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PW-16-2346Protect Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Parcel Number Expiration: 11/22/2016 Applicant 1285 NE 95 Street Miami Shores, FL 1132060144020 Block: Lot: ROBERT AND NANCY FREHLIN( Owner Information Address Phone Cell ROBERT AND NANCY FREHLING 421 E SAN MARINO Drive MIAMI BEACH FL 33139- 421 E SAN MARINO Drive MIAMI BEACH FL 33139- Contractor(s) TECO PEOPLES GAS SYSTEM Phone CeII Phone (305)957-3857 (305)970-1783 Valuation: Total Sq Feet: $ 1,000.00 0 Scanning: 3 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.25 $2.25 $0.20 $150.00 $9.00 $0.80 $165.10 Pay Date Pay Type Amt Paid Amt Due Invoice # PW -8-16-61057 08/24/2016 Check #: 3205 $ 115.10 $ 50.00 08/19/2016 Check #: 10275 $ 50.00 $ 0.00 Available Inspections: Inspection Type: Final Excavation Review Plumbing In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing inf• 'ion is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I author[' - • ov: -named • - ctor to do the work stated. Authorized Signature: plicant on ractor / Agent Building Department Copy August 24, 2016 Date August 24, 2016 1 BUILDING PERMIT APPLICATION El BUILDING ❑ ELECTRIC El PLUMBING ❑ MECHANICAL JOB ADDRESS: 1285 NE 95 ST. 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 Master Permit No. ❑ ROOFING ❑ REVISION FBC 2014x' pL1L' - 2-34. toe' Sub Permit No. •PUBLIC WORKS ❑ CHANGE OF CONTRACTOR ❑ EXTENSION ❑RENEWAL ❑ CANCELLATION SHOP DRAWINGS Citv: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): RIGHT OF WAY Phone#: Address: City: State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: TECO PEOPLES GAS Address: 5101 NW 21 AVE. STE. 460 Phone#: 954-453-0806 City: FT. LAUDERDALE Qualifier Name: JESUS VEGA State: FL Zip: 33309 Phone#: 954-453-0806 State Certification or Registration #: E1608 Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ 1000 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration New ❑ Repair/Replace Fl Demolition Description of Work: INSTALL A NEW 3/4" PLASTIC GAS SERVICE LINE LINE BY DIRECTIONAL DRILLING Specify color of color thru tile: f� �l Submittal Fee $ Permit Fee $ $ Z) ..- CCF $ 0 . Oa r n _ Scanning Fee $ l - GO Radon Fee $ '2 - G DBPR $ 2 " 2-S Technology Fee $ 0.03 Training/Education Fee $ 0 . 2. 0 Structural Reviews $ (Revised02/24/2014) CO/CC $ Notary $ Double Fee $ Bond $ 0 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoingeginstrument was acknowledged before me this day of , 20 . by /d day of , 20 ' 4 , by who is personally known to ,4�.,,Sw-s VE5.4-5 , who me or who has produced as me or who has produced identification and who did take an oath. identifica ' • n and ' ho di NOTARY PUBLIC: NOTAR Sign: S Print: Print: Seal: Seal: to as °�PRP,P,,a'� HUBERT NUNEZ Notary Public - State of Florida E, My Comm. Expires Sep 11, 2017 Commission # FF 043679 '',/8,.,00°.'s Bonded Throu0 National Notary Assn. **********************************J:************************************************************************ APPROVED BY 1 V i 0 [i Plans Examiner Zoning (Revised02/24/2014) Structural Review Clerk AR o® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 07/01/2016 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(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 thls certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER MCGRIFF, SEIBELS & WILLIAMS, INC. P.O. Box 10265 Birmingham, AL 35202 CONTACT NAME: (AIC. N . Ext): 800-476-2211 FAX No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Everest National Insurance Company 10120 INSURED Peoples Gas System TECO Energy, Inc. 702 North Franklin Street Tampa, FL 33602 INSURER B :Associated Electric & Gas Ins. Svcs. XL5129406P Self -Insured Retention $1,000,000 INSURER C : 07/01/2017 INSURER D : $ 1,000,000 INSURER E : X INSURER F : COVERAGES CERTIFICATE NUMBER:UU52W3Q9 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. INSRTYPE LTR OF INSURANCE ADDL D INSD SUBR MD POLICY NUMBER POUCY EFF (MM/DD/YYYY) POUCY EXP (MM/DD/YYYY) B X COMMERCIAL GENERAL LIABILITY XL5129406P Self -Insured Retention $1,000,000 07/01/2016 07/01/2017 EACH OCCURRENCE $ 1,000,000 X CLAIMS MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GE 'L AGGREGATE POLICY OTHER: LIMIT APPLIES O - JET PER: LOC GENERAL AGGREGATE $ 1,000,000 PRODUCTS - COMP/OP AGG $ $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS _ _ SCHEDULED AUTOS NON -OWNED AUTOS XL5129406P Self -Insured Retention $250,000 07/01/2016 07/01/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA UAB EXCESS UAB X OCCUR CLAIMS -MADE XL5129406P 07/01/2016 07/01/2017 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED RETENTION $ $ A B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A Excess Workers' Compensation: EN4GL00054-161ER Employer's Liability: XL5129406P 07/01/2016 07/01/2017 X STARUTE TH 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) Excess Liability policy provides insurance in excess of Peoples Gas System's Self -Insured Retention as stated above. Jesus Vega is the qualifier for TECO Peoples Gas. CERTIFICATE HOLDER CANCELLATION City of Miami Shores 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 ACORD 25 (2014/01) Page 1 of 1 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD C " B Board Construction Trades Qualifying BUSINESS CERTIFICATE OF COMPETENCY T � E1608 PEOPLES GAS SYSTEM INC VEGA JESUS Is certified under the provisions of Chapter 10 of Miami -Dade • •• • • • • • • • • ••• • • • •• • • ••• • •• • •.• • • • •••• • •• • • •• • • • • • •• • •• • • • . --- SYMBOLS: ® Work Area • Channelizing Device (See Index No. 600) []I Work Zone Sign Er. Flagger Automated Flagger Assistance Devices ▪ (AFAR), With Gate b Lane Identification + Direction of Traffic • • • • • • • • • • • • • • • • • • • • • • •• • • •• • • • • • • • •• • • • • ••• •• ••• Buffer Space / See Table 1 • • • • • • • • • 25t4 • • • • • • • • •• • •• • • • • • •• ••• C 4] nt A 0' L e •• r r r r • • • •••U•• a b 7 Tangent Taper Length 50' to 100' Taper Length 58 to 100' Device Spacing See Table 1 -e * May be omitted if ROAD WORK AHEAD sign i5 installed upstream within GENERAL NOTES: 1. Special Conditions may be required in accordance with these notes and the following sheets. 2. If the Work Area encroaches on the Centerline, use the Layout for Temporary Lane Shift to Shoulder on Sheet 2 only if the Existing Paved Shoulder width is sufficient to provide for an 11' lane between the Work Area and the Edge of Existing Paved Shoulder. Reduce the posted speed when appropriate. 3. Temporary Raised Rumble Strips: a. Use when both of the following conditions are met concurrently: . Existing Posted Speed is 50 mph or greater; 11. Work duration is greater than 60 minutes. b. Use a consistent Strip color throughout the work zone. c. Place each Rumble Strip Set transversely across the lane at locations shown. d. Use Option 1 or Option 2 as shown on Sheet 2. Use only one option throughout work zone. 4. Additional one-way control may be provided by the following means: a. Flag -carrying vehicle; b. Official vehicle; c. Pilot vehicles; d. Traffic signals. When flaggers are the sole means of one-way control, the flaggers must be in sight of each other or in direct communication at all times. 5. When a side road intersects the highway within the TTC zone, place additional TTC devices in accordance with other applicable TCZ Indexes. 6. The two channelizing devices directly in front of the work area may be omitted provided vehicles in the work area have high-intensity rotating. flashing. oscillating, or strobe lights operating. LAST REVISION 07/01/15 DESCRIPTION: GENERAL LAYOUT 7. When Buffer Space cannot be attained due to geometric constraints, use the greatest attainable length, not less than 200 ft. 8. Railroad Crossings: a. 11 an active railroad crossing i5 located closer to the Work Area than the queue length plus 300 feet, extend the Buffer Space as shown on Sheet 2. b. If the queuing of vehicles across an active railroad crossing cannot be avoided, provide a uniformed traffic control officer or fiagger at the highway -rail grade crossing to prevent vehicles from stopping within the highway -rail grade crossing, even if automatic train warning devices are in place. 9. ROAD WORK AHEAD and the BE PREPARED TO STOP signs may be omitted if all of the following conditions are met, a. Work operations are 60 minutes or less. b. Speed limit is 45 mph or less. c. There are no sight obstructions to vehicles approaching the work area for a distance equal to the Buffer Space shown in Table 1. d. Vehicles in the work area have high-intensity, ro oscillating, or strobe lights operating. e. Volume and complexity of the roadway has been f. If a railroad crossing is present, vehicles will n rail tracks. g. AFAD5 are not in use. 10. See Index 600 for general TCZ requirements and inf ormation. IL - TABLE 1 Posted Speed DEVICE SPACING Distance Between Signs Buffer Space Maximum Spacing of Cones or Tubular Markers Maximum Spacing of Type I or Type 11 Barricades/Panels/Drums On a Taper Ona Tangent On a Taper Ona Tangent A BCD 25 20' 50' 2a 50 200' 200' 208 100 155' 30 20' 50' 20' 50' 200' 200' 200' 100' 200' 35 20' 50' 20' 58 200' 200' 200' 100' 250' 40 20' 50' 20' 50 200' 200' 200' 100' 305' 45 20 50' 20' 50' 350' 350' 350' 175' 360 --$6--, 2a 50 20' ma 500' soa 5oa 250 425' -1 20' 58 28 100' 2640' 1500' 1000' 500' 495' 1 20' 58 20' 100' 2640' 1500' 1000' 500 570' a; 65/ 20' 50' 20' 100' 2640' 1500' 7000' 500' 645' WI -7' 20' 50' 20' 100' 2640' 1500' 1000' 500' 730' 11. Automated Flagger Assistance Devices (AFADs) may ReygsP8 accordance with the Notes on Sheet 3. 2016 -� DESIGN STANDARDS RT LANE, TWO-WAY, WORK WIITH[IIN THE TRAVEL WAY CONDITIONS WHERE ANY VEHICLE, EQUIPMENT, WORKERS OR THEIR ACTIVITIES ENCROACH THE AREA BETWEEN THE CENTERLINE AND A LINE 2' OUTSIDE THE EDGE OF TRAVEL WAY. INDEX NO. 603 SHEET NO. lof3 • SCALE: 1"=30' • • • • • • • • • • •. • ••• • • • •••• • • • • • • • • • • • •• • N R/W 15' 1 0 E.O.P , E_. O. P } -1- TIE IN SVC TO GAS MAIN WITH T.T./E.F.V. ALL EXISTING UTILITIES SHOWN ON THESE PLANS ARE TO BE CONSIDERED APPROXIMATE & SHOULD BE VERIFIED BY THE CONTRACTOR PRIOR TO THE START OF WORK OPERATIONS. XI T. 2" CS. GAS MAIN mmmm ALLEY WAY .111 R/W 10 CG j m PROP. 3/4" PLASTIC � 43' GAS SVC DIRECTIONAL BORE. 1 w F PROP NEW --- •ThISER METER • • 1ET LOCATION • • • • • • • • • • •••• • • • • •••• • • •• •• • • •• •• • • • • • • •••• LEGEND • • • • .• • .• MONUMENT LINE CENTER LINE RIGHT OF WAY PROPERTY LINE SEWER MAIN LINE WATER MAIN LINE TAPPING TEE EXCESS FLOW VALVE SERVICE LINE STEET PLASTIC COAT COATED STEEL EDGE OF PAVEMENT POLYETHELENE ELECTRONIC MARKER R/W P/L S/S W.M T/T EFV SVC SP CS E.O.P. PE EM O 0 a IMP NM 5 MO MI I Poo' De:k Deft( /ti,'Kh1. Rood /—:22.1515' # 1285 0 on nd 72 3( Punter r_c.&s. �4+ac S P /L GENERAL NOTES 1. REPLACE BASE MATERIAL OVER DITCH SHALL BE TWICE THE THICKNESS OF THE BASE, MIN. 8" AND MAX. 18" 2. BASE MATERIAL SHALL BE PLACE IN 6" MAX. (LOOSE MEASUREMENT) LAYER AND EACH LAYER THOROUGHLY ROLLED OR TAMPED TO 98% OF MAX. DENSITY PER AASHTO T-180 3. ASPHALT CONCRETE PAVEMENT JOINTS SHALL BE MECHANICALLY SAWED 4. SURFACE MATERIAL SHALL BE CONSISTENT WITH SURROUNDING SURFACE MATERIAL 5. BASE MATERIAL SHALL HAVE A MIN. LBR. OF 100 AND A MIN. CARBONATE CONTENT OF 70% (60% FOR LOCAL STREETS) 6. CONTRACTOR SHALL SOFT DIG TO VERIFY LOCATION OF EXISTING UTILITIES 0' a, xi 0 0 07-29-2018 Aria SURFACE r FULL LANE SURFACE REPLACEMENT SOD RESTORATION DETAIL SCALE: NOT TO SCALE REPLACEMENT BASE » (NEW MATERIAL) 1Y VARIES 12 RESTORATION OF ROAD TTIILITYYCSING SAW CUT ASPHALT (TYPICAL) 4 15' • :. • /4" PLAsI c 4 X. GRD. GAS SVC. TO BE • -ECM:VAL—BORED _ _._ L ri p j� T ,N 36" MIN.' ZIw — —4 EX-2"gcE GAS MAIN —4 PROFILE CROSSING ALLEY WAY SCALE: (V) 1:5' (H) NTS. z 0 61 H NO. 0! SN6NrB• i SHEET NO.: 1 Drawing File: \\browardfs\volt\users\stbxj\Documents\Marlen Cabrera\Marlen Cabrera\JOBS\1285 NE 95 STREET, MIAMI SHORES\1285 NE 95TH STREET.dwg 08/11/2016