PW-18-125Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
F�ORiDp`
Project Address
1201 NE 96 Street
Miami Shores, FL 33138-2553
Owner Information
BKT HOLDING LLC
rmit
issue Das. 1117i2018
Parcel Number
1132060143830
Block: Lot:
700 NE 90 Street
MIAMI FL 33138-
2691 E OAKLAND PARK Boulevard
FT. LAUDERDALE FL 33306-
Contractor(s) Phone Cell Phone
D.L.F. SERVICES LLC (305)420-8135
ning: 1
Fees Due
Amount
CCF
$0.00
DBPR Fee
$0.00
DCA Fee
$0.00
Education Surcharge
$0.20
Permit Fee
$100.00
Scanning Fee
$3.00
Technology Fee
$0.80
Total:
$104.00
Permit No. PW A-18-125
Permit Type: Public Work
Wot* aassirrCation: `Public Works
Permit Status APPROVED
Expiration: 04/17/2018
Applicant
BKT HOLDING LLC
Phone Cell
Valuation: $ 2,006.00
Total Sq Feet: 50
Pay Date Pay Type Amt Paid Amt Due
Invoice # PW-1-18-66146
01/16/2018 Credit Card $ 50.00 $ 54.00
01/17/2018 Credit Card $ 54.00 $ 0.00
Available Inspections:
Inspection Type:
Excavation
Review Public Works
Final Public Works EE
�j
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
construction and zoning. Futhermore, I auth
is accurate and that all work will be done in compliance with all applicable laws regulating
contractor to do the work stated.
January 17, 2018
Authorized Signature: Owner --/--Applicant (// Contractor / Agent
Building Department Copy
January 17, 2018
Miami Shores Village
\ 1 \ Public Works Department
(305)795-2210
Public works forms are available from the building department, 10050 NE 2"d 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#: C'�
Name of Applicant (if utility see below):
Owner off the following described property:
Legal Description: Lot / Z Block Subdivision
Folio #; 7 Ung ot3o
Address: ,l20 / n%F 1?L s
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City:
Telephone:
State Certification or Registration #:
Email:
State:
ZIP:
Certificate of Competency #
CONTRACTOR NAME: D_'F S_e_ 1V1"6 G--C,'e-1
Qualifier/Authorized Agent: dQ'ld (///�.,
Address:
City: a-.< State: it, ZIP: J
Telephone:,505 V2Qe136 Email:
State Certification or Registration #: % /S V ertificate of Competency #:
Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of
Type of Work: ❑ Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
City:
Telephone:' ;
Registration #:
-- State: ZIP:
Email: - .__..._.._._
Value of Work for.this Permit Zo_,>4 LSquare/-Lineal-Fobtage-of_Work"3 d r
*****Fees*****
Permit Fee $ 100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
Bond $ (if required) Total Fee Now Due $` t_�7
I , i ' , ,'r
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. I 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
Applicant or Authorized Agent
The foregoi instrum w s acknowledged kwfore
me this day of 20, by
who
is personally known to me or who has produced
as
identification.
NOTARY PUBLIC: ; l
Sign: z �i
Pri
398-0153
MY COMMISSION #FF101662
EXPIRES March 13. 2018
Signature
CSmpany/Utility Agent
The foreg i instru as acknowledge fore
me this day of 20 by
who
is personally known to me or who has produced
as
identification.
NOTARY PUBLIC:
Sign:
Print:
SEAL:
IJ
ISABEL VALDES
VOIRES March 13. 2018
(407) 3rs•ois:.= r rirlallotaryService.com
1
APPROVED BY: Public Works Director, or Designee
2017-04-15
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ad to Underground Conversion Sketch Form
L.
POWRI G moer FW"WFans menanmr-
Customer Name:4!. aytime ContactA-�) 420
Phone: �1
Service Address: -1 V City: �..� , +�" Zi ���a
J , p.
Example Instructions:
1. Building address
2. Pole location
ADDRESS 3. Indicate existing meter location on your home
(ex. 123) 4. Existing overhead wire to property
(Indicate with solid line)
#3 #1 5. Cable route for new underground conduit
#5 i 6. Street name
(609; 7. Indicate how many underground risers
are on pole:_0 (see FAQ #10 for detail)
i
i
#2
#6 Street name (ex. First St.)
Nit,- q lL0 "-�'T— Instructions:
1. Building address
2. Pole location
12 3. Indicate existing meter location on your home
4. Existing overhead wire to property
(Indicate with solid line)
0 5. Cable route for new underground conduit
(Indicate with dashed line, show cable route footage)
6. Street name
7. Indicate how many underground risers
are on pole:_ (See FAQ #10 for detail)47�0 S
N
se ry 1 e-e LLi n�
Z Rev. 11 /07
FPL SAP NE MEMO
DATE / FECHA: 017&Awl%
CUSTOMER NAME : lobe s-)//'&d LC -
(The name of the person or company who will be paying for the
invoice / E1 Nombre de la persona o empresa que va a pagar la
factura)
CUSTOMER SS # / TAX ID #
MAILING ADDRESS : , 0.
(Direccion postal a donde se
mandara la factura) Ll 2 A 5 0 l3
JOB LOCATION
(La Direccion donde se va ha realizar el trabajo)
G)mi jl�",rY�
I
i
CONTACT PHONE
(# de telefono)
Fill out this portion, if applicable. Complete esta porcon si es aplicable.
TEMP FOR CONSTRUCTION / TEMPORARIO PARA VONSTRUCION
CUSTOMER NAME:
(Name of the customer who will be opening the account / Nombre de la
,persona o empresa que abrira la cuenta
FPL USE OK Y
ISERVICE PLANNER :
IIO :
(AMOUNT :
PROCESS CONNECT ORDER ? YES NO
CUS# INV# / 11
0
FPL.
KHS"w0 SODA, IMK.M.6 10O -
Requirements For Underground Electric Service
Customer supplied meter can --_*
FPL pole
(same as where
existing wires to
house orighete)
Customer provided and Installed
golvantred or schedule 80 PVC riser.
Of SCH 80 PVC, it must be
&
MIN. similar to the AMRAK system.)
8'
MAX.
1 Plug end of PVC
FPL provided 90 degree
schedule 40 bend, (24" radius) FPL provided 90 degree
24" MIN. schedule 60 bend, (24" radius)
Wr MAX or 2 FPL provided 45 degree
� z I schedule 80 bends
Installation Instructions
If any of the following instructions can not be performed, contact your FPL representative. Any changes
from the specified guidelines, without prior approval from FPL could result in a delay of service or re -trenching.
Customer shall:
1) Hire a licensed electrical contractor to configure meter enclosure to receive underground service
2) Make payment to FPL N required
3) Make arrangements to pick up the PVC required from FPL. (PVC comes in 20 foot lengths)
4) Call for all utility locates prior to trenching. (1-800-432-4770 for locates)
5) Trench and install FPL provided PVC as follows:
a. Trench along FPL designated route.
b. Trench must be between 26" and 36" in depth with 24" minimum cover over PVC.
C. Use PVC cement on all joints.
d. For all turns along trench route, only two 90 degree bends are allowed, use 36" radius 90 degree "long" bends.
(Note: a combination of 45 and 90 degree bends may be used as long as the sum of the total bends used
does not exceed 180 degrees)
e. Use 24" radius 90 degree schedule 40 bend at pole, install flush against pole and plug end at grade level unless
otherwise instructed. Install FPL provided 90 degree schedule 80 bend at the meter downpipe.
f. Contact your FPL representative prior to backfilling trench, depth must be verified by FPL prior to
backfilling.
6) Electrical contractor will need to obtain an electrical inspection from local authority.
7) Contact your FPL representative for an appointment, please allow 2 - 3 weeks for scheduling and construction.
Rev. I1W