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WSW-12-179Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 169513 Permit Number: WSW -2 -12 -179 Scheduled Inspection Date: March 29, 2012 Inspector: Rodriguez, Jorge Owner: KATHE, JOHN Job Address: 9839 NE 13 Avenue Miami Shores, FL Project: <NONE> Contractor: A SEAWALL INSPECTION SERVICE I Permit Type: Retaining Walls /Seawalls Inspection Type: Final Work Classification: Repair Phone Number Parcel Number 1132050090500 Phone: 954- 764 -2770 Building Department Comments ENCASE OLD CAP AND BATTER PILLES & REPAIR IN NEW CAP Inspector Comments Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. March 28, 2012 For Inspections please call: (305)762 -4949 Page 8 of 22 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 f Tel: (305) 795.2204 Fax: (305) 756.8972 (1GJ fi L.-51-144,A0_, INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 non • Permit No. V VSS V\I i f2-_ 119 Master Permit No. Permit Type: BUILDING ROOFING rr 7 OWNER: N(a�me (Fee Simple Titleholder): A W C Phone #: 6U Address: q /3.79 . 13 °t 1ve_ rr�� Zip:�i Ir7 City: tMr AilAt slAccicA Tenant/Lessee Name: Email: State: Phone #: S JOB ADDRESS: 9M di. 3 ` OC-- City: Miami Shores Folio/Parcel #: 11 -32o —100q-05:50 Is the Building Historically Designated: Yes CONTRACTOR: Company Name: County: Miami Dade Zip: NO Flood Zone: Address: S e t - City: (.41 t AU Cl4/CAi UL State: i--, Zip:33/ (o Qualifier Name: L tiC.t�,.Cc>oTT el—i CP4 Ads Phone #: �� 4 ' fg State Certification or Registration #: C6C &. �/ t Certificate of Competency #: Phone #: I 'X,&i `C.'7c Contact Phone #: Email Address: DESIGNER: Archi t/Enginer :�tL�'�'�1Cs� Value of Work for this Permit: $ � OCR Type of Work: DAddition ❑Alteration Description of Work: Phone #: 75'4 -C1N -co . J Square/Linear Footage f Work: 13 Li, J iiiZ. i ❑New epair/Replace ►! , r ❑Demolition **** **** .x************** ** * * * ** : ********Fees **** **** *** * * *** ******* **** * *** **** x****** O Submittal Fee $ i Permit Fee $ ��� CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Feed Double Fee $ Structural Review $ 16 ° Oo Technology Fee $ TOTAL FEE NOW DUE $ 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 ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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. Owner or Agent The foregoing instrument was acknowledged before e day of 5O , 2012- , by iliteeTael who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: ,V c Print: Rt'kUL 1i, wilim Sci4004 My Co * * * * * * ** SS i$10 kipir ry Public State of Florida C, Paul William Schafer s aQ My Commission EE070433 �'P of ft Expires 03/03/2015 APPROVED BY Contractor The foreging instrument was acknowledged before me thN day oft( , 20 k by f%JtCJL) Ci.E who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: * * * * * * * * * * * * * * * * * * * ** (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Plans Examiner Structural Review Sign: -wd Pot Print: `W Art CC41616ele rs t. ►r °�e� Notary Public State of Florida Paul Wiliam Schafer 4, My Commission EE070433 *' * 8 INAIRRA,4244 * * * * * ** < * * * * * * * * * * * ** Zoning Clerk MIAMIBEACH BUILDING DEPARTMENT 1700 Conven on Miami Beech, FL, 33139 1111111 1111111111 11111 1111111111 Mil 1111 1111 • CFH 2O1,2RlDiOO8O OR Bk 27995 Ps 2506; (lps) RECORDED 02/0/2012 1144:33 HARVEY RUVIth CLERK OF COURT HIAHI—DADE COUNTY, 'FLORIDA &RECORDED .COPY MUST BE POSTED .ON THE JOB SITE AT TIME OF FIRST INSPE . . • • PERMIT NO W.,Sitib-747 "' I 19 TAX FOUO NO. 11'324CC-060".a - .. • • ... - . .. • STATE OF FLORIDA : • • - . .. • . • Thisspece.is reserved for use of recording al . . . • . THE UNDERSIGNED hereby gives :notice that Improvements will be made t� . certain real property and In -accordance With Chapter 713, Florida Siatutes, the folk:Wring .. . Woman Is provided In this Notice cf. Commencement, - . • ' . - - • ' ' • The Clerk of Courta,illarnl-Dade CountyRecorder - • - • • __ , - • Courthouse East, 22 NE 1 Street, 1•-Floor - • ' - billanil,Floikie 331251305-2754155 , _ . 14... .. _ ,....,....., „ ,;., i 0 Ar.,_ _ _ _;.., . i.., ",..: _ . 'I. Legal descdplion-of 'milady and streatladdrestt gm.14,E.isw,lot..30/vitimistwi r.., 141(.--1 rot.x0f4fgatka 2. Description of Improvement ' .9-,A1,4ALL_ r....0 . P. :Oil it , • • , - • .. - - . - • • . 1.0vmer(s) nonce and address' ' 447n15. IIK,WiiilWrirffterACV-illi—alt1 . . Interest In property* Name and address of fee simple tilieholder 4. Cordractor's name, address and phone number: 5. Surety: (Payment bond required by owner frorn Contractor, liany) Name, address tutd phone number, -(7)1.1 iiJ laaferle ' • 7• Persons Avitilin the Stab: of Florida designated by Owner upon whom notices cir other documents May be served as provIded by ' • Section 713.13(1Xa)7., Florlda.Stalutes, . Name, address and phone number: • • 8. In addition to himself, Owners designates the taming psisofl(&) b,ecetvea copy of the Lteninis Nellie as provided In Section • Name, eddrees and PhOne- number .9. Swirelion -date of this Noble of Commencement.. WARNING 10 OWNER: ANY PAYMENTS MADE BY THE OWNER AFTE11-IE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE cpt4SIDERED IMPROPER PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE *FIRST INSPECTION. 1F YOU INTF_ND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORECOMMENCING WORK OR FtECORDING YOUR NOTICE OF COMMENCEMENT • 2 Ma exPhallen date is 1 year from the date of mares; unless a different date Is speUad) . PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES AND CAN RESULT IN YOUR PAYING TAME FOR IMPROVEMENTS TDYOUR Signature(s) 01' ' Or Prepared ByYttNA feic_gf1:44 • . rfiParPO.BY Print -Name MM.ij1t t) 1:14:4 * • Print Name • • . Title/Office . • STATE OF FLORIDA ' • : • • COUNTY OF MIAMI-DADE . • . . • litre foregoing -Instrument was aCknowledged befcve me this 1 day.of viltitp6r0 ..dviet$ . AtA6(6.- • • • ersonally IcnoWn, or 0 ,produced the folloWIng type of Sbjnature of Notary Public: RIVSLONNI,40104 VERIFICATION PURSUANT TO SECTION 92.525, FLORIDA STATUTES Under penalties of perjury. I declare that I have reed the foregoing and that thelacts stated in ft are true.tolhe best of miknowledge and belief. : - • - • S s) of s) Owne sys Authorized OfficergrirectorpartnerfManager who signed above: „ HP( OF DADE CERTIFY that this' is a true copy of the' original filed in this attire, nn • • day of • 13 i _ , P 0 2 0 . WITNESS my nano an / f 1 Icia I Seal. / HARVEY of Circuit and County Courts -ARVEY R4111riV/A 2* D.C. "1 FEB-,1 -2018 09:29 FROM:SEAWAL LINPCET 9547632878 TO :13057568972 P.1 06 -24 -2011 JEFF ATWATER STATE OF FLORIDA CHIEF FINIU4C1AL OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * 40 CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers Compensation law. EFFECTIVE DATE 08/24/2011 EXPIRATION DATE 06/23/2013 PERSON CLIPPINGER LAWRENCE S FEIN: 650796669 BUSINESS NAME AND ADDRESS: A SEAWALL INSPECTION SERVICE INC 27 ISLA BAHIA DRIVE FT LAUDERDALE FL 33318 SCOPES OF BUSINESS OR TRADE 1- MARINE ACTION 2- CERTIFIED GENERAL CONTRACTOR IMPORTANT: Perssaat to Moister 440. OW14} r,3„ ao ellian el • tlorporatt.. Who Waifs eseseptiea from role chapter by illt.p • rwlIII ate al .Inch.* asesr 1111 section way ow recover eaaat1I* er eampans1ttan ander this chapter. Partvnl Is Cbmpler 440.0b112l, f,S., CdrlffiCStaa el 't.Ctin to ha exempt... apply only within Ike scups of the besiaaaa or trod* ils[1d on live malice el 61*010 10 be exempt. Punta' to Chapter 44a.afifl3i, F.S., Mak= e1 dotage 10 be altompt txt* certiflcataa ai elective 10 be esas•pi .hall be tgbpeq to raioiatioa 14 et say rive Sher the filing of me satics or the issaasco of the cerriileete, eka parses saved OR So actin or certificate op Maw sears The requirements of this section for laminar of a eartitlaata. The dapmtwaat shell teyaks a CertifiC*le *e say tltpe tar fetter, of the parson named on ea certificate to most Na require rents of MI5 section. nuESTIONS7 (1150) 413 -1609 )WC•252 CERTIFICATE OF E1.ECTION TO BE EXEMPT REVISED D1 -11 07-01-2011 JEFF ATWATER STATE OF FLORIDA cHIeF Flfdlwc m OFFICER DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION * * CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW * CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation Law. EFFECTIVE DATE: 07/01/2011 EXPIRATION DATE 06/30/2013 PERSON: SCHAFER PAUL W FEIN 660796669 BUSINESS NAME AND ADDRESS: A SEAWALL INSPECTION SERVICE INC 27 ISLA BAHIA DRIVE FT LAUDERDALE FL 333119 SCOPES OF BUSINESS OR TRADE 1- MARINE CONSTRUCTION 2- CERTIFIED GENERAL CONTRACTOR IIW[aTANTt Parana to Chapter 440. a*ti4: i.3., es officer of a a.rpar.tIu, who elects ■ieeptio. from Nis simper by 111119 certificate of elective attar lsit soak. may let recover beadits ar compaesed's under OW Aspire. Fount t* Chapter 440.051121. F,S_, Carllllntea o1 *main 10 be ex,mpI•• apply oily Walk 19. mope of Ss bashes of Wade listed no the .elite of 4lsCtien le he ax.mpt. Paattaal le Chapter 440.06114 F.S.. Mauna of election Iv be *Kesel .0el certificates of election at b. exempt :kali be sablect 10 revocation It at nay new altar Ind tiling *1 the natiCo or the lemena• of Ihe csrtlflc.tt, the pWWMM eamad s* the .stice w aarltlicets oo l0a9.i .Este t41 ragsirameora of eis mile. for lamas.e of a c.rttfle.t._ The deportment akdl royaka e certificate at any lima far fellers of the panel wed M him cartlflcus te tinsel th4 reoalremeala al Nis stolen. QUESTIONS? {$50) 41$ -16D9 nut•—van wrmrretnare nc El :mint wn eC t:MCIIDT ottoman n1 -11 FEB-1 -201? 09:27 FROM:SEAWAL LINPCET 174 59:.. : ;* .. ,- .;,,-.4-,-, f % i .. ail , „ 9 F , - - _-- �cril� t� .09 4.'$1idP- GENERAL. CONTRALTO 2k-.x''`;.. ITa»ied.:13.3fe w, IS'C73RTIPT tr '17gder the provi!bane o Elpirati.on &Me : AVG 31V • CLIPP=NGER 1:AteREN87k K SEAWALL• iN WECTY_. 27 alma BAHIA DR HOW LAUDERDALE 9547632878 TO:13057568972 P.1 s � ale ter,.- , ,'' -its Ytm„t� �� i. W �•. GOVERNORiST. sr 9: FS , Ss tIC ig CITY OF FORT LAUDERDALE BUSINESS TAX YEAR 2011 - 2012 RUaINLSS TAX DIVISION 700 NW 19 AVt:Nl1B; FORT LAUDERDALIE, FLORIDA 93911 (954)8204195 • Business TD: 987013 Business Name :A SEAWALL INSPECTION SERVICE Business Address: 27 ISLA BAHIA DR Tax Category BIOME OFFICE - RESTRICTED m# 490896 Feel AZ PER SEC 47 -19.7 A SEAWALL INSPECTION SERVICE 17,Ai7L W SC AFER 37 x SLA BAHIA DR FORT LAUDERUALB, FL 3341€ ***DET44.03 AND FOST RED IN A CONSPICUOUS PLACE**" - CERTIFICATE OF COMPETENCY •■ bfr rC r OrTINIRMIIIIMMPMEMBIMMIOPIRS ENGINEERING 213 UGHT MARINE A SEAWALL INSPECTION SERVICE, INC. CC 98- 1809 -X Ref. 13282885 Euplres 8/31/2013 001011-14792 aid re thy mimeo" 11 IBM tsP titintiffaatlia n u......... nua._iv' resfiefrave ne aerlyna' 71 st CvCaabT nemem 011.1+ ; 02/01n012 12:47 9545839802 JW INSURANCE CERTIFICATE OF LIAB PRODUCER JW Insurance Services 100 North State Road 7, # 108 Margate, FL 33063 Phone (954)583-7213 Fax (954)583-2045 INSURED A Seawall inspection Service, Inc. 27 Isla Bahia Drive Ft Lauderdale, FL 33316 PAGE 91/01 DATE (11141/DD/YY) ILITY INSURANCE 02/01/12 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDEFL THIS CERTIFICATE DOES NOT AMEND, EXTEND OR • ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE TNAIC INSURER A: Essex Ins Co. INSURER 0; INSURER INSURER D. INSURER E: INSURER F: COVERAGES THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO TI-I 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADM. TYPE OF INSURANCE GENERAL UABIUTY COMMERCIAL GENERAL LABILITY OL1 CLAIMS MADE OCCUR LJ POLICY NUMBER GEN% AGGREGATE LIMIT APPLIES PER: M POLICY 0 PROJECT LOC AUTOMOBILE UABILITY Ei ANY AUTO (.1 ALL OWNED AUTOS I; SCHEDULED AUTOS L HIRED AUTOS 17 NON OWNED AUTOS GARAGE LIABILITY 0 ANY AUTO EXCESS/UMBRELLA UABIUTY L., DEDUCTIBLE Ti RETENTION $ 9CD1302-0 L3 OCCUR CLAIMS MADE WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER / MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS Mow OTHER POLICY EFFECTN-7FT,OLICY EXF9RATION GATE (MAI/DD/Yr DATE Numpotrii__ 08/24/11 08/24/12 Laws EACH OCCURRENCE T 300,000 0 REN [ED EmisEs (ga 0o5srence) . MED EXP (Any one person) Ex-cluEle-cd s, PERSONAL & ADV INJURY GENERAL AGGREGATE 600,000 PRODUCTS - COMP/OP 300,000 • Fire Damage Liability 50,000, COMBINED SINGLE LIMIT (Ea accicl.n BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG • EACH OCCURRENCE AGGREGATE, 11 WC STATU- L. OTH- ., TORY UMITS ER_ pE.L EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT 1-- I–DISCRIPTION OF OPERATIONS/LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS *** DOCK & SEAWALL INSPECTION - BULKHEAD CONSTRUCTION / REPAIR - NO CRANE / BARGE WORK. EXCLUDES: E&O / PROFESSIONAL LIABILITY*** L. CERTIFICATE HOLDER Miami Shores Village 10050 NE 2nd Avenue Miami Shores, FL 33138 ACORD- 25 (2001/08) QF CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE 'THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO TH—ETEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD CORPORATION 1988 CUMULATIVE SUBSTANTIAL IMPROVEMENT VERIFICATION WORK SHEET In accordance with FEMA regulation and Miami Shores Village Flood Damage Prevention Ordinance the costs of all improvements must be monitored. The costs of any improvements in the past 12 months and the costs of any proposed improvements must be shown on the worksheet. The cost of improvements must include demolition, raw and finished materials (include those donated), labor (including volunteer and self- performed), construction supervision and management, and overhead and profit. A list of items the costs of which are to be included as well as those excluded is attached for your reference. (A Copy of the Contract must he attached) PROPERTY OWNER: 4P�tt 3Dco PERMIT # W 5 W '2-127 1121 ADDRESS:2jq f; .L . 'V �� Y�0� FOLIO NUMBER: I t - 7 .O eePr foceo FLOOD ZONE: BASE FLOOD ELEVATION: FREEBOARD: EAST OF FL.CCCL: COST OF PAST IMPROVEMENTS (12 MONTHS): plOpik, COST OF PROPOSED IMPROVEMENTS: *0 lo©b (ATTACH COPY OF CONTRACT) TOTAL CUMULATIVE COST OF IMPROVEMENTS (past and proposed): It l d i n . ©o VALUE OF PRINCIPAL STRUCTURE (attach appraisal): , �1' 'j,0 � 011.00 OWNERS SIGNATURE: 44 4 PLANREVIEWER: w DATE:0 Z4Z/ PLAN REVIEWER SIGNATURE: DATE: Created on June 2009 SEAWALL INSPECTION SERVICES, INC. 27 Isla Bahia Drive Fort Lauderdale, Florida 33316 Email: seawallinspect@prodigy.net (954) 764 -2770 (800) 244 -9314 PROPOSAL October 24, 2011 Bagon 3850 LLC 9839 N.E. 13th Avenue Miami Shores, Fl. Site: Same We propose to repair the seawall at the above referenced site to the following specifications: 1. Break out the cracked and spaulded areas on approximately 30' of cap and batter pile pods. 2. Form a new cap over to existing cap and batter pile pods 93'x48 "x24 ". 3. Code steel to the engineer's specifications will be installed. The formed area will be filled with 5,000 psi concrete mix and broom finished. 4. The holes, cracks on the facial surface will be sealed with Hydro - Cement. 5. The area directly behind the seawall will be backfilled to grade required by DERM. (Not responsible for sod replacement) ANY NECESSARY PERMITS AND ENGINEERING WILL BE OBTAINED BY THE CONTRACTOR AND BILLED AS A CONTRACT EXTRA, ANY ADDITIONAL REQUIREMENTS BY ANY AGENCY WILL BE Bii.LFED AS A CONTRACT EXTRA ALL SEAWALL WORK WARRANTEED 36 MONTHS! Any alteration or deviation from above specifications involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. The proposal is subject to acceptance within 30 days and is void thereafter at the option of the undersigned. In the event money due hereunder, or any portion thereafter, has to be collected on demand of an attorney or by suit, the accepter agrees to pay all costs of collection including interest at the highest legal rate and a reasonable attorneys fee. Not responsible for sod replacement shrubs, buildings, swimming pools, sprinklers, electrical or other utility hookups. All materials involved in this project remain the property of the contractor until the balance is paid by the accepter. Cost: $1 0,000.00 Payable: $2,000.00 on acceptance $4,000.00 plus permitting costs and engineering on commencement $4,000.00 on completi of work. Accepted Date Par Ikuthorized e ' Dat€ O -a-1 1 I "You Have A Friend In The Business" J.S. DEPARTMENT OF HOMELAND SECURITY = ederat Emergency Management Agency stational Flood Insurance Program ELEVATION CERTIFICATE Important Read the instructions on pages 1 -9. OMB No. 1660-0008 Expires March 31, 2012 SECTION A - PROPERTY INFORMATION Al. Building Owner's Name BAGON 3850 LLC For Insurance Company Use: Policy Number A2. Buying Street Address (including Apt, Unit, Suite, andlor Bldg. No.) or P.O. Route and Box No. 9839 NE 13 AVENUE Company NAIC Number City MIAMI SHORES State FL ZIP Code 33138 A3. Property Description (Lot and Block Numbers, Tax Parcel Number. Legal Description, etc.) LOT 5 BLOCK 4 P.B. 43 PG. 80 A4. Building Use (e.g.. Residential, Non - Residential, Addition, Accessory, eta) A5. Latitude/Longitude: Lat. 25 °51'58° Long. 80 °1017" A6. Attach at least 2 photographs of the building if the Certificate is being used A7. Building Diagram Number A8_ For a building with a crawlspace or enclosure(s): a) Square footage of crawlspace or enclosures) 3452 sq ft b) No. of permanent flood openings in the crawlspace or enclosure(s) within 1.0 foot above adjacent grade 14 c) Total net area of flood openings in A8.b 2040 sq in d) Engineered flood openings? ❑ Yes >14 No RESIDENTIAL. Horizontal Datum: ❑ NAD 1927 ® NAD 1983 to obtain flood insurance. A9. For a building with an attached garage: a) Square footage of attached garage sq ft b) No. of permanent ticed openings in the attached garage within 1.0 foot above adjacent grade 0 c) Total net area of flood openings in A9.b 0 sq in d) Engineered flood openings? ❑ Yes ® No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community Name & Commundy Number MIAMI SHORES 120652 B2: County Name MIAMI -DADE B3. State FLORIDA B4: Map/Panel Number 12086C / 0306 85. Suffix L 86. FIRM Index Date B7. FIRM Panel Effective/Revised Date B8. Flood Zone(s) B9. Base Flood Elevation(s) (Zone AO. use base flood depth) 9/11/2009 9/11/2009 VE 11 810. Indicate the source of the Base Flood Elevation (BFE) data or base flood depth entered in (tern B9. ❑ FIS Profile FIRM ❑ Community Determined ❑ Other (Describe) 811. indicate elevation datum used for BFE in Item B9: :+ NGVD 1929 ❑ NAVD 1988 ❑ Other (Describe) 812. Is the building loaf in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? ❑ Yes No Designation Date WA ❑ CBRS ❑ OPA SECTION C - BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) C1. Budding elevations are based on: ❑ Construction Drawings' ❑ Building Under Construction' Finished Construction A new Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones A1-A30. AE. AH, A (with BFE), VE, V1 V30, V (with BFE), AR. ARIA, AR/AE, AR/A1 -A30, AR/AH, AR/AO. Complete Items C2.a -h below according to the build-mg diagram specified in Item A7. Use the same datum as the BFE Benchmark Utilized Vertical Datum N.G.V.0.1929 Conversion/Comments NONt; a) b) c) d) e) 1) 9) h) Check the measurement used. Top of bottom floor (including basement, crawlspace, or enclosure floor) 4.50 El feet Top of the next higher floor 7.69 > feet Bottom of the lowest horizontal structural member (V Zones only) j /�A ❑ feet Attached garage (top of slab) Lowest elevation of machinery or equipment servicing the building 5.11 (Describe type of equipment and Nation in Comments) Lowest adjacent (finished) grade next to building (LAG) 4.50 Highest adjacent (finished) grade next to building (HAG) 4.§e Lowest adjacent grade at lowest elevation of deck or stairs, including structural support feet feet ® feet feet WA. ❑ feet ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) C ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) ❑ meters (Puerto Rico only) SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certification is to be signed and sealed by a land surveyor, engineer. or architect authorized by law to certify elevation information. 1 ceriiiy that the information on this Certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or Imprisonment under 18 U.S. Code, Section 1001. IN Check here If comments are provided on back of form. Were latitude and longitude in Section A provided by a licensed land surveyor? :+ Yes ❑ No Certifiers Name MIGUEL ESPINOSA,, License Number 5101 Title P.S.M. Company Name MIGUEL ESPINOSA LAND SURVEYING. INC. Address 10655 $W„ 190 STREET SUITE 3210 City MIAMI State FL Signature Date 10-25 -2011 Telephone 305 - 262 -2992 FEMA Form 81 -31, Mar 09 See reverse side for continuation. Replaces all previous editions Building Photographs See Instructions for Item A6. Building Street Address (including Apt, Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No 9839 NE 13T" AVENUE 1 For Insurance Company Use: Policy Number City MIAMI SHORES State FL ZIP Code 33138 Company NAIC Number If using the Elevation Certificate to obtain NFIP flood insurance, affix at least two building photographs below according to the instructions for Item A6. Identify all photographs with: date taken; "Front View" and "Rear View"; and, if required, "Right Side View" and "Left Side View." If submitting more photographs than will fit on this page, use the Continuation Page on the reverse. FRONT VIEW 10-25-2011 REARVIEW 10-25-2011 r 0 `TRACY CONSULTANTS INCORPORATED STRUCTURAL ANALYSIS January 30, 2012 PROJECT: GONCALVES RESIDENCE 9839 13th AVE., MIAMI SHORES, FL. JOB NO.: SIS09 -146R PERMIT NO: PAGES 1 & 2- CONCRETE BEAM CAP DESIGN THIS CERTIFICATION COVERS ALL OF THE ABOVE REFERENCED PAGES, ® * : cE p -t1�wv 1140P1 :1" : has. gTTE 0'Q�`. •• •L O R ` ROBERT N. TRACY, P.E., #11363 PRESIDENT 4660 SW 128` AVE., DAVIE, F1.,33330 -2302 PHONE 954.434.5035, FAX 954.434.1675, CELL 954.651.2840 • • R TRACY CONSULTANTS, INC. 1 Rev. 580010 User KW- 0607202, Ver5.8.0, 1-Nov -2006 Concrete Rectangular & Tee Beam Design (c)1983 -2006 ENERCALC Engineering Software SIS09-032. ECW:Calculations Description PILE CAP BEAM General Information Code Ref: ACI 318-02,1997 UBC, 2003 IBC, 2003 NFPA 6000 i Span Depth Width 16.00 ft 26.000 in 24.000 in Flange @ One Side Flange Thickness 8.000 in Web Spacing 2.200 ft Tee beam weight calc'd using Depth * Width fc 5,000 psi Fy 60,000 psi Concrete Wt. 145.0 pcf Seismic Zone 0 End Fodty Pinned - Pinned Uve Load acts with Short Term Reinforcing Reber @ Center of Beam... Count Size 'd' from Top 3 5 3.00in #2 3 5 23.00 in #1 Reber @ Left End of Beam... Count Size 'd' from Top #1 3 5 3.00 in #2 3 5 23.00 in Reber @ Right End of Beam... Count Size 'd' from Top #1 3 5 3.00 in #2 3 5 23.00 in Note: Load factoring supports 2003 IBC and 2003 NFPA 5000 by virtue of their references to ACI 318-02 for concrete design. Factoring of entered loads to ultimate Toads within this program is according to ACI 318-02 C.2 Uniform Loads 1 Dead Load 0.680 k Summary Uve Load 0.120 k Short Term k Start 0.000 if End 10.000 ft Beam Design OK Span = 16.00ft, Width= 24.00in Depth = 26.00in T Beam with Flange= 8.00in thick @ One Side, Web spat= 2.20ft Maximum Moment : Mu 55.15 k ft Allowable Moment : Mn*phi 105.40 k-ft Maximum Shear : Vu 11.21 k Max Reaction @ Left 10.53 k Maximum Deflection -0.0101 in Allowable Shear : Vn'phi 66.35 k Shear Stimrps... Stirrup Area @ Section 0.440 in2 Region 0.000 2.667 Max. Spacing Not Req'd Not Req'd Max Vu 11.207 9.643 Max Reaction @ Right 5.333 8.000 Not Req'd Not Req'd 4.171 4.171 7.53 k 10.667 13.333 16.000 ft Not Req'd Not Req'd Not Req'd in 5.921 8.285 8.961 k Bending & Shear Force Summary 1 Bending... @ Center @ Left End @ Right End Shear... @ Left End @ Right End Mn "Phi 105.40 k -ft 103.75 k -ft 103.75 k- ft Vn•Phi 66.35 k 66.35 k Mu, Eq. C-1 55.15 k -ft 0.00 k -ft 0.00 k -ft Vu, Eq. C-' 11.21 k 8.96 k Mu, Eq. C-2 41.36 k -ft 0.00 k-ft 0.00 k-ft Vu, Eq. 8.40 k 6.72 k Mu, Eq. C-3 32.37 k-ft 0.00 k-ft 0.00 k-ft Vu, Eq. 6.55 k 5.35 k Deflection Deflections... DL + [Bm Wt] DL + LL + [Bm Wt] DL + LL + ST + [Bm Wt] Reactions... DL + [Bm WtJI DL + LL + [Bm Wt] DL + LL + ST + [Bm Wt] . Upward 0.0000 in at 0.0000 in at 0.0000 in at 61 Left 9.702 k 10.527 k 10.527 k 0.0000 ft 0.0000 ft 0.0000 ft Right 7.152 k 7.527 k 7.527 k Downward -0.0094 in at 7.8080ft -0.0101 in at 7.8080ft -0.0101 in at 7.8080ft 1 '4TRACY CONSULTANTS, INC. Rev: 510 User. KW-0807202, Ver5.8.0, 1- Nov -2006 Concrete Rectangular & Tee Beam Design (c)1983 -2006 ENERCALC Engineering Software 9 9 SIS09 -032. ECW:Calculations Description PILE CAP BEAM Section Analysis Evaluate Moment Capacity... X : Neutral Axis a = beta * )(neutral Compression in Concrete Sum [Steel comp. fords] Tension in Reinforcing Find Max As for Ductile Failure... X- Balanced Xmax = Xbai * 0.75 a -max = beta * Xbal Compression in Concrete Sum [Steel Comp Forces] Total Compressive Force AS Max = Tot Force / Fy Actual Tension As Center 0.880 in 0.704 in 71.808 k 0.000 k - 111.600 k 13.612 in 10.209 in 10.890 in 1,281.869 k 51.848 k 1,333.717 k 22.229 in2 1.860 OK Left End 1.365 in 1.092 in 111.384 k 0.000 k - 111.600 k 13.612 in 10.209 in 10.890 in 833.069 k 51.848 k 884.917 k 14.749 in2 0.000 OK Rioht End 1.365 in 1.092 in 111.384 k 0.000 k - 111.600 k 13.6122 in 10.209 in 10.890 in 833.069 k 51.848 k 884.917 k 14.749 in2 1.860 OK ACI Factors (per ACI 318-02, applied ACI C-1 & C-2 DL ACI C-1 & C-2 LL ACI C-1 & C-2 ST seismic = ST * : 1.400 1.700 1.700 1.100 intemally to entered Toads) ACI C-2 Group Factor ACI C-3 Dead Load Factor ACI C-3 Short Term Factor 0.750 Add"! "1.4" Factor for Seismic 0.900 Add "I "0.9" Factor for Seismic 1.300 1.400 0.900 f 2' ONE #6 DOWEL 12' LG, 6' EMBED @ 24' 0/C ■ II ./ . r 3.� v�w!�nsl '.{amt W "III . r I— wCC U W Z •XLISTING BATTER o a ES - 0.9' MLW (ngvd) Z~ 0 W U —3 #5 RE -BARS TOP & BOTTOM w/ #3 HOOPS @ 12' O/C. NE #6 DOWEL 12' LG. 6' EMBED. EA BATTER PILE. + 5.47' ngvd EBAR & SHAPE BETWEEN BATTER PILES 3 - #6 DOWELS 30' LG 7' EMBED. + 1.6' MHW(ngvd) -2.2' BERM SECTION A -A, 1/4 # =1' -0u e e e 3 - #5 BARS TOP CONTINUOUS 3 - #6 DOWELS 30' LG 7' EMBED. EA SIDE OF BATTER CAP TIE TO BOTTOM STEEL 8 EXISTING PILE CAPS 0• 3 - #5 BARS BOTTOM BETWEEN BATTER CAPS EXISTING BATTER PILE & BATTER CAP WATER SIDE VIEW 1/4' =1' -0` A 16' • X.-3/7/7-2- -- 16' -4' NEW CAP ECEIVED JAN 31 2012 D_RM Coastal Resources Section Reso;:-ces Regulation & Restoration D vis or ('.NRRRD) 0a ©°°°©t9 l' ©sse ,e8 ®®ov 63 c... jo...4.....,AA/ oa: - 1'e2oaaeenOt 2' -OLD CAP EXISTING DAVIT PAD 93' EXISTING SEAWALL PLAN TRACY CONSULTANTS, INC. CA #3958 ROBERT N TRACY, P.E., #11363, PRESIDENT 4660 SW 128 AVE., SOUTHWEST RANCHES, FL. 33330 -2302 (954) 434 -5035, FAX(954) 434 -1675, MOBILE (954) 651 -2840 PROPOSED SEAWALL REPAIR GDNCALVES RESIDENCE 9839NE 13th AVE., MIAMI SHORES, FL. SHOWN 'I' 11,24.2011 • ie RNT SEAWALL INSPECTION SERVICES, INC FORT LAUDERDALE, FL. • t 11- 146.1of 2