PW-19-1124Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
577 NE 96TH ST, Miami Shores, FL 33138
rnntartc
PG'= Ff unon-JEC
Issue Date: 05/21/2019
Parcel Number
1132060171590
Permit NO.: PW-05-19-1124
Permit Type: Public Works
Work Classification: Public Works
Permit Status: Approved
Expiration: 11/18/2019
ONE LA LA LAND LLC Owner TECO PEOPLES GAS SYSTEM Contractor
57796 1ESUS VEGA
15779 West Dixie Hwy, North Miami Beach, FL 33162
Business:
305957385777247
Other:3059701783
on
Description: INSTALL 2" PLASTIC GAS MAIN BY DIRECTIONAL Valuation: $ 1,500.00 Ins ect2-4 Requests:
BORE IN REAR ALLEY AND 1-1/4" GAS SERVICE LINE 305-762 4949
TO REPLACE PW-11-18-3349 Total Sq Feet: 925.00
Fees
Amount
Education Surcharge
$0.40
Public Works Permit Fee
$100.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$105.90
a
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$105.90
Check # 3464
05/21/2019 $105.90
Amount Due:
$0.00
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 information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authorize the above nam c ntractor to do the w r stated.
Authorized Signature: Owner / Applicant / Contractor / Agent
May 21, 2019
Date
Page 2 of 2
y V 1
-,� Miami Shores Village
Public Works Department
Y 1 2��9
(305)795-2210
Public works forms are available from the building department, 10050 NE 2"' Ave., Miami Shores, FLE3.13
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property I
Permit#: 1 W — o5;"'1
9 —`1
Name of Applicant (if utility see below): TECO PEOPLES GAS
Owner off the following described property:
Legal Description: Lot Block Subdivision
Folio #;
Address: S 7 N2= 9G Ste'
UTILITY NAME: TECO PEOPLES GAS
Qualifier/Authorized Agent: JESUS VEGA
Address: 5101 NW 21 AVE.
City: FT. LAUDERDALE State: FL ZIP: 33309
Telephone: 954-453-0806 Email: MCABRERA@TECOENERGY.COM
State Certification or Registration #: E1608 Certificate of Competency #
CONTRACTOR NAME: ?�� e e, Pc`op C G.� 5
Qualifier/Authorized Agent:
Address:
City: State: ZIP:
Telephone: Email:
State Certification or Registration #: Certificate of Competency #:
!OG /
Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of
way: TO INSTALL A NEW GAS SERVICE LINE (1 1/4" PLASTIC) BY DIRECTIONAL BORE
Type of Work: ❑ Paving ■❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
Citv:
Telephone:
Registration #:
State:
Email:
ZIP:
Value of Work for this Permit: $ 100o Square/Lineal Footage of Work:
Permit Fee $ 100.00
Notary $
Bond $
*****Fees*****
-Train ing/Education $ 0.20 Technology Fee $ 0.80 Scanning $
(if required) Total Fee Now Due $
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 foregoing instrument was acknowledged before
me this day of 20 , by
who
is personally known to me or who has produced
as
identification.
NOTARY PUBLIC:
Signature
Company/Utility nt
The fore instrument was acknowledged before
me this day of 20�, by
K
me or who has produced
as
who
Sign:rign:
...... •. I I08ERT Nl INEZ
Print: Print: r.. rIne2zd
SEAL: SEAL: EXPIRCS: September 11, 2021
l hi Notary Public Undorwrilers
APPROVED BY: Public Works Director, or Designee
2017-04-15
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:11/06/2018
Location Address Parcel Number
577 NE 96TH ST, Miami Shores, FL 33138 1132060171590
Contacts
Permit NO.: PW-1 1 -18-3349
Permit Type: Public Works
Work Classification: Public Works
Permit Status: Approved
Expiration: 04/30/2019
ONE LA LA LAND LLC Owner TECO PEOPLES GAS SYSTEM Contractor
577 NE 96 ST, MIAMI SHORES, FL 33138 JESUS VEGA
Mobile: 3059866311 15779 West Dixie Hwy, North Miami Beach, FL 33162
Business:
305957385777247
Other:3059701783
Description: INSTALL 2" PLASTIC GAS MAIN BY DIRECTIONAL Valuation: $ 1,500.00 inspection Requests:
BORE IN REAR ALLEY AND 1-1/4" GAS SERVICE LINE 305-762-4949
TotalSq Feet: 925.00
Fees
Amount
Education Surcharge
$0.40
Public Works Permit Fee
$100.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$111.90
Payments
Date Paid Amt Paid
Total Fees
$111.90
Check # 3088
11/01/2018 $50.00
Check# 3186
11/06/2018 $61.90
Amount Due:
$0.00
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 S AFFI VIT- I certi that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regu ting co c ' a zon' g. Futhermore, authorize the above named contractor to do the work stated.
thorizo'§ignature: Owrg6r / Applicant / Contractor / Agent Date
November 06, 2018 Page 2 of 2
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Tom Faman
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SCALE: 1 "=30'
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�F_�•ti^C
TES
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)
• •
JAYER AND EACH•LAYER•THOROUGHLY ROLLED OR TAMPED TO 98% OF
• • • •
. MtX. 4DiNSITY PFA AASHTS T-180
• •
ai.
•ASPHALdr COIlCRElE PAVftENT JOINTS SHALL BE MECHANICALLY SAWED
s •
4.
•SURFACE MATERIA; SHi 131E CONSISTENT WITH SURROUNDING SURFACE
• •
• *A
• • • • • •
5.
I�ASE Tf=RIAL tgALL HAVE A MIN. LBR. OF 100 AND A MIN. CARBONATE
CONTENT OF 70X (60% FOR LOCAL STREETS)
6.
CONTRACTOR SHALL SOFT DIG TO VERIFY LOCATION OF EXISTING UTILITIES
7.
L R24D. AI Pi ST.Ij1AjION WITHIN F.D.O.T R/W SHALL COMPLY NTH INDEX
• • •
• •
i
•
.. .
.
. . . ... ..
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.
TIE IN PROP. G.M. TO EXIST. G.M. WITH 2X2' PL T/T
EXISTING 2" PE GAS MAI I T.T/T.F/E.F/E.M
VALVE2600 FLOW 241' ® GAS MAIN RESTORE
jiv — - — - — - — -ASPHALT TO CITY SPEC. N R/W
AS GAS — GAS GAS- -- ;, --- - -- o. -- — w w w w w w w w w w w w w w
\ 1 ALLEY WAY 0. P 1 0' 1 5'
PROP BORE 1 1/4" PLASTIC
37'-- --� S R W
GAS SERVICE FROM PROP. GAS EXIST. FENCE
LOT 515 I LOT 537 I 3' LOT 567 MAIN 2" PE TO RISER LOCATION 8'
I I ® 577 NE 96TH STREET I I
MIAMI SHORES I LOT 595
EXISTING LP TANK
:��:
PROP. NEW RISER
METER SET LOCATION A/C
�� AM ,1 PROP 2" PE GAS MAIN DIR. BORE
su�ACE SAW CUT 15'
577 NE 96th ST Lu
MIAMI SHORES
a J
PE!
// L �{�il1EHT BASE (NEW Mi j L` lit t ✓ 1� 4
(NEW AIEPoAL) 1.5' ' D11CH WID1H IN
12" VMES
RESTORATION OF ROAD CUT
FOR UTILITY CROSSING - — - — - — - — - — - — - — - — - — - — - — -
SEX. GRD.
51 /
4 1 1 M.
36 w 3� w w w w w w
i
2 I GAS GAS GAS GAS GAS G S
1
I
o IRECTIONAL PROP. 2 PE
BORE GAS MAIN
-2 • TIE IN PROP. G.M. TO
-3 EXIST. G.M. WITH 2X2' PL T/T
-4 I
PROFILE ALLEY WAY NORTH OF NE 96th ST
I
r
—w w _- w w 36"I 3
12
GAS GAS GAS GAS GAS GAS
I
I1
l o
IRECTIONAL
BORE 1
PROP. 1 114" PLASTIC I-2
GAS S VC. TO BE OPEN CUT 1-3
SCALE: (H) 1 "= 30' (V) 1" = 4
—4
I
I
N R/W
NE 96th ST
LEGEND
CENTER LINE
q
MONUMENT LINE
/tf
RIGHT OF WAY
R/W
PROPERTY LINE
P/L
EDGE OF PAVEMENT
E.O.P.
TAPPING TEE
T. T.
EXCESS FLOW VALVE
E.F.V.
SERVICE LINE
SVC
WATER MAIN
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