HomeMy WebLinkAboutRevisions/ Energy Cal's OFFICE USE ONLY.
DATE FILED: . aA a PERMIT# vt.6]-'_6 s3 1
REVISION FEE: RECEIPT#
f
PLANNING &DEVELOPMENT SERVICES RECEIVED
BUILDING&CODE REGULATION DIVISION DECO 4 1U1U
2300 VIRGINIA AVENUE
FORT PIERCE,FL 34982.5652 Permitting oepartment
(772)462-1553 St, Lucie County
APPLICATION FOR BUILDING PERMIT REVISIONS
PROJECT INFORMATION "
LOCATION/SITE
ADDRESS: I76 L—G"Li Irz
DETAILED DESCRIPTION OF PROJECT
I
_ REVISIONS: wa�" 'J A4 No
r
i
TRACTOR INFORMATION:
STATE of FL REG./CE ST. LU CO CERT. #: I,
BUSINESS NAME: S � � �.
QUALIFIERS NAME: G
ADDRES / 7 c�---- r-
CITY: STATE: f L ZIP: I
PHONE(DAYTIME): '77Z-Z/z-1 FAX:
OWNER/BUILDER INFORMATION:
NAME:
ADDRESS:
CITY: STATE: ZIP:
PHONE(DAYTIME: FAX:
ARCHITECT/ENGINEER INFORMATION:
NAME: 51°Li°i /32y4US>
ADDRESS:
CITY: STATE: ZIP:
PHONE(DAYTIME): FAX:
SLCCC: 9123109 ;
Revised 06/30/17
FORM R40542017
FLORIDA ENERGY EFFICIENCY CODE FOR BUILDING CONSTRUCTION
Florida Department of Business and Professional Regulation - Residential PerformMiRethod
ProjectName: MICHAEL FOSTER BuilderName: Permitting Department
Street 176 ESTEIA LANE Permit Office: St.Lucie County
City,State,Zip: PORT ST.LUCIE,FL, PermitNumber.
Owner Jurisdiction:
DesignLocation: FL,Fort Pierce County St.Lucie(Florida Climate Zone 2)
I..Now construction or existing Addition 9.'Wall Types.(1224.0'sgfL) Insulation Area
2.Single family or multiple family Single-family a.Concrete Block-Int Insul,Exterior R=4.1 1224.00 ftz
b.N/A R= fN
3. Number of units,if multiple family 1 c.N/A R= flz
4.Number of Bedrooms(Bednns In Addition) 3(0) d.N/A R= .fiz
5: Is this a worst case? No 10.Ceiling Types (1162.0 sgft.) Insulation Area.
a.UnderAttiC(Vented) R=30.0 1162.00ft2
6.Conditioned floor area above grade(ftiz) 1162 b.N/A R= ft2
Conditionedfloorareabelowgrade(ft2) 0 c.NIA R= ft2
11.Ducts R ft2
7. Windows(252.0 sgft.) Description Area a.Sup:Attic,Ret:Attic,AH:A/C 6 85
a. U-Factor: Sgl,U=1.10 252.00 ft2
SHGC: SHGC--0.39
b. U-Factor. WA {� 12.Cooling systems kBtu/hr "Efficiency
SHGC: a.Central Unit 24.6 SEER:16.00
c. U-Factor. N/A ft2
SHGC: 13.Heating systems kBtu/hr Efficiency
d. U-Factor. WA ft2 a.Electric Strip Heat 27.0 COP:1.00
SHGC:
Area Weighted Average Overhang Depth: 6.114 fL
Area Weighted Average SHGC: 0.390 14.Hot water systems -
a.Electric Cap:40 gallons
8. Floor Types (1162.0 sgft) Insulation Area EF:0.950
a.Slab-0n-Grade Edge Insulation R=0.0 1162.00f1= b.Conservation features
b.N/A R= ft2 None
c.N/A R= fP 15.Credits CF,Pstat
Glass/Floor Area: 0.217 Total Proposed Modified Loads: 43.91 PASS
Total Baseline Loads: 43.98
I hereby certify that the plans and specifications covered by . Review of the plans and Q 'v' AT�
this calculation are in compliance with the Florida Energy specifications covered by this _ 0. .
Code. calculation indicates compliance
with the Florida Energy Code.
PREPAR xx Before construction is completed
D
DATE: �1-54- this building will be inspected for a
compliance with Section 553.908 F.. 4.
I hereby certify that this building,as designed,is in compliance Florida Statutes. yes.
with the Florida Energy Code: COD yVE
OWNER/AGENT• BUILDING OFFICIAL:
DATE: DATE:
- Compliance requires certification by the air handler unit manufacturer that the air handler enclosure qualifies as
certified factory-sealed In accordance with R403.3.2.1.
=Compliance requires an Air Barrier and Insulation Inspection Checklist in accordance with R402.4.1.1 and this project requires
an envelope leakage test report with envelope leakage no greater than 5.00 ACH50(111402.4.1.2).
VISION
11/24/2020 2:01 PM EnergyGauge®USA6.0.02(Rev.1)-FlaRes2017 FBC 6th Edition(2017) 0% p
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Im / y:
FORM R405-2097 INPUT SUMMARY CHECKLIST REPORT
PROJECT
Title: MICHAEL FOSTER Bedrooms: 3 Address Type: StreetAddress
BuildingType: User ConditionedArea: 1162 Lot#
OwnerName: Total Stories: 1' - Block/Subdivision:
#of Units: 1 Worst Case: No PlatBook:
BuilderName: RotateAngle: 0 Street: 176 ESTEIA LANE
Permit Office: CrossVentilation: No County: St Lucie
Jurisdiction: W hole House Fan: No City,State,Zip: PORT ST.LUCIE,
FamilyType: Single-family FL
New/Existing: Addition
Comment:
CLIMATE
Design Temp Int Design Temp Heating Design DailyTemp
DesignLocation TMYSite 97.5% 2.5% Winter Summer DegreeDays Moisture Range
FL,Fort Pierce FL VERO_BEACH_MUNI 39 90 70 75 299 62 LOW
BLOCKS
Number Name Area Volume
1 Entire House 1162 10458
SPACES
Number Name Area Volume Kitchen Occupants Bedrooms InfilID Finished Cooled Heated
1 BATH 76. 684 No 0 1 Yes Yes Yes
2 BEDROOM 2 220 1980 No 0 1 1 Yes Yes Yes
3 BEDROOM 1- 180 1620 No 0 1 .1 Yes Yes Yes
4 BED 3 108 972 No 0 1 1 Yes Yes Yes
5 KITCHEN 121 1089 Yes 0 1 Yes Yes Yes
6 LIVING AREA 240 2160 No 0 1 Yes Yes Yes
7 LIVING 211 1899 No 0 1 Yes Yes Yes
8 A/C 6 54 No 0 - 1 No Yes Yes
FLOORS
# FioorType Space Perimeter PerimeterR Value Area JoistR Value Tile Wood Carpet
1 Slab-On-GradeEdgelnsulation BATH 15 ft 0 76 ft2 � 0 1 0
2Siab-On-GradeEdgeinsulation BEDROOM 32ft 0 220ft2 0 1 0
3 Slab-On-Grade Edge Insulation BEDROOM 1 27 ft 0 180 ft2 ____ 0 1 0
4Slab-On-Grade Edge Insulation BED3 9ft 0 108ft2 __a 0 1 0
5Slab-On-Gradotdgeinsulabon KITCHEN 22ft 0 121ft2 0 1 0
6 Slab-On-Grade Edge Insulation LIVING AREA 34 ft 0 240 ft2 0 1 0
7 Slab-On-GradeEdgelnsulation LIVING 13 ft 0 211 ft2 ____ 0 1 0
8Slab-On-Grade Edge Insulation A/C 1 ft 0 6ft2 0 1 0
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FORM R405-2017 INPUT SUMMARY CHECKLIST REPORT
ROOF
Roof Gable Roof Red Solar SA Emitt Emit Deck Pitch.
# Type Materials Area Area Color Barr Absor. Tested Tested Insul. (deg)
1 Hip Compositionshingles 122.5 ft2 0 fl2 Light N .0.5 No 0.7 No 0 18.4
ATTIC
V # Type Ventilation Vent Ratio(1 in) Area RBS IRCC
1 Full attic Vented 150 1162ft2 N N
CEILING
# CeilingType Space R-Value Ins Type Area Framing Frac Truss Type
1 UnderAttic(Vented) BATH 30 Blown 76 ft2 0.1 Wood
2 UnderAttic(Vented) BEDROOM 30 Blown 220fI2 0.1 Wood
3 UnderAttic(Vented) BEDROOM 1 30 Blown 180ft2 0.1 Wood
4 UnderAttic(Vented) BED 3 30 Blown 108 ft2 0.1 Wood
5 UnderAttic(Vented) KITCHEN 30 Blown 121 f12 0.1 Wood
6 UnderAttic(Vented) LIVING AREA 30 Blown 240ft2 0.1 Wood
7 UnderAttic(Vented) LIVING 30 Blown 211 f12 0.1 Wood
8 UnderAttiC(Vented) A/C 30 Blown 6ft2 0.1 Wood
WALLS
Adjacent Space Cavity Width Height Sheathing Framing Solar Below
10 WaIlType
R-Waille Ft In Et In Area R--Val,Fe Fraction Ahsor Grarle%_
1 SW Exterior Concrete Block-Int Insul BATH 4.1 8 0 -9 0 72.0 ft2 0 0" 0.3 0
2 NW Exterior Concrete Block-Int Insul BATH 4.1 7 0 8 0 56.0 f12 0 0 0.3 0
3 SE Exterior Concrete Block-Int InsuBEDROOM 2 4.1 16 0 8" 0 128.0 fF 0 0 0.3, 0
4 SW Exterior Concrete Block-Int InsuBEDROOM 2 4.1 16 0 8 0 128.0 W 0 0 0.3 0
5 NE Exterior Concrete Block-Int InsuBEDROOM 1 4.1 15 0 8 0 120.0 ft2 0 0 0.3 0.
6 SE Exterior Concrete Block-Int InsuBEDROOM 1 4.1 12 0 8 0 96.0 ft2 0 0 0.3 0
7 NE Exterior Concrete Block-Intlnsul BED 3 4.1 9 0 8 0 72.0 ft2 0 0 0.3 0
8 " SW Exterior Concrete Block-Int Insul KITCHEN - 4.1 11 0 8 0 88.0 ft2 0 0 0.3 0
9 NW Exterior Concrete Block-Int Insul KITCHEN 4.1 11 0 8 0 88.0 ft2 0 0 .0.3 0
10 NE Exterior Concrete Block-Int lnsd1IVING AREA 4.1 24 0 8 0 192.0 112 0 0, 0.3 0
11 NW Exterior Concrete Block-Int InsJLIVING AREA 4.1 10 0 8 0 80.0 ft2 0 0 0.3 0
12 SW Exterior Concrete Block-Int Insul LIVING 4.1 13 0 8" 0 104.0 ft2 0 0 0.3 0
DOORS
# Omt DoorType Space Storms U Value Width Height Area
Ft In Ft in
1 NW Insulated LIVING AREA None 28 3 7 21 ft2
2 SW Insulated LIVING None 28 3 7 21 fF
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FORM R405-2017 INPUT SUMMARY CHECKLIST REPORT
WINDOWS
Orientation shown istheentered,Proposed orientation.
Wall Overhang
# Omt ID Frame Panes .NFRC U-Factor SHGC Imp Area Depth Separation IntShade Screening
1 SW 1 Metal Low-ESingle Yes 1.1 0.39 Y 9.0 W 2 ft 0 in 1 ft 4 in None None
2 SE 3 Metal Low-ESingle Yes 1.1 0.39 Y 11.7 ft' 2 ft 0 in 1 ft 4 in None None
3 SW 4 Metal Low-ESingle Yes 1.1 0.39 Y 11.3 ft- 2 ft 0 in 1 ft 4 in None None
4 SW 4 Metal Low-ESingle Yes 1.1 0.39 Y 23.3 ft2 2 ft 0 in 1 ft 4 in None None
5 NE 5 Metal Low-ESingle .Yes 1.1 0.39 Y 11.7 ft2 2 ft 0 in 1 ft 4 in None None
6 NE 5 Metal Low-ESingle Yes 1.1 0.39 Y 12.0 ft2 2 ft 0 in 1 ft 4 in None None
7 SE 6 Metal Low-ESingle Yes 1.1 0.39 Y 11.7 ft2 2 ft 0 in 1 ft 4 in None None
8 NE 7 Metal Low ESingle Yes 1.1 0.39 Y 12.0 ft2 2 ft 0 in 1 ft 4 in None None
9 NE 7 Metal Low-ESingle Yes 1.1 0.39 Y 12.3 fie 2 ft 0 in 1 ft 4 in None None
10 SW 8 Metal Low-ESingle Yes 1.1 0.39 Y 9.0 ft2 2 ft 0 in 1 ft 4 in None None
11 NE 10 Metal Low-ESingle Yes 1.1 0.39 Y 11.7 ft2 12ft 0 in 11t 4 in None None
12 NE 10 Metal Low ESingle Yes 1.1 0.39 Y 12.0 ft2 12 ft 0 in 1 ft 4 in None None
13 NE 10. Metal Low ESingle Yes 1.1 6.39 Y 80.0 ft2 12 ft 0 in 1 ft 4 in None None
14 SW 12 Metal LowESingle Yes 1.1 0.39 Y 12.0 ft2 2 ft 0 in 1 ft 4 in None None
15 SW 12 Metal Low-ESingle Yes 1.1 0.39 Y 12.3 ft2 2 ft 0 in 1 ft 4 in None None
INFILTRATION
# Scope Method SLA CFM 50 ELA EgLA ACH ACH 50
1 Wholehouse Propos idACH(50) .000286 871.5 47.84 89.98 .1039 5
HEATING SYSTEM
# System Type Subtype Speed Efficiency Capacity Block Ducts
1 Electric Strip HeatlNone(Basel None COPA 27 kBtu/hr 1 sys#1
COOLING SYSTEM
# System Type Subtype Subtype Efficiency Capacity Air Flow SHR Block Ducts
1 Central Unit/None(Baseline as Split Single SEER:16 24.6 kBtu/hr crm 0.8 1 sys#1
HOT WATER SYSTEM
# System Type SubType Location EF Cap. Use SetPnt Conservation
1 Electric None Attic .0.95 40 gal 60.9gal 120 deg None
SOLAR HOT WATER SYSTEM
FSEC Collector Storage
Cart# CompanyName System Model# CollectorModel# Area Volume FEF
None None ft2
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FORM R405-2017 INPUT SUMMARY CHECKLIST REPORT
DUCTS
—.Supply— —Return— Air CFM 25 CFM25 HVAC#
# Location R Value Area Location Area LeakageType Handler TOT OUT QN RLF Heat Cool
1 Attic 6 - 85 112 Attic 35 ft= DefaultLeakage A/C (Default)c(Default)c 1 1
TEMPERATURES
ProgramableThermostat Y Ceiling Fans:
Cooling [[ ]]Jan [[]]Feb MMar ( ]Ma [X]Jun �C]Jul nAug
Au [X]Se [ ]Oct Nov H
Dec
Heatin (X]Jan [X]Feb Mar WApr
Apr []May [ )Jun [ ]Jul Au [ ]SeP []Oct Nov Dec
Venting [[ ]]Jan [[]]Feb Mar Apr []May [[[ l Jun [ ]Jul [ ]Se w Oct Nov Dec
TherrnostatSchedule: HERS 2006 Reference Hours
ScheduleType 1 2 3 4 5 6 7 8 9 10 11 12,
Cooling(WD) AM 78 78 78 78 78 78 78 78 80 80 80 80
PM 80 80 78 78 78 78 78 78 78 78 - 78 78
Cooling(WEH) - AM 78 78 78 78 78 78 78 78 78 78 78 78
PM 78 78 78 78 78 78 78 78 78 78 78 78
Heating(WD) AM 66 66 66 66 66 68 - 68 68 68 68 68 68
PM 68 68 68 68 68 68 68 68 68 68 66 66
Heating(WEH) AM 66 66 66 66 66 68 68 68 68 68 68 68
PM 68 68 68 68. 68 68 68 68 68 68 66 66
MASS
Mass Type Area Thickness FumitureFraction Space
Default(8lbs/sq.ft 0 ftz 0 It 0.3 BATH
Default(8lbs/sq.ft ft' It 0.3 BEDROOM 2
Default(8lbs/sq.fL ft' It 0.3 BEDROOM 1
Default(8lbs/sq.ft ftz ft 0.3 BED 3
Default(8lbs/sq.fL ft= ft 0.3 KITCHEN
Default(8 ibs/sq.ft fts It 0.3 LIVING AREA
Default(8lbs/sq.fL ft' It 0.3 LIVING
Default 8lbs/s .fL ft2 It 0.3 A/C
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2017 EPL DISPLAY CARD
RECEIVED
ENERGY PERFORMANCE LEVEL (EPL) DISPLAY CARD DEC'® 4 1020
Permitting.Department
ESTIMATED ENERGY PERFORMANCE INDEX*= 100 st. Lucie county
The lower the Energy Performance Index,the more efficient the home.
1.New home or,addition 1. Addition 12.Ducts,location&insulation level
a)Supply ducts R 6.0
2.Single-family or multiple-family 2. Siniale-family b)Return ducts R 6.0
c)AHU location A/C
3.No.of units(if multiple-family) 3. 1
4.Number of bedrooms 4. 3 13.Cooling system: Capacity 24.6
a)Split system SEER 16.0
5. Is this a worst case?(yes/no) 5. No b)Single package SEER
c)Ground/water source SEERICOP
6.Conditioned floor area(sq.ft.) 6. 1162 d)Room unit/PTAC EER
e)Other
7.Windows,type and area
a)U-factor:(weighted average) 7a. 1.100
b)Solar Heat Gain Coefficient(SHGC) 7b. 0.390 14.Heating system: Capacity 27.0
c)Area 7c. 252.0 a)Split system heat pump HSPF
b)Single package heat pump HSPF
8.Skylights c)Electric resistance COP 1.0
a)U-facton(weighted average) 8a. NA d)Gas furnace, natural gas AFUE
b)Solar Heat Gain Coefficient(SHGC) 8b. NA e)Gas furnace, LPG AFUE
f)Other
9. Floor type,insulation level:
a)Slab-on-grade(R-value) 9a. 0.0
b)Wood,raised(R-value) 9b. 15.Water heating system
c)Concrete,raised(R-value) 9c. a)Electric resistance EF 0.95
b)Gas fired,natural gas EF
10.Wall type and insulation: c)Gas fired, LPG EF
A.Exterior:. d)Solar system with tank EF
1.Wood frame(Insulation R-value) 10A1. e)Dedicated heat pump with tank EF
2.Masonry(Insulation R-value) 10A2. 4.1 f)Heat recovery unit HeatRec%
B.Adjacent: g)Other
1.Wood frame(Insulation R-value) 10131.
2.Masonry(Insulation R-value) 1OB26
16.HVAC credits claimed(Performance Method)
11.Ceiling type and insulation level a)Ceiling fans Yes
a)Under attic 11a. 30.0 b)Cross ventilation No
b)Single assembly 11b. c)Whole house fan No
c)Knee walls/skylight walls 11c. d)Multizone cooling credit
d)Radiant barrier installed 11d. No e)Multizone heating credit
f)Programmable thermostat Yes
*Label required by Section R303.1.3 of the Florida Building Code,Energy Conservation, if not DEFAULT.
I certify that this home has complied with the Florida Building Code,-Energy Conservation,through the above energy
saving features which will be installed(or exceeded)in this home before final inspection.Otherwise,a new EPL .
display card will be completed based on installed code compliant features.
Builder Signature: Date:
Address of New Home: 176 ESTEIA LANE City/FL Zip: PORT ST.LUCIE,FL
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2617-AIR BARRIER AND INSULATION INSPECTION COMPONENT CRITERIA
TABLE 402.4.1.1
AIR BARRIER AND INSULATION INSPECTION COMPONENT CRITERIA
Project Name: MICHAEL FOSTER Builder Name:
Street: 176 ESTEIA LANE Permit Office:
City,State,Zip: PORT ST.LUCIE,FL, Permit Number. Y
U
Owner. Jurisdiction: W
x
Design Location: FL,Fort Pierce U
COMPONENT AIR BARRIER CRITERIA INSULATION INSTALLATION CRITERIA
General A continuous air barrier shall be installed in the building envelope. Air-permeable insulation shall
The exterior thermal envelope contains a continuous air barrier. not be used as a sealing material.
requirements Breaks or joints in the air barrier shall be sealed.
Ceiling/attic The air barrier in any dropped ceiling/soffit shall be aligned with The insulation in any dropped ceiling/soffit
the insulation and any gaps in the air barrier shall be sealed. shall be aligned with the air barrier.
Access openings,drop down stairs or knee wall doors to
unconditioned attic spaces shall be sealed.
Walls The junction of the foundation and sill plate shall be sealed. Cavities within comers and headers of frame walls
The junction of the top plate and the top of exterior walls shall be shall be insulated by completely filling the cavity
sealed. with a material having a thermal resistance of R-3
Knee walls shall be sealed. per inch minimum.
Exterior thermal envelope insulation for framed
walls shall be installed in substantial contact and
continuous alignment with the air barrier.
Windows,skylights The space between window/doorjambs;and framing,and
and doors skylights and framing shall be sealed.
Rim joists -Rim joists shall include the air barrier. Rim joists shall be insulated.
Floors The air barrier shall be installed at any exposed edge of Floor framing cavity insulation shall be installed to.
(including insulation. maintain permanent contact with the underside of
above-garage subfloor decking,or floor framing cavity insulation
and cantilevered shall be permitted to be in contact with the top side
floors) of sheathing,or continuous insulation installed on
the underside of floor framing and extends from the
bottom to the top of all perimeter floor framing
members.
Crawl space walls Exposed earth in unvented crawl spaces shall be covered with Where provided instead of floor insulation,insulation
a Class I vapor retarder with overlapping joints taped. shall be permanently attached to the crawlspace
Shafts,penetrations Duct shafts,utility penetrations,and flue shafts opening to
exterior or unconditioned space shall be sealed.
Batts in narrow cavities shall be cut to fit,or narrow
Narrow cavities cavities shall be filled by insulation that on
installation readily conforms to the available cavity
spaces.
Garage separation Air sealing shall be provided between the garage and conditioned spac 3s.
Recessed lighting. Recessed light fixtures installed in the building thermal envelope Recessed light fixtures installed in the building
shall be sealed to the drywall. thermal envelope shall be air tight and IC rated.
Plumbing and wiring Batt insulation shall be cut neatly to fit around wiring
and plumbing in exterior walls,or insulation that on
installation readily conforms to available space shall
extend behind pil2ing and Wring,
Shower/tuff The air barrier installed at exterior walls adjacent to showers and Exterior walls adjacent to showers and tubs shall
on exterior wall tubs shall separate them from the showers and tubs. be insulated.
Electrical/phone box or The air barrier shall be installed behind electrical or communication
exterior walls boxes or air-sealed boxes shall be installed.
HVAC register boots HVAC register boots that penetrate building thermal envelope shall
be sealed to the sub-floor or drywall.
Concealed When required to be sealed,concealed fire sprinklers shall only be
sprinklers. sealed in a manner that is recommended by the manufacturer.
Caulking or other adhesive sealants shall not be used to fillboids
between fire sp OW cover
lates and walls or cau
a.In addition,inspection of log walls shall Min accordance with the provisions of ICC-400.
11/24/2020 2:03 PM EnergyGauge®USA 6.0.02(Rev.1)-FlaRes2017 FBC 6th Edition(2017) Compliant Software Page 1 of 1
401 E JACKSON STREET PREMIUM FINANCE AGREEMENT IPFS CORPORATION
SUITE 1250
TAMPA,FL33602
0-FAX:(813)8863988
CUSTOMER SERVICE:(866)412-2452
CASH PRICE ; $2,766.751, :AGENT ;INSURED
(TOTAL PREMIUMS) i (Name 8�Place of business) ;(Name&Residence or business)
!LOTT INSURANCE SERVICES LLC jAGLER&SONS CONSTRUCTION INC
CASH DOWN $553.351 i ;102 NE LIMA COURT
PAYMENT 4808 S US HIGHWAY 1
PORT ST LUCIE,FL 34983
c1PRINCIPAL BALANCE { ✓T$2,213.401 FORT PIERCE,FL34982-7078 (772)214-5432
(A MINUS B) i ; (772)468-1009 FAX (77268-1837
D `s DOC STAMP $8.051 '
Commercial
Account#: LOAN DISCLOSURE Quote Number: 13849187
ANNUAL PERCENTAGE RATE FINANCE CHARGE AMOUNT FINANCED ':,TOTAL OF PAYMENTS
The cost of your credit as a yearly rate. The dollar amount the credit will The amount of credit provided to !The amount you will have paid after you
cost you. you or on your behalf. have made all payments as scheduled
14.786% $153.35 $2,221.45 $2,374.80
1
ITEMIZATION OF THE AMOUNT FINANCED:THE
YOUR PAYMENT SCHEDULE WILL BE
__ AMOUNT FINANCED IS FOR APPLICATION TO THE
Number Of Payments. Amount Of Payments !When Payments i PREMIUMS SET FORTH IN THE SCHEDULE'OF
;Are Due MONTHLY POLICIES UNLESS OTHERWISE NOTED.
10 $237.48 Beginning: l1/25/2020
Security: Refer to paragraph 1-below for a description of the collateral assigned to Lender to secure this loan.
Late Charges:A late charge will be imposed on any installment in default 5 days or more.This late charge will be 5.00%of the installment due.
Prepayment: If you pay your account off early,you may be entitled to a refund of a portion of the finance charge in accordance with Rule of 78's or
as otherwise'allowed by law.The finance charge includes a predetermined interest rate plus a non-refundable serviceforigination fee of$20.00.See
the terms below and on the next page for additional information about nonpayment,default and penalties.
POLICY PREFIX `EFFCTfVE D11T� SCt�EDULI=0�P�OLtCIES -, COVERAGE 1NINIMUM COL PtZE IUM�
AWD NUMBER. �'"� OE POUCIt! �� (NSURANCE COMRANY3AND GENERAL AGENT - F' EARNED TERM '" �' a ' ��'
;PENDING 10/25/2020 EVANSTON INSURANCE CO GENERAL 0.000% 12 i 2,500.00
AMWINS ACCESS INSURANCE LIABILITY Fee:136.58;
Tax:130.17
Broker Fee: $0.00
TOTAL: $2,766.75
The undersigned insured directs IPFS Corporation(herein,"Lender")to pay the premiums on the policies described on the Schedule of Policies.In consideration
of such premium payments,subject to the provisions set forth herein,the insured agrees to pay Lender at the branch office address shown above,or as otherwise
directed by Lender,the amount stated as Total of Payments in accordance with the Payment Schedule,in each case as shown in the above Loan Disclosure.The
named insured's),on a joint and several basis if more than one,hereby agree to the following provisions set forth on pages 1 and 2 of this Agreement: 1.
SECURITY:To secure payment of all amounts due under this Agreement,insured assigns Lender a security interest in all right,title and interest to the scheduled
policies,including(but only to the extent permitted by applicable law):(a)all money that is or may be due insured because of a loss under any such policy that
reduces the unearned premiums(subject to the interest of any applicable mortgagee or loss payee),(b)any unearned premium under each such policy,(c)
dividends which may become due insured in connection with any such,policy and(d)interests arising under a state guarantee fund. 2.POWER OF ATTORNEY:
Insured irrevocably appoints its Lender aftomey-in-fact with full power of substitution and full authority upon default to cancel all policies above identified.The
insured agrees that Lender may endorse the insured's name on any check or draft received from the insuring company and apply the same as payment of this
Agreement,returning any excess to the insured only if such excess is equal to or greater than$1.00.
NOTICE:A.Do not sign this agreement before you read it or if it
contains any blank space.B.You are entitled to a completely filled in The undersigned hereby warrants and agrees to Agent's
copy of this agreement.C.Under the law,you have the right to pay in Representations set forth herein.
advance the full amount due and under certain conditions to obtain a
partial refund of the finance charge.D.Keep your copy of this
agreement to protect your legal rights.
Signature of Insured or Authorized Agent DATE Signature of Agent DATE
(10/17)Copyright 2017 IPFS Corporation TM Page 1 of 5 11/17/2020 Web-FLCFEE
Insured and Lender further agree that:3.POLICY EFFECTIVE DATES:The finance charge begins to accrue as of the earliest policy effective date.4.
AGREEMENT EFFECTIVE DATE This Agreement shall be effective when written acceptance is mailed to the insured by Lender.5.DEFAULT AND
DELINQUENT PAYMENTS Insured will be in default if a payment is not made when it is due.The acceptance by Lender of one or more late payments from the
insured shall not estop Lender or be a waiver of the rights of Lender to exercise all of its rights hereunder or under applicable law in the event of any subsequent
late payment 6.CANCELLATION:Lender may cancel the scheduled policies after providing at least 10 days notice of its intent to cancel or any other required
statutory notice if the insured does not pay any installment according to the terms of this Agreement or transfers any of the scheduled policies to a third party and
the unpaid balance due to Lender shall be immediately due and payable by the insured.Lender at its option may enforce payment of this debt without recourse to
the security given to Lender.7.CANCELLATION CHARGES:If cancellation occurs,the insured agrees to pay a finance charge on the outstanding indebtedness
at the maximum rate authorized by applicable state law in effect on the date of cancellation until the outstanding indebtedness is paid in full or until such other
date as required by law.8.INSUFFICIENT FUNDS(NSF)CHARGES:If an insured's payment is dishonored for any reason,the insured will pay to Lender a fee,if
permitted by law,equal to$15.00 or the maximum amount permitted by law.9.MONEY RECEIVED AFTER CANCELLATION Any payments made to Lender
after Lender's Notice of Cancellation of the insurance policy(ies)has been mailed may be credited to the insured's account without any obligation on the part of
Lender to request reinstatement of any policy.Any money Lender receives from an insurance company shall be credited to the balance due Lender with any
surplus refunded to whomever is entitled to the money.In the event that Lender does request a reinstatement of the policy(ies)on behalf of the insured,such a
request does not guarantee that coverage under the policy(ies)will be reinstated or continued.Only the insurance company has authority to reinstate the.policy
(ies).The insured agrees that Lender has no liability to the insured if the policy(ies)is not reinstated.10..ASSIGNMENT:The insured agrees not to assign this
Agreement or any policy listed hereon or any interest therein(except for the-interest of mortgagees or loss payees),without the written consent of Lender,and that
Lender may sell,transfer and assign its rights hereunder or under any policy without the consent of.the insured,and that all agreements made by the insured
hereunder and all rights and benefits conferred upon Lender shall inure to the benefit of Lenders successors and assigns(and any assignees thereof). 11.
INSURANCE AGENT OR BROKER:The insured agrees that the insurance agent or broker soliciting the policies or through whom the policies were issued is not
the agent of Lender,and the agent or broker named on the front of this Agreement is neither authorized by Lender to receive installment payments under this
Agreement nor to make representations,orally or in writing,to the insured on Lender's behalf(except to the extent expressly required by applicable law).As and
where permissible by law,Lender may compensate your agent/broker for assisting in arranging the financing of your insurance premiums.If you have any
questions about this compensation you should contact your agentibroker.12.FINANCING NOT A CONDITION The law does not require a person to enter into a
premium finance agreement as a condition of the purchase of insurance. 13:COLLECTION COSTS:Insured agrees to pay attorney fees and other collection
costs to Lender,.not to exceed 20%of the amount due,if this Agreement is referred to an attorney or collection agency.who is not a salaried employee of Lender,
to collect any money.insured owes under this Agreement.14.LIMITATION OF LIABILITY`.The insured agrees that Lender's liability to the insured,any other
person or entity for breach of any of the terms of this Agreement for the wrongful or improper exercise of any of its powers under this Agreement shall be limited to
the amount of the principal balance outstanding,except in the event of Lender'gross negligence or willful misconduct Insured recognizes and agrees that Lender
is a lender only and not an insurance company and that in no event does Lender assume any liability as an insurer hereunder or otherwise.15.CLASSIFICATION
AND FORMATION OF AGREEMENT This Agreement is and will be a general intangible and not an instrument(as those terms are used in the Uniform
Commercial Code)for all purposes.Any electronic signature or electronic record may be used in the formation of this Agreement,and the signatures of the
insured and agent and the record of this Agreement may be in electronic form(as those terms are used in the Uniform Electronic Transactions Act).A photocopy,a
facsimile or other paper or electronic record of this Agreement shall have the same legal effect as a manually signed copy.16.REPRESENTATIONS AND
WARRANTIES:The insured represents that(a)the insured is not insolvent or presently the subject of any insolvency proceeding(or if the insured is a debtor of
bankruptcy,the bankruptcy court has authorized this transaction),(b)if the insured is not an individual,that the signatory is authorized to sign this Agreement on
behalf of the insured,(c)all parties responsible for payment of the premium are named and have signed this Agreement,and(d)there is no term or provision in
any of the scheduled policies that would require Lender to notify or get the consent of any third party to effect cancellation of any such policy.17.ADDITIONAL
PREMIUM FINANCING:Insured authorizes Lender to make additional advances under this premium finance agreement at the request of either the Insured or the
'Insured's agent with the Insured's express authorization;and subject to the approval of Lender,for any additional,premium on any policy listed in the Schedule of
Policies due to changes in the insurable risk.If Lender consents to the request for an additional advance,Lender will send Insured a revised payment amount
("Revised Payment Amount").Insured agrees to pay the Revised Payment Amount,which may include additional finance charges on the newly advanced amount,
and acknowledges that Lender will maintain its security interest in the Policy with full authority to cancel all policies and receive all unearned premium if Insured
fails to pay the Revised Payment Amount.18.PRIVACY.Our privacy policy may be found at https./fipfs.com/Privacy.19.ENTIRE DOCUMENT/GOVERNING
LAW:This document is the entire Agreement between Lender and the insured and can only be changed in writing and signed by both parties except that the
insured authorizes Lender to insert or correct on this Agreement,if omitted or incorrect,the insurer's name and the policy number(s).Lender is also authorized to
correct patent errors and omissions in this Agreement In the event that any provision of this Agreement is found to be illegal or unenforceable,it shall be deemed
severed from the remaining provisions,which shall remain in full force and effect The laws of the State of Florida will govern this Agreement 20.
AUTHORIZATION:The insurance company(ies)and theiragents,any intermediaries and the agent/broker named in this Agreement and their successors and
assigns are hereby authorized and directed by insured to provide Lender with full and complete information regarding all financed insurance policy(ies),including
without limitation the status and calculation of unearned premiums,and Lender is authorized and directed to provide such parties with full and complete
information and documentation regarding the financing of such insurance policy(ies),including a copy of this Agreement and any related notices.21.WAIVER OF
SOVERIGN IMMUNITY:The insured expressly waives any sovereign immunity available to the insured,and agrees to be subject to the laws as set forth in this
Agreement(and the jurisdiction of federal and/or state courts)for all matters relating to the collection and enforcement of amounts owed.under this Agreement and
the security interest in the scheduled policies granted hereby.
AGENTBROKER REPRESENTATIONS
The agentibroker executing this,and any future,agreements represents,warrants and agrees:(1)installment payments totaling$0.00 and all applicable down .
payments)have been received from the insured in immediately available funds,(2)the insured has received a copy of this Agreement;if the agent/broker has
signed this Agreement on the insured's behalf,the insured has expressly authorized the agent/broker to sign this Agreement on its behalf or,if the insured has
signed,to the best of the undersigned's knowledge and belief such signature is genuine,(3)the policies are in full force and effect and the information in the
Schedule of Policies including the premium amounts is correct,(4)no direct company bill,audit,or reporting farm policies or policies subject to retrospective rating
or to minimum earned premium are included,except as indicated,and the deposit of provisional premiums is not less than anticipated premiums to be earned for
the full term of the policies,(5)the policies can be cancelled by the insured or Lender(or its successors and assigns)on 10 days notice and the unearned
premiums will be computed on the standard short rate or pro rate table except as indicated,(6)there are no bankruptcy,receivership,or insolvency proceedings
affecting the insured,(7)to hold Lender,its successors and assigns harmless against any loss or expense(including attorney fees)resulting from these
representations or from errors,omissions or inaccuracies of agentibroker in preparing this Agreement,(8)to pay the down payment and any funding amounts
received from Lender under this Agreement to the insurance company or general agent(less any commissions where applicable),(9)to hold in trust for Lender or
its assigns any payments made or credited to the insured through or to agent/broker directly or indirectly,actually or constructively by the insurance companies.
and to pay the monies,as well as the unearned commissions to Lender or its assigns upon demand to satisfy the outstanding indebtedness of the insured,(10)all
material information concerning the insured and the financed policies necessary for Lender to cancel such policies and receive the unearned premium has been
disclosed to Lender,(11)no term or provision of any financed policy requires Lender to notify or get the consent of any third party to effect cancellation of such
policy,and(12)to promptly notify Lender in writing if any information on this Agreement becomes inaccurate.
(10/17)Copyright 2017 IPFS Corporation Tm Page 2 of 5 11/17/2020 Web-FLCFEE
c�
In the near future.. paper forms will no longer be used to enroll in Recurring ACH. - - .'
In an effort to streamline the premium finance process, insureds will be ,-
asked to enroll in Recurring ACH after registering on ipfs.com. U�le �Nill notify you
IAL
when this change takes effect.
ipfs.com
Copyrighti
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IPFS Corporation
AUTOMATIC DEBIT AUTHORIZATION
Name&Address of InsuredlBorrower:AGLER&SONS CONSTRUCTION INC
102 NE LIMA COURT PORT ST LUCIE, FL 34983
!Telephone Number:(772)214-5432
Name&Address of Account Holder(If different from above):
;Telephone Number:( ) - Email Address:
IPFS Use Only: Quote No.: 13849187 Debit Begins: 11/25/2020
IPFS
401 E JACKSON STREET
TAMPA, FL33602
Phone: (Y
FAX: (813)886-3988
Please verify with your bank that the bank routing number for ACH transactions is the same as listed on your
check or deposit slip.
.Bank Account Title(Name): C:AP�fr [ Checking or []Savings
Financial institution: ,0 J ABA#/Routing#:
iAddress(City, State,ZIP): ` �US �1' 3 1SL' Acct.No:60 YZ 77/fd L
Number of Payments: 10 Payment Amount: $237.48 First Payment Due: 11/25/2020
AGREEMENT
i hereby authorize IPFS Corporation(IPFS)to initiate electronic debit entries to the account indicated on this form,from the
financial institution identified above(BANK). I authorize BANK to honor the debit entries initiated by IPFS and debit the
same to such account.This authority pertains to all financial obligations existing from time to time under the Premium
Finance Agreement(PFA)I enter into with IPFS, including but not limited to scheduled payments and the cash down
payment described in the PFA(or)revised payment amounts resulting from revisions to the PFA or otherwise, and
applicable fees and charges.
The debits for scheduled payments will be in accordance with the schedule of payments disclosed in the PFA,with a debit
occurring on the First Payment Due Date,and on the subsequent same day of each month (or per the PFA Schedule of
payments if different)thereafter, until all scheduled payments have been made.If the payment due date falls on a
weekend of holiday,IPFS will debit the account on the following business day.I understand that funds must be
available in the account on the date the debit is made.
I understand and agree that each time the BANK rejects a debit entry for Non-Sufficient Funds(NSF)or Account Closed,
my account with IPFS will be assessed the maximum NSF fee permitted by law not to exceed$40.00.The NSF Fee may
be electronically debited from my BANK account indicated on this form. I also understand and agree that IPFS may re-
initiate a debit returned NSF up to two more times, and the re-initiated debit may occur on a date other than my regular
payment due date.
I also understand and agree that this authorization is to remain in force until(1) IPFS receives from me a signed written
notice of revocation,sent to the IPFS address set forth above by first class mail postage prepaid in such time and manner
as to afford IPFS a reasonable opportunity to act on it;OR(2)1 have received written notification from IPFS that this
authorization and agreement is terminated for rejecti/older)
ebit entry due to NSF or Account Closed.
By: Date�l
(Account Holder or orized Signatory of Ac unt
Printed or Typed Name: mil/'" D B A
(10117)Copyright 2017 IPFS Corporation Tm Page 4 of 5 11/17/2020 Web-FLCFEE
ACH (Automated Clearing House)
GUIDELINES & PROCEDURES
1. For an account to be set up on ACH, insured needs to sign an automatic debit authorization form.
1 a. If form is electronically signed, keep for your records only and do not mail to IPFS.
2. IPFS Needs at least two business days before the next payment due date. If authorization is received less than two
business days before the next payment due date, insured has to send in a payment for that period and(IPFS)will initiate
debit transactions the following installment due date.
'*Send back to:
IPFS Corporation
401 E JACKSON STREET TAMPA, FL33602
Phone:()-
FAX: (813)886-3988
(10/17)Copyright 20171PFS Corporation TM Page 5 of 5 11/17/2020 Web-FLCFEE
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MICHAEL FOSTER 317 SE WCIE LANE FWd—RUtp-8U'"rersW 2019
178ESTEIALANE FORT PIERCE,FL34.946 2 1s.020 -0112. .38
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