenant/Lessee Name: JV4 Phone#: Email: 05E 6i+AiL`CONTRACT pany Ae.:(� ,�// t-1 '� n 'f�.J L, Phone#: Address: 0 V ..1 I tL t 61 k C� Email: b, ` I V' ll Qualifier Name: e_✓1J 0 Phone `l d- It"02 State Certification or Registration #: Certificate of Competency #:, I2 S Li DESIGNER: Architect/Engineer: Phone#: Address: City: State: Value of Work for this Permit: $—, 1 B U Square/Linear Footage of Work: Type of Work: ❑ "ition Alteratipn ❑ /� New/� I , / Repair/Replace El Demolition Description of Work:/ IYtS��� (xiJIIu—( RW LA '� Qnd , I a, ui Specify color of color thru tile: Submittal Fee $ Permit Fee $ Scanning Fee $ Technology Fee $, DCA Fee $ Training/Education Fee $ X CCF $ CO/CC $ DBPR $ Notary Double Fee $ Structural Reviews $ (Revised04/05/2022) P&Z Review $ Bond $ TOTAL FEE NOW DUE $ m Bonding Company's Name (if applicable) Bonding Company's Address City S1 Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 of such posted notice, the inspection will not be approved and a reinspection fee will be charged. l Signature -4 4.?,41 / OWNER or AGENT T e foregoing instru ent was 'ac/knno edged before me this day of L V 20 2:)— , by ,?ho is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: AtIgn: ``III,l„ Print: ..is Seal: ' �r HH06gg71 �Z EXPIRES Ox. 7, 2024 St ,Plllll� APPROVED BY The foregoing instrunniq was ackknno'ywpdged before me this day of v'"'.��' 20 a)- by '6vhb is personally known to as me or who has produced identification and who did take an oath. NOTARY PUBLIC: as IUII Print:,`1f�"�E`'1 ,ul�� t kul V 1 V` 4� 3 Seal: - 6 uuMBEn 2 •. m Z c * HEXPIRES mi _O• Dm. 7. 2024 C; ( ''�1IIIIIIIIIIIII Plans Examiner Zoning 4 (Revised04/05/2022) Structural Review Clerk 8/20/22, 3:34 PM Address ' Owner Name SEARCH: 1 170 n.e. �05st PROPERTY INFORMATION Folio: 11-2230-050-0260 Sub -Division: j THE SHORES CONDO Property Address 1700 NE 105 ST UNIT: 207 Owner JOSE JORGE ARIAS SR TRS - JOSE JORGE ARIAS SR REV TR I { Mailing Address 1700 NE 105 ST 207 MIAMI SHORES, FL 33138 PA Primary Zone 4900 MULTI -FAMILY - CONDOMINUM Primary Land Use 0407 RESIDENTIAL - TOTAL VALUE: CONDOMINIUM - RESIDENTIAL Beds / Baths 1 Half 1/1/0 Floors 0 httpslhw.miamidade.gov/Apps/PA/propertysearch/`#/ Property Search AoDlication - Miami -Dade Cn, mfv Subdivision Name Folio Suite L Back to Search Results 116 8120/22, 3:34 PM Living Units 0 Actual Area Living Area 859 Sq.Ft Adjusted Area 859 Sq.Ft Lot Size I 0 Sq.Ft Year Built 1965 Featured Online Tools Comparable Sales Glossary Property Record Cards Property Search Help Report Discrepancies Report Homestead Fraud Tax Comparison Tax Estimator Value Adjustment Board ASSESSMENT INFORMATION Year Land Value Building Value Extra Feature Value Market Value 2022 $0 $0 $0 $122,574 PA Additional Online Tools Property Taxes Special Taxing Districts and Other Non -Ad valorem Assessments TRIM Notice 2021 2020; $0 $0 $0 $0 $0 $0 $116,737 $109,100 Assessed Value $65,829 --- $63,912 $63,030 TAXABLE VALUE INFORMATION 2022 2021 2020. COUNTY Exemption Value $40,829 $38,912 $38,030 httpsJ/www.miamidade.gov/Apps/PAtpropertysearch/#/ 2/6 ww♦ Tm S OfkES CONDOMINIUM 1700 NORTHEAST1051A STREET • MIAMI SHORES, FLORIDA 33138 • PHONE (305) 843-8741 FAX (305) 881-0590 • I:.•MAIL theshore cando@att.net WORK REQUEST APPLICATION Owner's Name UDSS %;r; )44d S& . Unit R 07 I hereby request approval from the Board of Directors for the following modification or alteration to my unit that will be performed by a licensed contractor. Electrical work Plumbing work Carpet Installation ** Windows Tile installation Other work Descri tion of work_1�+Q1) U �hI �C� 1A4 M- 0) VinyI /�l CM 1 ��1 (oor>^ Before you ci to upgrade lyour unit (o r thtan paint or carpet) you must obtain permission from the Board of Directors and/or Miami Shores Village. A copy of plans, specifications and permits, and a description of the licensed work to be performed must be submitted for consideration and approval by the Miami Shores Village Building Department. Contact Miami Shores Village BD directly (305-795-2204). It is the owner's responsibility to ensure that the contractor removes all excess construction material or building debris. It cannot be placed in the dumpsters. ** Window frames must be gray in color to look like aluminum. Windows must be Two (2) panels over Two (2) panels. Glass must be clear color. I, as the unit owner acknowledge responsibility for any damage to the building or personal injuries that may occur during this project. The Shores Condominium Inc. its officers and employees are in no way responsible for damage or theft to my apartment or my belongings. (A $200.00 deposit is required and will be refunded if no damage to the property is reported) and agree to the statements made above. ►V at reD e Date / en Page 1 of 1 10 Ln w M N_ A A co Ln 0 F2 Ln 0 M N W U V7 we, I_j cva4r -tor it -A ,� <:n l IP Outl o9-fo1•oso-0ff -1I r Ad�oo Ally OWlad o I;oln6a aouelidwoo al ] a[gnPU Ile ;dap 6ulpling ;da0 6UIUOZ 1 ng a6elliA saJ"S i.wei,t^ ]6 ^� E1 3& r LLZ ,,t I -PU 7 0 .M ►1A FA Green Approval CRI Green Label Plus Certified for Optimal Indoor Air Quality Thickness 1.9 mm (77 mil) Content 100% Virgin Latex Rubber with Block Copolymer Antimicrobial Yes Protection Roll Width 30" '. Roll Length 80 ft Roll Weight 34 lbs :-" Rolls/Pallet 16 Pallets/Truck 26 Full Roll 200 sf Color Green Warranty 10 Year Limited Warranty APPROVED SUBSTRATES • Completely Cured Concrete • Interior Plywood • Cement Backer Units • Properly Prepared OSB SOUND RATINGS Luxury vinyl tiles and planks - 6" Concrete Floor With No Ceiling — IIC 57, STC 51 - 6" Concrete Floor With Ceiling Assembly — IIC 73, STC 63 - Delta IIC 27 LEED® POINT CATEGORIES • 100% Post -Consumer Recyclable • Acoustical Properties - LEED® IEQp3 • Low Emitting Materials - LEED® E04.3 • Regional Priority - LEED® MRc5.1, 5.21 APPROVED FOR USE UNDER Laminate and Luxury Vinyl Tiles & Planks INSTALLATION METHODS Float, Single Glue, Double Glue SPECIFICATIONS Material Composition: Rubber Compression Set: ASTM D 1055-97 (22h, 70C) —16% Indentation: ASTM F1914 —12% Smoke Density: ASTM A662 — Less Than 89 Max Flammability Test: ASTM D 2859(DOC FF 1-7O P Thermal Resistance: 0.205 (R-Value) .# , Indoor Air Quality: CRI Certified For Low Emitting' a FLOORING PRODUCTS: Laminate and Luxury Vinyl Tiles & Planks Floor Prep Substrate must be level, clean and dry with no protruding nails or staples. Substrate must be checked for excessive moisture. If substrate moisture/vapor is beyond 41b. emissions or an RH level of more than 75% of slab, these conditions must be mitigated prior to Whisper Mat LVT installation. Leveling cements must be completely dry before membrane application. ACCLIMATE UNDERLAYMENT FOR A MINIMUM OF 24 HOURS PRIOR TO INSTALLATION. Floating Installation 1. Roll out underlayment parallel to the wall, in the opposite direction the floor covering will be installed. 2. Trim the underlayment to fit the sub -floor, leaving a 1/4" gap at each wall. 3. Unroll the pre-cut underlayment. Smooth underlayment as you go to remove any wrinkles or air pockets. 4. Roll out the next section of underlayment in the same manner making sure the seams are butted together but not overlapping. 5. Install the floor covering according to the manufacturer's guidelines. Glue Installation 1. Roll out underlayment parallel to the wall, in the opposite direction the floor covering will be installed. 2. Trim the underlayment to fit the substrate, leaving a Y4" gap at each wall. 3. Unroll the pre-cut underlayment. Smooth underlayment as you go to remove any wrinkles or air pockets. 4. Roll out the next section of underlayment in the same manner making sure the seams are butted together but not overlapping. 5. Install the floor covering according to the manufacturer's installation instructions. Note: When installing vinyl flooring tiles or planks be sure to allow adhesive to become tacky to the touch before installation of flooring over underlayment. DO NOT WET SET FLOORING PRODUCTS OVER UNDERLAYMENT. DISCLAIMERS: IN GLUE INSTALLATIONS PLEASE NOTE THAT THE UNDERLAYMENT IS NOT DESIGNED TO COUNTERACT FLOORING MATERIAL MOVEMENT OR CHANGES IN WIDTH OR LENGTH DUE TO TEMPERATURE FLUCTUATIONS OUTSIDE THE SPECIFIED ACCEPTABLE RANGE OF THE FLOORING MANUFACURERS. ANY CLAIMS RESULTING FROM CUPPING, PEAKING, WARPING OR OTHER DEFORMATION OF FLOORING PLANKS OR TILES WILL NOT BE APPROVED OR ACCEPTED BY PROTECTO WRAP COMPANY. DO NOT WET SET FLOORING MATERIALS INTO ADHESIVE. BE SURE TO ALLOW THE ADHESIVE TO PROPERLY FLASH AND BECOME TACKY TO THE TOUCH BEFORE APPLICATION OR FAILURES COULD RESULT SUCH AS SEPERATION OF THE PLANKS OR TILES, CUPPING, PEAKING OR OTHERWISE. ONLY APPROVED AND TESTED ADHESIVES SHOULD BE USED. Z M. 1955 South Cherokee Street Denver, CO 80223 (800) 759-9727 www.ProtectoWrap.com WLVN-200 (4-21) • MAPEI - EC0360 - EC0373 - G90 - G21 • ROBERTS - 6300 • FRANKLIN -TITEBOND670 -TITEBOND771-STEP - TITEBOND 811 • BOSTIK - BEST FLOORING ADHESIVE - EFA - GREENFORCE - GREEN FUSION • STAUFF - D-737 - D764 • TEC - 744 SOLID VINYL PLANK AND TILE ADHESIVE - 752 PREMIUM TRANSITIONAL VINYL ADHESIVE AL Architectural Testing G0665.12-113-11-R1 ACOUSTICAL PERFORMANCE TEST REPORT ASTM E 90, ASTM E 492, ASTM E 2179 Rendered to PROTECTO WRAP COMPANY Series/Model: Protecto Wrap Whispermat LVT Specimen Type: Concrete Slab -152 mm Overall Size: 3023 mm by 3632 mm STC 51 IIC 57 AHC 27 Test Specimen Identification: Floor Topping: 4 mm Luxury Vinyl Plank Floor Underlayment: 1.8 mm Protecto Wrap Whispermat LVT Floor Slab: 152 mm Concrete Slab Reference should be made to Intertek-ATI Report G0665.12-113-11 for complete test specimen description. This page alone is not a complete report. 130 Derry Court p. 717.764.7700 York, PA 17406 www.archtest.com www.intertek.com/building f, 717.764.4129 AL G0665.12-113-11-R1 Architectural Testing Page 1 of 4 Acoustical Performance Test Report PROTECTO WRAP COMPANY 1955 South Cherokee Street Denver, Colorado 80223 Report 00665.12-113-11 Test Date 07/11/16 Report Date 05/10/18 Revision Date 05/23/18 Project Scope This report is a reissue of the original Report No. G0665.04-113-11 and is rendered to Protecto Wrap Company through written authorization. A summary of the results is listed in the Test Results section, and the complete test data is included as attachments to this report. The original client provided the test specimen. Test Methods The acoustical tests were conducted in accordance with the following standards. The equipment listed in the attachments meets the requirements of the following standards. ASTM E 90-09, Standard Test Method for Laboratory Measurement of Airborne Sound Transmission Loss of Building Partitions ASTM E 413-10, Classification for Rating Sound Insulation ASTM E 492-09(2016)e 1, Standard Test Method for Laboratory Measurement of Impact Sound Transmission Through Floor -Ceiling Assemblies Using the Tapping Machine ASTM E 2179-03(2016), Standard Test Method for Laboratory Measurement of the Effectiveness of Floor Coverings in Reducing Impact Sound Transmission Through Concrete Floors ASTM E 989-06 (2012), Classification for Determination of impact Insulation Class (IIC) ASTM E 2235-04 (2012) Standard Test Method for Determination of Decay Rates for Use in Sound Insulation Test Methods Test Procedure All testing was conducted in the VT test chambers at Intertek-ATI located in York, Pennsylvania. The microphones were calibrated before conducting the tests. The airborne transmission loss test was conducted in accordance with the ASTM E 90 test method using the single direction method. Two background noise sound pressure level and five sound absorption measurements were conducted at each of five microphone positions. Four sound pressure level measurements were made simultaneously in both rooms, at each of five microphone positions. 130 Derry Court p. 717.764.7700 www.archtest.com • www.intertek.com/building York, PA 17406 1 1 . f. 717.764.4129 Ak G0665.12-113-11-R1 Architectural Testing Page 2 of 4 Test Procedure (Continued) The impact sound transmission test was conducted in accordance with the ASTM E 492 test method. Two background noise sound pressure level, two sound pressure level measurements with the tapping machine operating at each position specified by ASTM E 492, and five sound absorption measurements were conducted at each of five microphone positions. The air temperature and relative humidity conditions were monitored and recorded during all measurements. Test Conditions Source Room Receive Room Average Temperature 22.1 °C Average Temperature 22.4°C Average Relative Humidity 58% Average Relative Humidity 61 % Test Calculations The STC (Sound Transmission Class), IIC (Impact Insulation Class), and DIIC (Delta Impact Insulation Class) ratings were calculated in accordance with ASTM E 413, ASTM E 989, and ASTM E 2179, respectively. Test Specimen Materials and Installation Details Material Dimensions (mm) Thickness (mm) Manufacturer and Series Quantity Average Weight 914.4 by 152.4 4.0 N/A 10.980 7.52 kg/m� Luxury Vinyl Plank Note: Installed with releasable self-adhesive 914 by 3048 1.8 Protecto Wrap 10.98 m2 0.76 kgW Whispermat LVT Note: Loose laid 3023 by 3632 152.0 N/A 10.98 0 366.18 kg/& Concrete Slab Note: The concrete slab was installed in a test frame flush to the source room. Comments The total weight of the floor/ceiling assembly was 4111.6 kg. Intertek-ATI will store samples of the test specimen for four years. Photographs of the test specimen are included in the attachments. A drawing of the test specimen is included in the attachments. Ak G0665.12-113-11-RI Architectural Testing Page 3 of 4 This report is reissued in the name of Protecto Wrap Company through written authorization from the original report holder. The original Report No. is G0665.04-113-11. Intertek-ATI will service this report for the entire test record retention period. Test records, such as detailed drawings, datasheets, representative samples of test specimens, or other pertinent project documentation, will be retained by Intertek-ATI for the entire test record retention period. The test record retention period ends four years after the test date. This report does not constitute certification of this product nor an opinion or endorsement by this laboratory. It is the exclusive property of the client so named herein and relates only to the specimen tested. This report is intended to help in the client's quality assurance program, but it does not represent a continuous or exhaustive evaluation of the specimen tested or of other products or materials that were not evaluated. The statements and data provided herein do not constitute approval, disapproval, certification, or acceptance of performance or materials. This report may not be reproduced, except in full, without the written approval of Intertek-ATI. FOR INTERTEK-ATI: -- ftlM IA In1A 1in [.ey Ly6.! Cody R. Snyder Technician I - Acoustical Testing �dOK.�N Wine byl.p.l�l.n llryl.. Jordan Strybos Project Manager - Acoustical Testing Attachments (9 Pages): This report is complete only when all attachments are included. * Stated by Client/Mant4facturer N/A - Non Applicable Revision Date Page(s) RO 05/10/18 N/A R1 05/23/18 All pages AL Architectural Testing Revision Log Description G0665.12-113-11-R1 Page 4 of 4 Original Report Issue - Reissue of Report No. G0665.04-113-11 in the name of Protecto Wrap Company. ASTM E2179 data. added This report produced from controlled document template ATI 00629(d), Revised 02/09/15. G0665.12-113-11-RI Architectural Testing Attachments Instrumentation Instrument Manufacturer Model ATI Number Date of Calibration Data Acquisition Unit National Instruments PXI-1033 65124 06/16 Microphone Calibrator Norsonic 1251 INT00127 01/16 Receive Room Microphone PCB Piezontronics 378B20 63748 06/16 Receive Room Microphone PCB Piezotronics 378B20 63744 06/16 Receive Room Microphone PCB Piezotronics 378B20 63745 06/16 Receive Room Microphone PCB Piezotronics 378C20 65617 06/16 Receive Room Microphone PCB Piezotronics 378B20 63747 06/16 Receive Room Environmental Indicator Comet T7510 63810 10115 63811 10/15 Source Room Microphone PCB Piezotronics 378B20 63738 05/16 Source Room Microphone PCB Piezotronics 378B20 63739 05/16 Source Room Microphone PCB Piezotronics 378B20 63740 05116 Source Room Microphone PCB Piezotronics 378B20 63742 05/16 Source Room Microphone Scantek 378B20 63741 05116 Source Room Environmental Indicator Comet T7510 63812 11115 Tapping Machine Look Line s.r,l, IEM50 (TM50) 65351 02/16 * The calibration frequency for this equipment is every two years per the manufacturer's recommendation. Test Chambers VT Receive Room Volume 158.86 m3 VT Source Room Volume 190 m3 Page 1 of 9 Architectural Testing AIRBORNE SOUND TRANSMISSION LOSS ASTM E 90 G0665.12-113-I1-Rl ,"N 1.1.1m Test Date 07/11/16 Data File No. G0665.04 Client Protecto Wrap Company Description 4 mm Luxury Vinyl Plank, 1.8 mm Protecto Wrap Whispermat LVT, 152 nun Concrete Slab Specimen Area 10.98 m' Technician ICody R. Snyder Freq (Hz) Background SPL (dB) Absorption W) Source SPL (dB) Receive SPL (dB) Specimen TL (dB) 95% Confidence Limit Number of Deficiencies 80 38.9 14.8 109 67 42 3.70 100 35.5 12.4 107 67 40 1.60 - 125 37.1 9.4 106 70 38 1.10 0 160 26.9 8.5 107 72 37 1.90 1 200 24.6 11.1 104 72 33 2.20 8 250 24.2 10.9 104 64 40 1.00 4 315 23.9 9.7 105 62 44 0.60 3 400 19.1 8.0 104 61 44 0.20 6 500 22.8 7.5 104 57 49 0.40 2 630 18.6 7.2 104 53 53 0.40 0 800 17.7 7.0 105 49 59 0.40 0 1000 15.3 6.9 104 44 63 0.40 0 1250 9.4 7.0 104 42 66 0.20 0 1600 6.1 7.0 104 40 67 0.20 0 2000 4.2 7.7 104 38 68 0.30 0 2500 4.1 8.7 102 36 68 0.30 0 3150 4.0 9.6 103 34 70 0.40 0 4000 4.6 11.0 104 33 72 0.50 0 5000 5.2 12.9 104 32 72 0.50 - 6300 5.8 16.7 97 27 69 0.70 - 8000 6.2 22.0 97 20 75 0.80 - 10000 6.4 26.7 92 11 79 1 0.70 - STC Rating 51 (Sound Transmission Class) Deficiencies 24 (Sum ofDe/iciencies) Notes: 1) Receive Room levels less than 5 dB above the Background levels are highlighted in yellow. 2) Specimen TL levels listed in red indicate the lower limit of the transmission loss. 3) Specimen TL levels listed in green indicate that there has been a filler wall correction applied ATI 00614 Revised 02/09/15 Page 2 of 9 Intertek G0665.12-113-11-R1 Architectural Testing AIRBORNE SOUND TRANSMISSION LOSS C: ASTM E 90 ACCREDITED Toting ubmtwy Test Date 07/11/16 Data File No. G0665.04 Client Protecto Wrap Company Description 4 mm Luxury Vinyl Plank, 1.8 mm Protecto Wrap Whispermat LVT, 152 nun Concrete Slab Specimen Area 10.980 Technician Cody R. Snyder Airborne Sound Transmission Loss 100 90 80 ' i O. bLAI y 70 60 p 50 a 40 p 30 20 f 10--.--spwlnmn ....� Coatow c'urvc � I 0 I p N O O O O A •••� N k!► C CD N IV 00 00 Frequency (Hz) ATI 00614 Revised 02/09/1 S Page 3 of 9 A Architectural Testing IMPACT SOUND TRANSMISSION ASTM E 492 G0665.12-113-11-R1 9: ACCREDITED' E barimy Test Date 07/11/16 Data File No. G0665.04 Client Protecto Wrap Company Description 4 mm Luxury Vinyl Plank, 1.8 mm Protecto Wrap Whispermat LVT, 152 mm Concrete Slab Specimen Area 10.98 m2 Technician Cody R Snyder Freq (Hz) Background SPL (dB) Absorption (m2) Normalized Impact SPL (dB) 95% Confidence Limit Number of Deficiencies 80 37.6 15.9 53 2.8 - 100 32.8 12.6 54 3.1 0 125 38.1 9.6 54 1.8 0 160 25.8 8.9 56 1.2 1 200 21.6 10.9 63 2.5 8 250 22.0 10.3 60 0.8 5 315 21.5 9.2 56 1.2 1 400 17.1 7.9 52 0.4 0 500 22.4 7.4 46 0.9 0 630 19.2 7.3 42 0.5 0 800 18.7 7.0 40 0.9 0 1000 15.3 6.9 36 1.2 0 1250 9.7 7.0 29 0.6 0 1600 6.9 7.1 25 0.5 0 2000 5.7 7.7 19 0.6 0 2500 5.1 8.7 14 1.0 0 3150 4.7 9.6 7 0.6 0 4000 5.4 11.0 5 0.5 - 5000 5.9 12.9 5 0.5 - 6300 6.6 16.5 6 0.6 - 8000 7.0 22.1 8 0.7 - 10000 7.1 26.6 9 0.8 - HC Rating 57 (Impact Insulation Class) Deficiencies 15 (Stun of'Deficiencies) Note: Receive Room levels less than S dB above the Background levels are highlighted in yellow. ATI 0061 S Revised 0210911 S Page 4 of 9 Ak AM G0665.12-113-11-111 Architectural Testing . i IMPACT SOUND TRANSMISSION ASTM E 492 ACCREDITED' 110111, utwalm Test Date 07/11/16 Data File No. G0665.04 CIient Protecto Wrap Company Description 4 mm Luxury Vinyl Plank, 1.8 mm Protecto Wrap Whispermat LVT, 152 mm Concrete Slab Specimen Area 10.980 Technician Cody R. Snyder Impact Sound Transmission 100 10 90 I i 20 80 , i 30 70 I 40 4� 60 50 V 50 60 •.C° a � i b � 40 � 70 � W I I i ` ' 30 80 2 0 90 1 ' �� Nom allmd Impact SPL i 100 —�-- comosu 03M 0 i 110 en tn CD N Frequency (Hz) ATI 0061 S Revised 02109/1 S Page 5 of 9 A Architectural Testing DELTA IMPACT INSULATION ASTM E 2179 G0665.12-113-11-R1 C: ACCREDITED' iS"I Mtn Test Date 07/11/16 Data File No. G0665.04 Client Foam Solutions Inc Description 4 mm Luxury Vinyl Plank, 1.8 mm Protecto Wrap Whispermat LVT, 152 mm Concrete Slab Specimen Area 10.98 e Technician Cady R. Snyder Freq (Hz) Bkgrd SPL (dB) Absorption (Square Meters) Normalized Impact SPL BARE (dB) 95% Conf Limit Normalized Impact SPL SPEC (dB) 95% Conf Limit Resulting Array Lrg,, No. of Defici- envies 100 32.8 12.6 56.8 0.7 53.6 1.0 64 7 125 38.1 9.6 57.7 1.3 53.5 0.3 63 6 160 25.8 8.9 62.2 1.7 56.5 1.9 62 5 200 21.6 10.9 70.3 1.3 63.5 2.0 62 5 250 22.0 10.3 68.0 2.3 59.7 2.2 61 4 315 21.5 9.2 68.1 2.7 55.6 1.9 57 0 400 17.1 7.9 69.1 1.3 52.2 0.8 53 0 500 22.4 7.4 67.6 1.5 45.6 1.6 49 0 630 19.2 7.3 69.7 1.8 42.3 2.2 44 0 800 18.7 7.0 71.4 2.0 40.3 0.8 40 0 1000 15.3 6.9 71.5 2.6 35.8 0.3 36 0 1250 9.7 7.0 71.9 3.2 29.3 0.8 29 0 1600 6.9 7.1 72.6 3.3 24.9 1.0 24 0 2000 5.7 7.7 73.3 3.3 19.1 0.6 18 0 2500 5.1 8.7 73.0 3.0 13.7 1.0 13 0 3150 4.7 9.6 72.5 2.3 7.3 0.3 7 0 AIIC Rating Deficiencies Note: 27 (Delta Impact huttlation Class) 27 (Sitm of'Deficiencies) Receive Room levels less than 5 dB above the Background levels are highlighted in yellow. ATI 00756 Revised 02/09/15 Page 6 of 9 Ak • w G0665.12-113-11-R1 Architectural Testing DELTA IMPACT INSULATION 0 ASTM E 2179 ACCREWEC laborastrtory t�enQ Test Date 07/11/16 Data File No. G0665.04 Client Foam Solutions Inc Description 4 mm Luxury Vinyl Plank, 1.8 mm Protecto Wrap Whispermat LVT, 152 mm Concrete Slab Specimen Area 10.98 mZ Technician Cody R. Snyder Delta Impact Insulation 100 I 10 90 20 I 80 ' i ` 30 i 70 I i 40 T 60 50 11 ` a V 50 60 •r3° 40 ' 70 y i 30 ! 80 20 R 90 10 --E— Resulting Array ! 100 —♦— Contour Curve ' 0 110 en kn in pp O O O O N �t Frequency (Hz) ATI 00756 Revised 02/09/15 Page 7 of 9 A G0665.12-113-11-RI Architectural Testing Photographs Source Room View of Test Specimen Installation Receive Room View of Test Specimen Installation Page 8 of 9 G0665.12-113-11-R1 Architectural Testing Drawing In •'i�A w'. •�1 • '•- _. i •. t� � • • • • • N �s"�1 •!+ice � _►••__. �.� 1-Floor Topping 2-Underlayment 3-Concrete Slab Page 9 of DON BAILEY FLOORING TODAY 10"95" INSTALLATION CARPET • TILE * LAMINATE • HARDWOOD * BLINDS 2 914 3 4 •- C.O.D95112-2014831 N.W. 7th Avenue, Miami, Florida 33168 305-7574578 DATE ZZ 8300 Biscayne Blvd., Miami, Florida 33138 305-7574560 C.O.D 2208 S. State Rd. 7, Hollywood, FL 33023 954-963-4186 1=866=721-7171 1283 N.W. 31 st Avenue, Fort Lauderdale; FL 33312 954-797-5378 (Toll Free) NAME DELIVERY PROMISE 1&�' I.,b' AND INSTRUCTIONS www.donballoyflooring.com y� ADDRESS CITYJ)trtol STAT ZIP 331 PHONE: Homer 00 -7Z 0-70 Work: Cell: } Email- A QI a Sold B Kind of Sale Payment Received DEP SIT ,U COD 0 CHG O PAID 0 Cash ❑ Check ❑ V/MC ❑ AMX ❑ $ Quantity SIZE Tag# Style Color Unit Price Amount $ $ . $ $ $ $ $ $ --Ago EiC ha6e. $ $ . $ $ $ $ L $ $ wilk $ $ $ $ $ $ . ESTIMATE (pre -measure): Factory Fuel Surcharge $ $ 20.00 R0. ? 1� � Delivery Removal & Disposal $ $ @$.15/SF t 1�l 1�j � if�'�5y BAILEY JR DIRECT es no $ • CALL DON Installation (Payable Direct ❑y ❑ ) Total(Materlals Only) WITH ANY QUESTIONS �E Ift OR CONCERNS 1-866-721-7171 K i eAen $ READ lr $ ' We are not responsible for the sub-f m, seams showing, pile crushing, color variation from roll to roll, fuzzing and loop pile raveling Total (Labor Only) $ . ' Most In Static Inventory Is Irregular or discontinued. lnspeclion available upon request Term: Net cash upon completion unless otherwise specified herein If it becomes necessary to enforce payment (Material & Labor) Grand Total $ of this contract, purchaser agrees to pay costs of collection, JuLeraK reasonable a€ttomeys fees and court costs at Miami, Dade County, Florida or Hollywood, Brounty, ficawa. `No Refunds on Any Special Ordered Goods ' Less Deposit $ • ,For any sale using In stock product a 50% c cella essj&(on total sale for any job cancellation.) Balance Due $ customer stgnature s. delivery, installation & notes have been verfffed. WhttaXIdninal Offim (Innu Valinw r`a retnmar Po%nw X :4 � �.: ti: �y v ;+ CX, OY,, tft, ZA (a 1- CONRAIL-01 JPERON ACORN" CERTIFICATE OF LIABILITY INSURANCE DATE (MMroD1YYYY)9/9/2022 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Butler, Buckley, Deets, Inc. 6505 Blue Lagoon Dr Suite 250 Miami, FL 33126 c NTACT JENIFFER PERON PHONE, 305 262-0086 265 FAX, No ;(305 262-0187 L . JPERON u@BBDINS.COM INSURERS AFFORDING COVERAGE NAIC # INSURER A: TWIN CITY FIRE INSURANCE CO 29459 INSURED DON BAILEY CARPETS INC. 14831 NW 7 AVENUE MIAMI, FL 33168 INSURER B : HARTFORD CASUALTY INS CO 29424 INSURER C : INSURER D : INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 JXLA TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X 21 SBM TY7624 10/14/2021 10/14/2022 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 MED EXP (Anv one erson $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY El jpC- LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG 2,000,000 $ A AUTOMOBILE LIABILITY AUTO OWNED X SCHEDULED AUTOS ONLY AUTOS �Iy p AUTOS ONLY X AUTOS ER 21 UEC HH7702 10/1412021 10/14/2022 COMBINED SINGLE LIMIT (Ea accidentlANY $ 1,000,000 BODILY INJURY Perperson) BODILY INJURY Per accident) X PerOacExident AMAGE A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 21 SBM TY7624 10/14/2021 10/1412022 EACH OCCURRENCE 5,000,000 AGGREGATE $ 5,000,000 DED I X I RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYSTATUTE ANY PROPRIETORIPARTNER/EXECUTNE YIN (CNpFICER/M Mgt 1 EXCLUDED? (Mandatory n NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 21WBCAE4YS2 12/2312021 1212312022 X PER X OTH- E L EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1 000 000 ' ' DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) LICENSE # 06BS00859 CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED WITH RESPECTS TO THE GENERAL LIABILITY POLICY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE MIAMI SHORES VILLAGE BUILDING DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10050 NE 2ND AVENUE MIAMI SHORES, FL 33138 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD