Loading...
DOCK-16-1284 (3)Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Parcel Number Expiration: 01/09/2017 Applicant 1350 NE 101 Street Miami Shores, FL 1132050230020 Block: Lot: DIRK & ELIZABETH PETERSON Owner Information Address Phone Cell DIRK & ELIZABETH PETERSON 1350 NE 101 ST MIAMI SHORES FL 33138-2611 Contractor(s) Phone DOCK & MARINE CONSTRUCTION 305-751-9911 Cell Phone Valuation: Total Sq Feet: $ 25,000.00 0 Type of Dock: NEW MARGINAL DOCK, FINGER PIER AND Additional Info: Bond Return : Classification: Residential Scanning: 4 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Plan Review Fee (Engineer) Pian Review Fee (Engineer) Scanning Fee Technology Fee Total: Amount $15.00 $11.25 $11.25 $5.00 $750.00 $120.00 $120.00 $12.00 $20.00 $1,064.50 Pay Date Pay Type Amt Paid Amt Due Invoice # DOCK -5-16-59749 05/12/2016 Check #: 2379 $ 50.00 $ 1,014.50 07/13/2016 Credit Card $ 1,014.50 $ 0.00 Available Inspections: Inspection Type: Final PE Certification PE Letter of Intent Final Framing in Progress Review Electrical Review Electrical Review Building Review Building Review Structural Review Structural Review Planning Review Planning 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, RiAOFING 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, F rmore, I authorize th9.above-named. contractor to do the work stated. ----7-7"------ (_,--'l. _.__ July 13, 2016 --- - Authorized Sign e: Owner � Applicant / Contractor / Agent Date Building Department Copy July 13, 2016 1 September 22, 2016 LEAF ENGINEERING Citi of Miami Shores Village Building Department Building Official Ismael Naranjo 10050 NE 2"d Ave. Miami Shores Village, FL 33138 RE Peterson Residence 1350 NE 101 Street Miami Shores, FL Permit # DOCK -5-16-1284 Contractor. Dock & Marine Construction Final Inspection Letter Present at site: -Glen — Dock & Marine Construction, Contractor. Dear Sir/Madam: I, Leandro Fernandez, P.E., having performed and approved the required inspections, hereby attest that "To the best of my knowledge and belief, the above described construction of all structural load-bearing components complies with the permitted documents. I also attest to the best of my knowledge and belief, the approved permit plans represent the as -build condition of the structural and envelope components of said structure." This document is being prepared in accordance with the 2010 Florida Building Code and is being submitted to the City of Miami Shores Building Department at the time of the final inspection for the above referenced structure. Should you have any questions or need any additional information, please do not hesitate to contact me. Sincerely, Leandro Fernandez, P.E. FL PE# 71519 Leaf Engineering CA# 29777 ®rel FEfis �® v; * ; No. 71519 * Er r ▪ STATE OF .40,z. °'�▪ 0'c�::424 0RIO P:•°��'�� C� ®1:e6,S�L'������ �lONAfgale��! LEAF ENGINEERING 85 NW 86 STREET, MIAMI, FLORIDA 33150 786.390.74931eaf©leafengineering.net Gas Connection and Equipment DROP TEST CERTIFICATE DADE: 305-940-8820 BROWARD: 954-965-8060 STATE LIC: 24314 LPG BROWARD CC# 08-CLPG-14752 Florida Building Code, Fuel Gas SECTION 406 (LFGS) INSPECTION< TESTING< AND PURGING 406.1 General Prior to acceptance and initial operation, all piping installations shall be. inspected and pressure tested to detetmine that the materials, design, fabrication and installation practices comply with the requirements of this code. Owners L1 Information Name S4 VeleieSCI-° + d s t� j �C Pekes -0A) Address ( 35-0 ,A.). 4.; . !O! 577 City /' (Alin a SAC/re.". Contractor Information Company Name State r�L. License# 2' 3/ `r c 6/16c.„, te-yoirp.teal Type of Installation: New Upgrade to Existing K Existing piping Description of Work: (Must include test details and include piping and appliances) N.54 r 4,r -an, !3r Med c 1 %2e P'cvw rvt tori 6e 4006( ®viz Se w 4- Z psl 54-er VGcc ii 12 System Pressure from Meter zest If Hybrid system, branch Pressure Inches Water Column Pressure Test '2,c±tvest Duration —°14.-7—Date of Test Notary Information: State of Florida County of D Swornto(or atm) and subscaiedbefore me this dayof by "`0� �- Qk" ., J "(name ofperson making statenent). —Pxgsonaly Known a� `-•" Produced Identification ( i + YAWNTELAY A. TOWNSEMD Notary Public, State of Florida Commission+# FF 14....1 My comm. epires Am. 10, 2018 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 BUILDING PERMIT APPLICATION BUILDING ELECTRIC ❑ ROOFING ❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS FBC 20 NN Master Permit No. 0(.. ( 6- 4 `•tt Sub Permit No. ❑ REVISION ❑ CHANGE OF CONTRACTOR JOB ADDRESS: 13Sb VE. ,DA SAte e.k- City: Miami Shores County: ❑ EXTENSION ❑RENEWAL ❑ CANCELLATION ❑ SHOP DRAWINGS Miami Dade Zip: Folio/Parcel#: 1'— d23 Occupancy Type: Load: - 002 �O Construction Type: Is the Building Historically Designated: Yes Flood Zone: BFE: NO V� FFE: OWNER: Name (Fee Simple Titleholder): ZNA Z at, tk4, 4.y% Q,ja.,V s O Phone#: Address: V Sb tp‘ 4 - City: V`N' ♦ Com,, State: f� \, Zip: 3 31 3 F- Tenant/Lessee Name: Phone#: Email: �1SC\j. 2oc 3 •stglppey. i Qf CONTRACTOR: Company Name:Df C L. G l �Ctt •t1iZ 1 [�$�i+ c # An Phone#: 3w -is t- chit. Address: "")S NNE. q Q n City: %V\%, State: P L. Zip: 32 3 r Qualifier Name: C\s ef\ Phone#: Of -1,f‘ gi1t State Certification or Registration #: f ;..4,,e /C c. ($ ten. ¶ Certificate of Competency #: DESIGNER: Architect/Engineer: Lee" 01 re, Fe A.... alt Phone#: "% c- ? TO 4 13 Address: ?S M S} Value of Work for this Permit: $ D5. 1000) Type of Work: ❑ Addition ❑ Alteration City: INV WYE.. State: P ` Zip:731$ 0 Square/Linear Footage of Work: New n Repair/Replace ❑ Demolition Description of Work: Nklr.4 Cst.g. *t r,,d) Specify colorof color thru tile: 100. Submittal Fee $ Permit Fee $ � 0 = CCF $ ' 5 . Scanning Fee $ (2 " C Radon Fee $ . d.S DBPR $ 1 I 2G Technology Fee $ . + Training/Education Fee $ G ' Double Fee $ Structural Reviews $ i 1ZO Bond $ CO/CC $ Notary $ (Revised02/24/2014) Is.a TOTAL FEE NOW DUE$ II CI 9 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 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, POOL5, 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 tice, the inspection will not be approved and a reinspection fee will be charged. Signature Ai WNER or AGENT galSignature CONTRACTOR The foregoing instrument was acknowledged before me this Theforegoinginstrument wasrma acknowledged before m_ a this t 3 day of / � �, Cif CA , 20 1 to , by I�tn days offs 11'^IiV 1) , 20 1 ALV , by G 1 f L. be s. Pe 4'd, on , who is personally know,p to .60 La J OA , whoa personally know to y me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY Sign: Print: Seal: ALYSSA • ,K MY COMMISSION #EEE 197431 :4 EXPIRES: May 9, 2016 ..` Bonded T ru Notary Public Underwriters Sig Print: Seal: APPROVED BY / 1 J ('' Plans Examiner Structural Review (Revised02/24/2014) oning Clerk 16 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFES.ItlNAL`REGULATION CGC1505283 ISSUED; 07/10/2014 CERTIFIED GENERAL CONTRAGTOF LAIRSON, GLENANDREWa;�r DOCK & MARINE CONSTRTIONINC IS CERTIFIED under the provisions of Ch.489 FS. Expiation date': AUG` 1; 2016 L1407100001090 RICK SCOTT, GOVERNOR STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL' REGULATION CGC1521069 :4{, ISSUED' 07/09/2014 CERTIFIED GENERAL CON_TRACTf R LAI SON, GL N.ANDREIIV bock AND.MAtRINE CONSTP• UCTION CORP IS CERTIFIER under the. provisions of Ch.489 FS. Expiration dale : AUG 31, 2016 L1407090001172 KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER` ,, 2CGi521069 T6e-. ENERAL:CQNTRACTOR Named t3elow ISeERTIFIED Under-tJieroviJpnof Chapter 489 FS. Expirrafiori date::AUG.31, 2016 -'LA13-SO I; GLENANDREW_ ._ DOCI ANI MARINECONSTRUCTION CORP 752 NE-79TH'STREET' MIAMI ' FL 33-138 1' ISSUED: 07/09/2014 DISPLAY AS REQUIRED BY LAW RICK SCOTT, GOVERNOR LICENSE NUMBER • SEQ # L1407Q90001172 KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESSAIVD PROFESSIONAL REGULATION CONSTRUCTICI : IN,DUSTRY LIC€LASING BOARD • The GENERAL CQNTRACTOR N4-4dBelo*:IS CERTIFIED Under the proyisioFrs of Chapter 489 FS. Expiratiol dale:' AUG 31,-2016 - , LARSON; GLENAND�,,RREW 'PCK-&:VMA NE"CONS°TRUCTION.INC --.--- :75 NE•'79T STRBET M AMI- _.. °'FL33138 ISSUED: 07/10/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1407100001090 RICK SCOTT, GOVERNOR STATE OF FLORIDA I DEPARTMENT OF BUSINESS AND Ate' PROFESSIONAL REGULATION CGC1521069 ISSUED: 07/09/2014 CERTIFIED GENERAL CONTRACTOR LARSON, GLEN ANDREW DOCK AND MARINE CONSTRUCTION CORP IS CERTIFIED under the provisions of Ch.489 FS. Expiration date : AUG 31, 2016 L1407090001172 KEN LAWSON, SECRETARY STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD LICENSE NUMBER CGC1521069 The GENERAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration date: AUG 31, 2016 LARSON, GLEN ANDREW DOCK AND MARINE CONSTRUCTION CORP 752 NE 79TH STREET MIAMI FL 33138 ISSUED: 07/09/2014 DISPLAY AS REQUIRED BY LAW SEQ # L1407090001172 RECEIPT NO. 01 cri U z z O oC af5F- U 0z w� co 2w NM N N W z w z z V m0 r`� U1 W O >o(N Mu M • N w J N 20 0 2U W X 0 Ea q 0 z_ v) N w ww Zz z Dw0m 0¢c IL V Z u V z z 0 rr N 0 V z c CC 0.6 30 00 004459 0222-15-003461 For more information, visit www.miam MIAMI-DADE COBB N O t� ■ — CD O CO) LL CIC Oa O Z 0 w (13o 1 - / J J CA >=¢ C o =0 z co • ,,ww (-) = 0) H -C3 _ o v E co ...1 2 W y H 0 ._9 N '3 y0 158 c4 W CO m c t C. a o Q W `° a.— co XT C W G a % n W4E2 CL W cn Z J " W w N cc ▪ cc Lc) BUSINESS NAME/LOCATION Local Business Tax Receipt Miami—Dade County, State of Florida -THIS IS NOTA BILL - DO NOT PAY 5787669 BUSINESS NAME/LOCATION DOCK & MARINE CONSTRUCTION INC 752 NE 79 ST MIAMI FL 33138 OWNER DOCK & MARINE CONSTRUCTION INC Worker(s) 20 RECEIPT NO. RENEWAL 6034938 co co co M M O IA w Z w J J irp Q ce 5Qu d ce =ug z� 22o ▪ oo yo 0 0 O wU i J 3 111 \ ul O r" -- U 1 wX O rn 2a q 'a r- o_ 0. CO bq U - z O cc z= o� Aggregate sq. ft. 4053 O d m v v 0 i 0E U E E 0 03 0 n O a E N 0 0. Laiv d H LBT EXPIRES SEPTEMBER 30, 2016 Must be displayed at place of business Pursuant to County Code Chapter 8A - Art. 9 & 10 SEC. TYPE OF BUSINESS 196 GENERAL BUILDING CONTRACTOR CGC1505283 PAYMENT RECEIVED BY TAX COLLECTOR $75.00 07/08/2015 FPPU09-15-004148 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 8a-276. For more information, visit www.miamidade.gov/taxcollector 005820 . Local Business Tax Receipt Miami—Dade County, State _ of Florida —THIS IS NOTA BILL —, DO NOT PAY 7162688 BUSINESS NAME/LOCATION DOCK AND MARINE CONSTRUCTION CORP 752 NE 79 ST MIAMI FL 33138 OWNER DOCK AND MARINE CONSTRUCTION CORP Worker(s) 30 000128 RECEIPT NO. RENEWAL 7440751 LBT EXPIRES SEPTEMBER 30, 2016 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art 9 & 10 SEC. TYPE OF BUSINESS 196 GENERAL BUILDING CONTRACTOR CGC1521069 PAYMENT RECEIVED BY TAX COLLECTOR $105.00 07/13/2015 CHECK21-15-090654 This Local Business Tax Receipt only confines 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 8a-276. For more information, visit www.miamidade.00v/taxcollector Local Business Tax Receipt Miami—Dade County, State of Florida —THIS IS NOTA BILL — DO NOT PAY 252403 BUSINESS NAME/LOCATION DOCK & MARINE CONSTRUCTION INC 752 NE 79 ST MIAMI FL 33138 OWNER DOCK & MARINE CONSTRUCTION INC Worker(s) 10 RECEIPT NO. RENEWAL 252403 LBT EXPIRES SEPTEMBER 30, 2016 Must be displayed at place of business Pursuant to County Code Chapter 8A — Art. 9 & 10 SEC. TYPE OF BUSINESS PAYMENT RECEIVED 196 SPECIALTY ENGINEERING CONTRACT BY TAX COLLECTOR E410 $45.00 07/10/2015 CHECK21-15-087101 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. p The RECEIPT NO. above must be displayed on all commercial vehicles — Miami—Dade Code Sec Ba -276. For more information, visit www.miamidade.gov/taxcollector AccoRb® CERTIFICATE OF LIABILITY INSURANCE DATE 2/19/2016 D/YYYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Sihle Insurance Group PO Box 160398 Altamonte Springs FL 32716 CONTACT Certificate Department HON 407-869-5490 FAX ( F,, I LAIC. Nol: 407-389-3580 AE -MAIL er: certificates@sihle.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Ohio Security Ins.Co. 24082 INSURED DOCK&MA-02 Dock & Marine Construction, Inc. 752 NE 79th Street Miami FL 33138 INSURER B :Commerce & Industry Insurance 19410 INSURER C : INSURERD: $ INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 93946240 • 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) OMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GE 'L AGGREGATE POLICY OTHER: LIMIT APPLIES JECOT- PER: LOC GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ $ A AUTOMOBILE X LIABILITY ANY AUTO ALL OWNEDS AUX HIRED AUTOS X SCHEDULED S NON -OWNED AUTOS BAS (16) 56148081 7/8/2015 7/8/2016 COMBINED aaccident) DINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP $10,000 UMBRELLA LAB EXCESS LAB ^ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC051-75-4853 2/1/2016 2/1/2017 X PEATUTE X OTHR USL&H Coverage 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 H more space Is required) Re: Marine Construction E-410 CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores Village FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD THIS CERTIFICATE SUPERSEDES PREVIOUSLY ISSUED CERTIFICATE ACCMCP, AAA CERTIFICATE OF LIABILITY INSURANCE k.,....--- DATE (MM/DD/WYY) 02/18/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(Ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Mitchell, York & Cooper Marine Insurance 1442 Arthur Rd Monticello KY 42633 CONTACT Stephen York PHONEFAX (A/C No Exn. 866-539-7077 (ac, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Great American Insurance Cos 26344 INSURED Dock & Marine Construction, Inc Dock & Marine Construction Corporation 752 NE 79th Street Miami FL 33138 INSURER B: Navigators Insurance Co 42307 INSURER C : 09/18/2016 INSURER D : $ 1000000 INSURERE: $ 100000 INSURER F : COVERAGES CERTIFICATE NUMBER: 1 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 TYPE OF INSURANCE AJNSD DDL SUER POLICY NUMBER EFF (MMI IDDYIYYYYY) ( MMM//DD/YYYY) UMITS A ✓ COMMERCIAL GENERAL LIABILITY 1.LI 21 • . OMH144-16-50 P&I includes crew coverage for 9 members and Tower's Liability 09/18/2015 09/18/2016 EACH OCCURRENCE $ 1000000 DAMAGE TO NTED PREMISES EaEoccurrence) $ 100000 CLAIMS -MADE nOCCUR MED EXP (Any one person) $ 10000 L Protection & Indemnity PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JEC LOC OTHER: PRODUCTS - COMP/OP AGG $ 1000000 $ AUTOMOBILE — LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ SCHEDULED AUTOS NON -OWNED AUTOS 1--11--1 COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B L. UMBRELLA LIAB EXCESS UAB___. .L OCCUR CLAIMS -MADE L (I v I HOL15L1A95720201 09/20/2015 09/20/2016 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 $ DED 1 1 I RETENTION $ 10000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A u STATUTE I I W- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ ao DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space Is required) MARINE CONSTRUCTION OPERATIONS CERTIFICATE HOLDER CANCELLATION Miami Shores Village Building Dept 10050 NE 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE r _- -, ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Produced using Forms Boss Web software. www.FormsBoss.com; 7 Impressive Publishing 800-208-1977 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 MIAMI SHORES VILLAGE NOTICE TO BUILDING DEPARTMENT OF EMPLOYMENT AS SPECIAL INSPECTOR UNDER THE FLORIDA��BUILDING CODE 1(We) have been retained by YGt y� l /hoCkaiN to perform special inspector services under tie Florida Building Code at the IASsi NI c 4. project on the below listed structures as of 5 h r t j, , (date). I am a registered architect or professional engineer licensed in the State of Florida. ` PROCESS NUMBERS: SPECIAL INSPECTOR FOR PILING, FBC 1822.1.20 (84404.6.1.20) SPECIAL INSPECTOR FOR TRUSSES >35' LONG OR 8' HIGH 2319.17.2.4.2 (R4409.6.17.2.4.2) SPECIAL INSPECTOR FOR REINFORCED MASONRY, FBC 2122.4 (R4407.5.4) SPECIAL INSPECTOR FOR STEEL CONNECTIONS, FBC 2218.2 (R441:.5.2) SPECIAL INSPECTOR FOR SOIL COMPACTION, FBC 1820.3.1 (R4404.4.3.1) SPECIAL INSPECTOR FOR PRECAST UNITS & ATTACHMENTS, FBC 1927.12 (R4405.9.12) SPECIAL INSPECTOR FOR ❑❑❑❑❑❑t Note: Only the marked boxes apply. The following Individuai(s) employed by thls firm or me are authorized representatives to perform inspection * 1 2. 3. 4. *Special inspectors utilizing authorizzed representatives shall Insure the authorized representative is qualified by education or ['censure to perform the duties assigned by the Special Inspector. The qualifications shall Include ['censure as a professional engineer or architect; graduation from an engineering education program in civil or structural engineering; graduation from an architectural education program; successful completion of the NCEES Fundamental Examination; or registration as building Inspector or general contractor. I, (we) will notify Miami Shores Village Building Department of any changes regarding authorized personnel performing inspection services. I, (we) understand that a Special Inspector inspection log for each building must be displayed in a convenient location on the site for reference by the Miami Shores Village BuRding Department Inspector. All mandatory Inspections, as required by the Florida Building Code, must be performed by the County. The Wage building inspections must be called for on all mandatory inspections. Inspections performed by the Special Inspector hired by the Owner are in addition to the mandatory inspections performed by the Department. Further, upon completion of the work under each Building Permit I will submit to the Building Inspector at the time of final inspection the completed inspection log form and a sealed statement indicating that, to the best of my knowledge, belief and professional judgment those portions of the project outlined above meet the intent of the Florida Building Code and are In substan . (id aq the approved plans. $igq ' ' P. t�ii EnglneerlArchitect � "" .�•� • i10 Name LEANDRO FERNANDEZ, PE - ° 85 NW 86 STREET, MIAMI, FL 33150 Address • Sto •..� Op Phone No. 786.390.7493 DAVID A. DACQUISTO, AICD PLANNING d ZONING DIRECTOR DEVELOPMENT ORDER anti Aoreo File Number: PZ -03-16-201626 Property Address: 1350 NE 101st St Property Owner/Applicant: Address: Agent: Address: 10050 N.E. SECOND AVE. MIAMI SHORES. FLORIDA 33138-2382 Telephone: (305) 795-2207 Fax: (305) 756-8972 Dirk & Elizabeth Peterson 1350 NE 1016tSt, Miami Shores, FL Glen Larson 752 NE 79th Street, Miami, FL Whereas, the applicant Dirk & Elizabeth Peterson (Owner), has filed an application for site plan review before the Planning Board on the above property. The applicant sought approval as follows: Pursuant to Articles IV, V and VI of Appendix A Zoning, Sec. 400 Schedule of Regulations, Sec. 534 and Sec. 600. Site plan review and approval required. Waterfront development. Dock and boatlift. Whereas, a public hearing was held on April 28, 2016 and the Board, after having considered the application and after hearing testimony and reviewing the evidence entered, finds: 1. The application was made in a manner consistent with the requirements of the Land Development Code of Miami Shores Village. 2. The conditions on the property and the representations made at the hearing merit consideration and are consistent with the requirements of the Land Development Code. The Board requires that all further development of the property shall be performed in a manner consistent with the site plan, drawings, and the conditions agreed upon at the hearing: 1) Planning and Zoning Board zoning approval is granted as shown on the plans submitted and made a part of this approval for work inside the D5 Triangle to construct a 40 ft. wide dock 12 ft. into the bay and a 10 ft. wide 7,000 LB cradle lift an additional 10.5 ft. into the bay. 2) Applicant to apply for and obtain all required building permits from the Building Department before beginning work. Page 1 of 2 3) Applicant to apply for and obtain all necessary permits and approvals from outside agencies before beginning work. 4) Applicant to secure final approval from the Department of Regulatory and Economic Resources, Natural Resources Division and the Army Corps of Engineers, before a building permit will be issued. MD DRER, NRD. 5) Applicant to comply with all requirements of FEMA, the NFIP and the Florida Building Code for construction in the AE9 special flood hazard area. 6) Applicant to add not less than two (2) lights on the outside piles of the boat lift and night time reflectors on outside posts on the dock. 7) Applicant to meet all applicable code provisions at the time of permitting. 8) This zoning permit will Lapse and become invalid unless the work for which it was approved is started within one (1) year of the signing of the development order by the board chair, or if the work authorized by it is suspended or abandoned for a period of at least one (1) year. The application with conditions was passed and adopted this 28th day of April, 2016 by the Planning and Zoning Board as follows: Mr. Abramitis Yes Mr. Busta Yes Mr. Reese Yes Mr. Diaz Yes Chairman Fernandez Absent x(011(, Date bramitis e Chairman, Planning Board Page2of2 DAVID A. DACOUISTO, AICP DEVELOPMENT ORDER File Number: PZ -03-16-201626 Property Address: 1350 NE 101st St ShoreiWiacie 10051) N E SECOND AVE. MIAMI 'HORS Fi_C)RIDA 33135 238'2 -Telephone r305) 705 2207 Fa>.: i305) 75b -S072 Property Owner/Applicant: Dirk & Elizabeth Peterson Address: 1350 NE 101st St, Miami Shores, FL Agent: Address: Glen Larson 752 NE 79th Street, Miami, FL Whereas, the applicant Dirk & Elizabeth Peterson (Owner), has filed an application for site plan review before the Planning Board on the above property. The applicant sought approval as follows: Pursuant to Articles IV, V and VI of Appendix A Zoning, Sec. 400 Schedule of Regulations, Sec. 534 and Sec. 600. Site plan review and approval required. Waterfront development. Dock and boatlift. Whereas, a public hearing was held on April 28, 2016 and the Board, after having considered the application and after hearing testimony and reviewing the evidence entered. finds: 1. The application was made in a manner consistent with the requirements of the Land Development Code of Miami Shores Village. 2. The conditions on the property and the representations made at the hearing merit consideration and are consistent with the requirements of the Land Development Code. The Board requires that all further development of the property shall be performed in a manner consistent with the site plan, drawings, and the conditions agreed upon at the hearing: 1) Planning and Zoning Board zoning approval is granted as shown on the plans submitted and made a part of this approval for work inside the D5 Triangle to construct a 40 ft. wide dock 12 ft. into the bay and a 10 ft. wide 7,000 LB cradle lift an additional 10.5 ft. into the bay. 2) Applicant to apply for and obtain all required building permits from the Building Department before beginning work. Page 1 of 2 3) Applicant to apply for and obtain all necessary permits and approvals from outside agencies before beginning work. 4) Applicant to secure final approval from the Department of Regulatory and Economic Resources, Natural Resources Division and the Army Corps of Engineers, before a building permit will be issued. MD DRER, NRD. 5) Applicant to comply with all requirements of FEMA, the NFIP and the Florida Building Code for construction in the AE9 special flood hazard area. 6) Applicant to add not less than two (2) lights on the outside piles of the boat lift and night time reflectors on outside posts on the dock. 7) Applicant to meet all applicable code provisions at the time of permitting. 8) This zoning permit will lapse and become invalid unless the work for which it was approved is started within one (1) year of the signing of the development order by the board chair, or if the work authorized by it is suspended or abandoned for a period of at least one (1) year. The application with conditions was passed and adopted this 28th day of April, 2016 by the Planning and Zoning Board as follows: Mr. Abramitis Yes Mr. Busta Yes Mr. Reese Yes Mr. Diaz Yes Chairman Fernandez Absent I'D 1 l6 ��DateRob; bramitis e Chairman, Planning Board Pace 2 of 2 American Testing Materials Engineering,LLC rESTING LABORATORIES -ENGINEERING -INSPECTION SERVICES -DRILLING ENVIRONMENTAL SERVICES. 1950 West 84th Street, Hialeah, Florida 330141 Phone: 305846-18881 Fax 305.646.1887 Revised: June 8, 2016 June 1,2016 Dock & Marine Construction 752 NE. 79th Street Miami, Florida 33138 RE: Dear Sir: Subsurface investigation for a proposed dock & sea wall located at 1350 NE. 101 Street, Miami, Florida Pursuant to your authorization, AMERICAN TESTING MATERIAL ENGINEERING, LLC. (ATM), conducted a subsurface investigation at the above referenced project. The investigation was performed on June 1, 2016 The purpose of the investigation was to develop preliminary information about the site and the subsurface conditions existing at the proposed site location. To achieve the desired objective three (3) standard penetration test borings were performed and the logs are enclosed in this report. TEST METHOD: The borings were conducted in accordance with procedures outlined for standard penetrations test and split spoon sampling of soils by ASTM Method D-1586. A two (2) feet long two (2) inches O.D. Split Spoon Sampler was driven into the ground by successive blows with 140 Ib. Hammer dropping thirty (30) inches. The soil sampler was driven two (2) feet at a time then extracted for visual examination and classification of the retained soil samples. The number of blows required for a one (1) foot penetration of the sampler is designated as "N" (known as the standard penetration resistance value). The "N" value provides an indication of the relative density of non -cohesive soils and the consistency of cohesive soils. Suitable corrections are applied to this number in order to include the effects of soil overburden pressure and other factors. A general evaluation of soils is made from the established correlation between "N" and the relative density or consistency of soils. This dynamic method of soil testing has been widely accepted by foundation engineers and architects to conservatively evaluate the bearing capacity of soils. A continuous drilling and sampling procedures was used therefore, the samples were taken at intervals of two (2) feet or at every change i4 soil characterislicfi. • • • •••..••• • . •. • . . . . The types of foundation material encountered have ken ylspa$y ilas; to J'and he described in detail in the boring logs. The results of the field penetration tests are presented in the boring Togs in numerical forms. The average ground water level at the site was found at four (4) feet six j6) inches, below the existing surface (see logs). Fluctuation in the observed ground water level should be expected t1uE ctri'vercainfall variation, surface water run-off and other, specific factors related to the site in queiion:. • .: :. • •:: : .• • .. .. 1!Page ..• • • . . •• • •• •• • . •• . .•. • • . . . . • • ••...• ••• . • • ••• • • • • •• • •• •• • • • • • • • ••• •• ((liTuni31. American Testing Materials Engineering, LLC TESTING LABORATORIES-ENGINEERING-INSPECTION SERVICES -DRILLING ENVIRONMENTAL SERVICES. 1950 West 84th Street, Hialeah, Florida 330141 Phone: 305-646-18881 Fax 305-646-1887 Revised: June 8, 2016 June 1, 2016 Dock & Marine Construction FOUNDATION RECOMMENDATIONS: Based on the sub -surface conditions encountered AMERICAN TESTING MATERIAL ENGINEERING, LLC. .(ATM) have evaluated a number of foundation systems for providing support to the proposed structure. Special consideration in the analysis was given to the following: 1. The presence of layers of very loose silt and organic material of varied thickness, which makes the site less appropriate for construction using regular spread footings and single column pads at the existing grade. 2. Length to width ratio of the proposed structure with special emphasis on differential settlement and column spacing. 3. The coastal location of the property. Given the above, the following foundation systems were selected. ALTERNATIVE I: AUGERCAST (Pressure grouted) PILES: Augercast (pressure grouted) piles are a feasible foundation alternative. The capacity of these piles is essentially developed in tip bearing and side friction. When these piles are installed or socketed into place, they will "lock into" the rock and sand strata thereby providing adequate bearing capacity. The relationship obtained is as follows: SIZE (DIA) PROPOSED LENGTH (FT.) LATERAL LOAD TENSILE CAPACITY COMPRESSIVE BEARING CAPACITY 14" 4) 15' 1 tons 8 tons. 35 tons. Large volumes, possibly up to twice (or more) of the theoretical pile volume, may be required for proper auger cast pile installation. A minimum of three (3) piles should initially be driven (installed) at strategic locations in order to verify the suggested pile length. The entire pile driving (installation) operation should be monitored and performed in accordance with the relevant local and state requirements. ALTERNATIVE II: TYPE B HELIX PIER: HELICAL EItf9:• • • • • . . . . Helical piles are another feasible altemative. The capacit 'c tfi a Digs is dssantially developed in tip bearing and side fiction. When these piles are installed or socketed into place, they will 'lock into" the rock and sand strata thereby providing adequate bearing capacity. The analysisJor this foundation jtematiye cgpsisted of determining a pile capacity • •• •• •• •• •• • • • • for specific size and depth of installation. • • •• •• • • ... . •. • • .• . • .• • • • .. . • . .. . .. .. •• . 21Page •.• • . • • ••• • ._ • • •. •• • . • . • •. •• •... •• •• • • . • • •• • •• • • • • • •. •• • • • .• •• ••• • . • •• ••• • • 31. American Testing Materials Engineering, LLC rESTING LABORATORIES -ENGINEERING -INSPECTION SERVICES •DRIWNG ENVIRONMENTAL. SERVICES. 1950 West 84th Street, Hialeah, Florida 330141 Phone: 305-646.1888! Fax 305646-1887 Revised: June 8, 2016 June 1, 2016 Dock & Marine Construction ALTERNATIVE 11: TYPE B HELIX PIER: HELICAL PILES (con't): SIZE (DIA) PROPOSED LENGTH (FT.) TENSION CAPACITY COMPRESSIVE BEARING CAPACITY Type B. Pier 3.5" 15' 5 tons 15 tons. A minimum of three (3) indicator piles should initially be driven (installed) at strategic locations in order to verify the suggested pile length. The entire pile driving (installation) operation should be properly monitored and performed in accordance with the relevant local and state requirements. ALTERNATIVE 111: PIN PILES: Pin piles are another feasible altemative. The capacity of these piles is essentially developed in tip bearing. The analysis for this foundation system consisted of determining a pile capacity for specific pile size and depth of installation. The relationship obtained is as follows: SIZE (DIA) PROPOSED LENGTH (FT.) COMPRESSIVE BEARING CAPACITY 3" 15' 5 tons. A minimum of three (3) indicator piles should initially be driven (installed) at strategic locations in order to verify the suggested pile length. The entire pile driving (installation) operation should be monitored and performed in accordance with the relevant local and state requirements. The proposed length is based on the existing surface at the time of drilling. ALTERNATIVE IV: WOOD PILES: Wood piles are also a feasible alternative, the capacity of these piles is essentially developed in tip bearing. The analysis for the foundation system consisted of determining a pile capacity for specific pile size and depth of installation. The relationship obtained is as follows: • • • • • • •• ••• . • • • 0 •• • • • SIZE (DIA) PROPOSED LENGTH (FT.) _ , �. - - - • . "ALLOWABLE BEARING CAPACITY 8"(1) 15' ::; _ ; _ ; _ ;� :•: ;15tons. 31 Page • •• •• • .. ... . • .• •.• •• .. • -.-1. •- • . "• ••• • • • . •. •• •• . • •• • •. •. ••.. •• •. •• • • • •• . •• • . • •• • • •••• •• • • •• •• ••• .• ••• • • • .• •.• • . • • i American Testing Materials Engineering, LLC rESTING LABORATORIES -ENGINEERING -INSPECTION SERVICES -DRILLING ENVIRONMENTAL SERVICES. 1950 West 84th Street, Hialeah, Florida 330141 Phone: 305-646.18881 Fax 305-646.1887 Revised: June 8, 2016 June 1, 2016 Dock & Marine Construction CONCLUSION: Regardless of the thoroughness of our geotechnical exploration there is always a possibility that conditions on the subject property (site) may be different from those at the test locations. Therefore, AMERICAN TESTING MATERIALS ENGINEERING, LLC. (ATM) is not responsible for any sub -soil conditions different from those reported in our boring logs. This report was prepared exclusively for the use of DOCK & MARINE CONSTRUCTION. The conclusions provided by AMERICAN TESTING MATERIALS ENGINEERING, LLC. (ATM) . are based solely on the information presented in this report. As a mutual protection to clients, the public and ourselves, all reports are submitted as the confidential property of clients, and authorization for publication of statements, conclusions or extracts from or regarding our reports is reserved pending our written approval. We appreciate the opportunity to have been of service to your company. Please feel free to contact us if there are any questions or comments pertaining to this report. • r`% 14P!?,71.:Y.1 • ENS i ,. 8 No. 51481 * * E- W a(seem Quadri, P.E., S.I.#5' STATE OF Special Inspector -Threshold Build § •.• F(ORIO ...' (4,q• President '� F Civ34 il Structural and Environmental Engineering!!ars of experience in Geo-Technlcal, 1,i/SIONA� E 11��'```` IH / 111 American Testing Materials Engineering, LLC Sincerely yours, Wglbm-dock&marine Wage ••• ••• • • • • • •• • • • • • • • •• ••• •• • • • •• • ••• • • • • • • •• • • • •• •• • • •0• • • • • • • • • • • • • • • • • •6 • • •• • • • •• • • • •• • •• • ••• • • • • 0041 • • i • . • • • • • • • • ••• • • • • • . • • • • • • • • •• •• • • • •• •• 000 • . • 000 • •