PW-19-6Permit NO.: PW -0149-8
Miami Shores Village Permit Type, Public Works
10050 NE 2 Ave
Miami Shores FL 33138 Work Clossificati ? Public Works
305-795-2204 !L!!mrtwtad
Issue Date: 01/18/2019 1 Expiration: 07/17/2019
Location Address Parcel Number
85 NW 103RD ST, Miami Shores, FL 33150 1121360131080
Contacts
DM Investement Services LLC Owner FPL L
85 103
Description: INSTALLING ONE NEW POLE WR#8586800 Valuation: $17,903. 00 Ins ection Requests:
1305-762
Total Sq Feet: 0.00
Fees
Amount
Education Surcharge
$0.00
Public Works Permit Fee
$0.00
Scanning Fee
$0.00
Technology Fee
$0.00
Total:
$0.00
Building Department Copy
Payments Date Paid Amt Paid
Total Fees
Amount Due:
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 fof �LECTRICAL`R UMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNE AFFIDAVIT: I certify that all t foregoing information is accurate and that all work will be done in compliance with all applicable laws
reg ting onstruction and zoning. uth orfr; I authorize the above named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent Date
January 18, 2019 Page 2 of 2
FPL WR # 8586800
Miami shores Village RECEIVED
Public Works Department JAN 022019
10050 N.W. 2nd Avenue, Miami Shores, Florida 33138%
Tei: (305) 795.2204 Fax: (305) 756.8972
Public Works Permit No.�/
Permit Application
FBC 2004
UTILITY _ _
-Rer+ it . Public Worksl WATER
Owner's Name (Fee Simple Titleholder) Florida Power & Light Phone#: 305-529-6120
OwneesAddress_4200 West Flaqler St
City Miami State Florida Zip 33134
Tenant/LesseeName N/A Phone# N/A
ALLEY BEHIND 85 NW 103 STRFFT
Job Address (where the work is being done)
City _ Miami Shores Village
Is Building Historically Designated: Yes N/A
County Miami -Dade
No N/A
Zip
Utility's
GenlraetoF% Company Name FLORIDA POWER AND LIGHT COMPANY Phone #: (305) 442-5150
Utility's
GGAtrastoies Address 4200 W. FLAGLER ST. — EPM / LFO
City: MIAMI State:LF ORIDA Zip: 33134
Architect/Engineer's Name (if applicable) Patric Pierre
$ Value of Work For this Permit: $ 17,903
Phone#: 305-626-7698
Lineal Footage Of Work:
Type of Work: ® Addition ❑ Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Describe Work: INSTALLING 1 NEW POLE
Submittal Fee $
Notary $
Scanning $
Code Enforcement S
Total Fee Now Due $
(Continued on opposite side)
................"" Fees ....................
_ Permit Fee $ CCF $ _
Training/Education Fee$
Radon $ Zoning
Structural Plan Review $
Technology Fee $
CO/CC
Bond $
Bonding Company's Name (if applicable)
Bonding Company's Address NIA
City
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
State
Zip
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 this issuance of a Public Works 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 time recorded notice of coement must be poste t the job silo for the first
inspection which occurs seven (7) days after the building permit is Issued. In the ab encs of such posted no tic , f inspection will not be
approved and a reinspection Yee will be charged.
Signature Signature U U" 01tA v U11J
Owner or Agent
Utility Representative /-GenlraeteF
The tgoing in meat was acknowledged before me this 28 day of December 20 18 by
Tiyiam ilneQa , who is personally known to me eF who -has pFedaced N/A as
Identification, and who-did/did not take an oath.
NOTARY PUBLIC: NOTA13Y PU�LIC:
Sign: Sign: l
Print: Print: Marta Ramirez
My Commission Expires: My Commission Ex --"�° -- ---
` WARTA3A RA%i 2cT
MY COMMISSION # GG 010311
EXPIRES: July 11, 2020
I :F� W Bonded Thru No`ay Public Underwriters
�rrr a rrrrrrrrrrrrrrrrr■ ■ ■rrrr■ on ■rr■(rrrfrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr■
APPLICATION APPROVED BY: °1 1 Public Works Director or
his designee.
11/17/2005
December 28, 2018
Engineering and Project Management
4200 W. Flagler Street, Miami, Florida 33134
Office: (305) 442-5140 Fax: (305) 442-5123
Miami Shores Village
Director of Building Department
10050 N.E. 2 Avenue
Miami Shores, Florida 33138
SUBJECT: WR# 8586800
PROCESS
(Need to hand carry permit)
FPL plans to construct electrical facilities within you City limits. Attached for you approval
for a "No fee" permit are the following documents:
a. Permit application form
b. Two copies of the job sketch with the proposed facilities highlighted
If you have any questions, please call our engineer Mr. Patrick Pierre at 305-626-7698.
Otherwise, advise me of your approval avia e-mail @ Viviam.Pineda(CD-fpl.com so I make
arrangements to pick permit.
Very truly yours,
FPL
Permit Cordinator
Attn.: Viviam Pineda
305-442-5680
4200 W. Flagler Street — EMP/LFO
Miami, Florida 33134
��iam �ine�ec
Permit Coordinator
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Proposed FPL owned concrete pole
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Exlsting ore ignwoo poe SOB AND PERMIT OVERVIEW
x Proposed Foreign wood pole
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LOC 1 -F.0 W
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IP85 Northwest
103rd Street
WE
MUST CALL SUNSHINE UTILITIES LOCATIONS
COM PANYAT 1-800-432.4770 AT LEAST 48 HOURS
PRIOR TO DIGGING TO VERIFY EXACT LOCATIONS �,//
OF UNDERGROUND FACILITIES J:
MOT#599 4'*:MOT #605 ALL REQUIRED GROUNDRODS HAVE BEENDRIVENB VERIFED TO JOB(
FOREMAN'5 SIGNATURE DATE FOREMAN'S SIGNATURE DATE SUPERVISOR'S SIGNATURE DATE INTIALS CERT. DATE
Easement? Yes[-] No ❑ 1 Survey/Stake? Yes ❑ No® Work with SMO?Yes [:]No ® FPL INST NEW 40/3 POLE
Tree Work? Yes[-] NEE] Designer/Stake?Yes N No[:] CT/Special MtR Yes [:]No N FEEDER# 803431
PERMIT Ci Count Rd. County Air State Road FAA SUB: MIAMI SHORES
NWMDI RR Xing DR. Dist. Transm. R/0 NW 103RD STREET & NW 1STAVE IN THE ALLEY
Requested Tel Co. Set Poles ?YES ❑ NO ® Tele. Attachment Per Designed by: Patrick PierreDate: 12/26/18
Requested Tel Co. Transfer? YES E] NO
Request CAVT Transfer? YES ❑ NO N — Drawn by: PP Check by: Dwg No.
POLE LINE FEET 0. DUCT BANK FT. 0' Rural Location Sec. 36 TWP. 52 S, R. 41 E.
01 1 TRENCH FT. 0' SCALE: N.T.S I St. Lt MAP No. I Pri Map No. AD0268
TLM/LDS MODEL No. - Map Posting? YES N NO ❑ Posted by: WR 8586800 IWR D00008586800 M/A ND
NW 103rd St
LOCATION: R/O 85 NW 103"" STREET
GPS X COORDINATE: -80.19971469
GPS Y COORDINATE: 25.86998071
TLN:8-7261-4775-0-6
RTIFED COMPLETEDAS SHOWN ON THE ASBULT AS -BUILT COPY
MINT. MATERIAL CHANGES SHOWN ON ROS
lities
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meet
side
point aistance of 3T
from cone d Curb a
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back of soewadk.
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intact ym CCR, for
further instruct:cns.�
Exlsting ore ignwoo poe SOB AND PERMIT OVERVIEW
x Proposed Foreign wood pole
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LOC 1 -F.0 W
EOP
EOP
ALLEY
LOC 1
IP85 Northwest
103rd Street
WE
MUST CALL SUNSHINE UTILITIES LOCATIONS
COM PANYAT 1-800-432.4770 AT LEAST 48 HOURS
PRIOR TO DIGGING TO VERIFY EXACT LOCATIONS �,//
OF UNDERGROUND FACILITIES J:
MOT#599 4'*:MOT #605 ALL REQUIRED GROUNDRODS HAVE BEENDRIVENB VERIFED TO JOB(
FOREMAN'5 SIGNATURE DATE FOREMAN'S SIGNATURE DATE SUPERVISOR'S SIGNATURE DATE INTIALS CERT. DATE
Easement? Yes[-] No ❑ 1 Survey/Stake? Yes ❑ No® Work with SMO?Yes [:]No ® FPL INST NEW 40/3 POLE
Tree Work? Yes[-] NEE] Designer/Stake?Yes N No[:] CT/Special MtR Yes [:]No N FEEDER# 803431
PERMIT Ci Count Rd. County Air State Road FAA SUB: MIAMI SHORES
NWMDI RR Xing DR. Dist. Transm. R/0 NW 103RD STREET & NW 1STAVE IN THE ALLEY
Requested Tel Co. Set Poles ?YES ❑ NO ® Tele. Attachment Per Designed by: Patrick PierreDate: 12/26/18
Requested Tel Co. Transfer? YES E] NO
Request CAVT Transfer? YES ❑ NO N — Drawn by: PP Check by: Dwg No.
POLE LINE FEET 0. DUCT BANK FT. 0' Rural Location Sec. 36 TWP. 52 S, R. 41 E.
01 1 TRENCH FT. 0' SCALE: N.T.S I St. Lt MAP No. I Pri Map No. AD0268
TLM/LDS MODEL No. - Map Posting? YES N NO ❑ Posted by: WR 8586800 IWR D00008586800 M/A ND
NW 103rd St
LOCATION: R/O 85 NW 103"" STREET
GPS X COORDINATE: -80.19971469
GPS Y COORDINATE: 25.86998071
TLN:8-7261-4775-0-6
RTIFED COMPLETEDAS SHOWN ON THE ASBULT AS -BUILT COPY
MINT. MATERIAL CHANGES SHOWN ON ROS
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200' 4100'
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400' 50'
200' 200'
More Than
ROAD 200
WORK
AHEAD
CONDITIONS
WHERE ANY VEHICLE, EQUIPMENT, WORKERS
OR THEIR ACTIVITIES ENCROACH ON THE
PAVEMENT REQUIRING THE CLOSURE OF ONE
TRAFFIC LANE, FOR WORK AREAS LESS THAN
200' DOWNSTREAM FROM AN INTERSECTION
FOR A PERIOD OF MORE THAN 60 MINUTES.
CONDITIONS
WHERE ANY VEHICLE, EQUIPMENT, WORKERS
OR THEIR ACTIVITIES ENCROACH ON THE
PAVEMENT REQUIRING THE CLOSURE OF ONE
TRAFFIC LANE, FOR WORK AREAS 200' OR
MORE DOWNSTREAM FROM AN INTERSECTION
FOR A PERIOD OF MORE THAN 60 MINUTES.
DURATION NOTES
SYMBOLS
GENERAL NOTES
® Work
Area
1. Work operations shall be confined to one travel lane, leaving
5. The FLAGGER legend sign may be substituted for the symbol sign.
1. ROAD WORK AHEAD sign may be omitted if all of the following
the opposing travel lane open to traffic.
conditions are met:
■ Channelizing
Device (See Index No. 600)
5. The maximum spacing between devices shall be no greater than 25.'
Z. When vehicles in a parking zone block the line of sight to TCZ
a. Work operations are 60 minutes or less.
Work
Zone Sign
signs or when TCZ signs encroach on a normal pedestrian
7. For general TCZ requirements and additional information, refer to
b. Speed is 45 mph or less,
walkway, the signs shall be post mounted and located in
Index No. 600.
C. No sight obstructions to vehicles approaching the work
area for
accordance with Index No. 17302.
a distance of 600 feet.
0— Flogger
S. The two chaprelizing devices directly in front and directly at the
d. Vehicles in the work area have high-intensity, rotating,
3. If work area is confined to an outside auxiliary lane, the work
end of the work area may be omitted provided vehicles in the work
flashing, oscillating, or strobe lights operating.
==C> Lane Identification + Direction of Traffic
area shall be barricaded and the FLAGGER signs replaced by
area have high-intensity rotating, flashing, oscillating, or strobe
e. Volume and complexity of the roadway has been considered.
ROAD WORK AHEAD signs. Flaggers are not required.
lights operating.
4. Fla ggers shall be in sight of each other or in direct
9. Use Temporary Raised Rumble Strips in accordance with Index 603.
communication at all times.
Placement of Rumble Strips and additional signs should begin at
FLAGGER sign location.
LAST
o DESCRIPTION:
2016
INDEX
SHEET
REVISION
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FDOT�
TWO-LANE TWO-WAY, WORK NEAR
INTERSECTION
NO.
NO.
07/01/15
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85 Northwest
703rd Street
— — — — U NW 103rd St
i POLE SETTING PROFILE
(TYPICAL)
e EOP 4 EOP i PROFILE VIEW
NO UTILITIES WILL BE CROSSED TO SETMUST CALL SUNSHINE UTILITIES LOCATIONS LOCATION: R/O 85 NW 103RD STRE
POLES ® COMPANY AT 1-800-432-4770 AT LEAST 48 HOURSj4Oi GPS XCOORDINATE: -80.19971469
POLES TO BE SET AT 6.5 FT DEEP PRIOR TO DIGGING TO VERIFY EXACT LOCATIONS (�rjl+r •�/ GPS Y COORDINATE: 25.86998071
FPL Construction Drawing Symbols and Specifications OF UNDERGROUND FACILITIES 0��/-
P — PM.®.. o-x..ffx�„x�N o TW:8-7261-4775-0-
AmmRmalOi>�Elies n aom wrxr Nnrtwr cx>xacs sxvawwxos A—UILT COPY
MOT #599 4* MOT #605
■ Existing FPL owned wood pole tt PPIeNrem
x �❑ N° ❑ wsbw., Y- El uw�e Sao?vim ❑No ®° INST NEW 4013 POLE
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tcm�do ar rxPb Cr �— .
■ Existing FPL Owned concrete pole baaM s.dewaR. ....�. Ci CDun Rd. County Air State Road FAA SUB: MIAMI SHORES
CCR
wMD RR Xin DR. Dist. Trans-. RIO NW 103RD STREET & NW IST AVE IN THE ALLEY
ne Dom, sPns �. A„ecN nt Pe,
❑ Proposed FPL owned concrete pole A"'" R.wF-Telco. T, PokI YEs No Designed by: Patrick Pll?rre Date. 01/07/19
Roa�nloa rol. co. r,no.N, , vlts ❑ No
F-- u.-- vEsNo Drawn by. PP Check by Dwg No.
® Existing Foreign wood pole JOB AND PERMIT OVERVIEW POLE LINE FEET D-,CTaANN rT'"• 0' Rural Location Sec. 36 TWP. 52 S, R. 41 E.
x Proposed Foreign wood pole 0' 1TRENCH FT. 0' SCALE. N.T.S I SL Lt MAP No. on Map No. AD0268
TLMILDS MODEL No. _ M.PP O.g? YES 0 NO ❑ PPsteaby: wR 8586800 IM D00008586800 M/A NO