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PW-18-2489Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Permit NO.: PW-9-18-2 89 Pe IVR Number: 631584 Permit Type: Public Works War k Classification: Public Works Permit Status: Approved issue Date: 10/04/2018 + Expiration: 12/18/2018 Parcel Number Project 1421 NE 103 ST, Miami Shores, FL 33138-2625 1132050310150 <NONE> Contacts VILMA QUINTANA 1421 NE 103 ST, MIAMI SHORES, FL 33138 Other: 3055273904 Owner TECO PEOPLES GAS SYSTEM JESUS VEGA 15779 W DIXIE HWY, MIAMI, FL 33162 Business: 305957385777247 Other: 3059701783 Contractor VILMA QUINTANA 1421 NE 103 ST, MIAMI SHORES, FL 33138 Other: 3055273904 Applicant Description: TO INSTALL A NEW GAS SERVICE LINE (3/4" PLASTIC) BY DIRECTIONAL BORE Fees Amount Education Surcharge Permit Fee Scanning Fee Technology Fee Total: $0.20 $100.00 $9.00 $0.80 $110.00 Valuation: $ 1,000.00 TotalSq Feet: 0.00 Payments Total Fees Check # 2240 Deposit Amount Due: Amt Paid $110.00 $60.00 $50.00 $0.00 Inspection Requests: 30 762-4949 Building Department Copy In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations • pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWN regul AFFj* VIT: I ction and ture: Owner he foregoing information is accurate and that all work will be done in compliance with all applicable laws rmore, I authorize the above named contractor to do the work stated. Applicant / Contractor / Agent Date October 04, 2018 Page 2 of 4 SYMBOLS: MWork Area ■ Channelizing Device (See Index No. 600) al Work Zone Sign Er. Flagger Lane Identification + Direction of Traffic • • ••• • • • ••• •• •• • • •• • •• •• • • • • • •• •• •• •• • • • • • • •• •••• •• • •• • • •• •• • •• •• • • • ui• • •$£ . . • • • • • • • • •• • • • • •• • • • • Buf`er Sp-e TV!, • • • • • • • • • • • • • • •• •250• • •• • • • • • • • • • • • • • • • • • •♦ • • • • •• • • • • • • • • • • • • • • • • • • T • -• t74,7/i7// • : ///////%p • ••.. . 4 8 4' D 4' A 43 Tangent Taper Length sa To 100' A B GENERAL NOTES: 1. Special Conditions may be required in accordance with these notes and the following sheets: A. Railroad Crossings: a. if an active railroad crossing is located closer to the Work Area than the queue length plus 300 feet, extend the Buffer Space as shown on Sheet 3. b. If the queuing of vehicles across an active railroad crossing cannot be avoided, provide a uniformed traffic control officer or flagger 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. B. If the Work Area encroaches on the Centerline, use the Layout for Temporary Lane Shift to Shoulder on Sheet 3 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. 2. Temporary Raised Rumble Strips: A. Use when both of the following conditions are met concurrently:: a. Existing Posted Speed is 55 mph or greater; b. 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. 3. 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. C Device Spacing (See Table 1) +x May Be omitted if ROAD WORK AHEAD sign is installed upstream within the project limits. WITHOUT TEMPORARY RAISED RUMBLE STRIPS 4. When a side road intersects the highway within the TTC zone, place additional TTC devices in accordance with other applicable TCZ Indexes. 5. 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. 6. When Buffer Space cannot be attained due to geometric constraints, use the greatest attainable length, not less than 200 ft, for posted speeds greater than 25 mph. 7. 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, rotating, flashing, oscillating, or strobe lights operating. E. Volume and complexity of the roadway has been considered. F. If a railroad crossing i5 present, vehicles will not queue across rail tracks. G. AFADs are not in use. 8. See Index 600 for general TCZ requirements and additional information. 9. Automated Flagger Assistance Devices (AFADs) may be used in accordance with Specifications Section 102, 990 and the APL vendor drawings. 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 II Barricades/Panel,/Drums On a Taper On a Tangent On a Taper On a Tangent A BCD 25 20' 50' 20 50' 20U 200' 200' 100' 155' 30 20' 50' 20' 50' 200' 200' 200' 100' 200' 35 20' 50' 20' 50 2019 200' 200' 100' 250' 40 20' 50' 20' 50 200' 200' 200' 100' 305' 45 20' 50' 20' 50 350' 350' 350' 175' 360' 50 20' 50' 20' 100' 500 500' 500' 250' 425' 55 20' 50' 20' 100 2640' 1500' 1000' 500' 495' 60 20' 50' 20' 100' 2640' 1500' 1000' 500' 570' 65 20' 50' 20' 100' 2640' 1500' 1000' 500' 645' 70 20' 50' 20' 100' 2640' 1500' 1000 500' 730' CONDITIONS WHERE ANY VEHICLE, EOUIPMENT, WORKERS OR THEIR ACTIVITIES ENCROACH THE AREA BETWEEN THE CENTERLINE AND A LINE 2' OUTSIDE THE EDGE OF TRAVEL WAY. LAST REVISION 01/01/16 0 DESCRIPTION: FY 2017-18 FD— " Y DESIGN STANDARDS TWO-LANE, TWO-WAY, WORK WITHIN THE TRAVEL WAY INDEX NO. 603 SHEET NO. 1 of 3 i LOCATION MAP (N.T.) FULL LANE SURFACE RFPLACOAENT SURFACE SAW CUT ASPHALT (TYPICAL) • • •REPLACf1AENT BASE • *4V041s ) • •' • • • • • • • • A' DITCH WID •••• • • • •• • rtt 'OW • 12. 12" • • • • • • • RES'TORATIUIV:r7F ROAD CUT • "POR UTtL•hT•`f•CROSSING • GENERAL N€ S. • • • • • . • WE SCALE:1'-20' LEGEND CENTER LINE te MONUMENT LINE R/W RIGHT OF WAY P/L PROPERTY LINE E.O.P. EDGE OF PAVEMENT T.T. TAPPING TEE E.F.V. EXCESS FLOW VALVE SVC. SERVICE LINE PE. PLASTIC STM. SEW. STORM SEWER SOD RESTORATION DETAIL SCALE: NOT TO SCALE 1. REPLACEND' I A% MATERIAL OAR DITCH SHALL BE TWICE THE THICKNESS •OF THE BASE, MIN. 8" AND MAX. 18" 2. BASE MATERIAL SHALL BE PLACED 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 (1.5" MIN. THICKNESS) 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 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. 8 8 3 54' 3 eel 2' a ix a N LC� X. GRD. (3. +s— 4 PR G 1 1/4" PLASTI ----- 4 GAS DIRECTIONAL 4SVC. TO BE BORED 36" MIN. GAS 1 GAS GAS I I I GAS _r__ GAS -GAS I 0 1 1 0 2" C.S GAS MAIN I J -N P/L I R� j I SEP 19 zoi8 1411 PROP. GAS RISER DRIVEWAY PROP.1 1/4" P.E. GAS SVC. TO BE DIRECTIONAL BORED N R W 84' SWALE 4 P E.O.P 17' S R/W DRIVEWAY cot, al O (pct., DRIVEWAY V) S IV 1431 Otitertitct S P/L -^NING DEPT SWALE.-�_,'T 1,J • 10 CCMPI.IFNCE WITH All FE o_ (5,4}N l'b rstA- PNg REGULATIONS 4 ° NE. 103 rd ST. E-- n) v lL 4(•)-( X).1 "-_ TIE IN SVC. TO GAS MAIN WIT T. T/E. F. V. e d 6 6— c e� 4 n to a OM MI OM MR INIO M — 11.110. I✓1 IZ�A Al4 21 ,20-rl Z., (s q f xf & XIST. 2" C.S GAS MAIN 1-3 az CA 0 CO p � F z2 C < z rn 0 rn NO. OF SHEETS' 1 PROFILE CROSSING NE 103 RD ST. SCALE: (V) 1: ' (H) NTS. SHEET NO.: 1 Drawing File: GADocuments SHORES\1421 NE 103rd ST MIAMI SHORES FL 33138\1421 NE 103rd ST MIAMI SHORES FLdwg 05/23/2018 Miami Shores Village Public Works Department (305)795-2210 Public works forms are available from the building department, 10050 NE 2nd Ave., Miami Shores, FL 33138 PUBLIC WORKS PERMIT APPLICATION Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property Permit#: RECEIVED SEP 19 2018 Name of Applicant (if utility see below): Owner off the following described property: Legal Description: Lot 13 Block 6 Subdivision RE -PLAT OF TR C MIAMI SHORES BAY Folio #; 11-3206-031-0150 Address: 1421 NE 103 ST. UTILITY NAME: TECO PEOPLES GAS Qualifier/Authorized Agent: JESUS VEGA Address: 5101 NW 21 AVE. City: FT. LAUDERDALE Telephone: 954-453-0806 Email: State Certification or Registration #: E1608 CONTRACTOR NAME: TECO PEOPLES GAS Qualifier/Authorized Agent: JESUS VEGA Address: 5101 NW 21 AVE State: FL ZIP: 33309 MCABRERA@TECOENERGY.COM Certificate of Competency # L I60�. City: FT. LAUDERDALE State: FL Telephone: 954-4534206 Email: MCABRERA@TECOENERGY.COM ZIP: 33309 State Certification or Registration #: E1608 Certificate of Competency #: Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of way: TO INSTALL A NEW GAS SERVICE LINE (3/4" PLASTIC) BY DIRECTIONAL BORE Type of Work: ❑ Paving ❑■ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation ❑ Landscape ❑ Antenna ❑ Other: DESIGNER: Architect/Engineer: Address: City: State: ZIP: Telephone: Email: Registration #: Value of Work for this Permit: $ loon Square/Lineal Footage of Work: *****Fees***** Permit Fee $ 100.00 Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $ Bond $ (if required) Total Fee Now Due $ S Bonding Company's Name (if applicable): Bonding Company's Address: City: State: ZIP: Application is hereby made to obtain a public works permit to do the work in the right of way 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, regulation construction in this jurisdiction. 1 understand that separate permits must be secured for APPLICANT'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with applicable laws regulating construction and specifically construction in the right-of-way. "WARNING TO APPLICANT: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO THE RIGHT-OF-WAY. 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 public works permit with an estimated value exceeding $2,500, 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 the 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 public works permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection will be charged. Signature Signature 1( c3az:10.-a Ar"? Applicant or Authorized Agent Company/Utilityt The foregoing instrument was acknowledged before The foregoing instrument was acknowledged before me this day of , 20 , by me this 7 day of 46<<� , 20) g , by whogrstc4 A who is personally known to me or who has produced Is personally known to me or who has produced as as identification. identificati NOTARY PUBLIC: NOTARY Sign: Sign Print: Print: kt,,k, —7 A(J d 4J e SEAL: SEAL: / APPROVED BY: 2017-04-15 HUBERT NUNEZ MY COMMISSION # GG 104234 u° = EXPIRES: September 11, 2021 \%; ?" Bonded Thru Notary Public Underwriters �I��(� , Public Works Director, or Designee