PW-18-3601Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
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issue Date 12/12/2018
Location Address Parcel Number
�321 NE 93RD ST, Miami Shores, FL 33138 1132060136240
Contacts
Permit No.: PW-12-18-3601
Permit Type: Public Works
Work Clossifrcatiorr: Public Works
Permit Status: Approved
Expiration: 06/10/2019
ELIZABETH COWEN Owner TECO PEOPLES GAS SYSTEM Contractor
321 NE 93 ST, MIAMI SHORES, FL 33138 JESUS VEGA
Other: 3054580120 15779 West Dixie Hwy, North Miami Beach, FL 33162
Business:
305957385777247
Other:30597017A3
Description: INSTALL 3/4' PLASTIC GAS SERVICE BY Valuation: $ 1,000.00 Inspection Requests:
DIRECTIONAL BORE 305-762-4949
Total Sq Feet: 26.00
Fees
Amount
Education Surcharge
$0.20
Public Works Permit Fee
$100.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$111.70
Payments
Date Paid Amt Paid
Total Fees
$111.70
Check # 3260
12/05/2018 $50.00
Check # 3267
12/12/2018 $61.70
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.
OWNERS AFFIDAVIT: I certify that all the foregoing information is
regulating construction and zoning. Futhermore, I authorize the above r
that all work will be done in compliance with all applicable laws
x to do the work stated.
Z /Z-12-/g
Authorized Signature: Owner / Applicant / Contractor /
Date
December 12, 2018 Page 2 of 2
-� Miami Shores Village RECEIVED
" Public Works Department
\ (305)795-2210 DEC 0 5 2018
\%J . Public works forms are available from the building department, 10050 NE 2nd Ave., Miami Shores, FL 33138 �
�� 1,►(`f�+ PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property
t, Permit#: 1' Vy�WO
Name of Applicant (if utility see below): SEE BELOW
Owner off the following described property:
Legal Description: Lot Block
Folio #; 11-3206-013-6240
Address: 321 NE 93rd St.
Subdivision
UTILITY NAME: TECO-PEOPLES GAS
.Qualifier/Authorized Agent: JESUS VEGA
Address: 5101 NW21stAVE.
City: FT. LAUDERDALE State: FL ZIP: 33309
Telephone: 954-453-0811 Email: ARROCHE@TECOENERGY.COM
State Certification or Registration #: E1608 Certificate of Competency #
CONTRACTOR NAME:
Qualifier/Authorized Agent:
Address:
City: State: ZIP: _
Telephone: Email:
State Certification or Registration #: Certificate of Competency #:
Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of
way: INSTALL 3/4" PLASTIC GAS SERVICE BY DIRECTIONAL BORE
Type of Work: ❑ Paving ❑■ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
City:
Telephone:
Registration #:
State:
Email:
ZIP:
Value of Work for this Permit: $ 1,00o Square/Lineal Footage of Work: 26 FT.
*****Fees*****
Permit Fee $ 100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
Bond $ (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:
Sign:
Print:
SEAL:
Signature
Company/Utili y Agent
The foregoing instrument was acknowledged before
me this day of 'DZi� 20i 9 , by
cc_S 1%E.5 r4 who
p rsonally known tome or who has produced
as
identifications -�
NOTARY PIUBLIC:
Print:
SEAL:
MY COMMISSION # GG 104234
APPROVED BY: a9vPublic Works Director, or Designee
2017-04-15
• _ ;_.�:,,'�: ti�mi Shires Village
•
APPROVED BY DATE RECEIVELo
2p� "G DF•F DEC
.. . , .. .. ROAD 0 51033
WORK
000 • •00 of ••e AHEAD `/`,SV_4/
II ' zoo zoo' 4oa CONDITIONS
U T 1'0 CChIPI- CE WI H LL FEllZE � 4 • • • • • ... • • WHERE ANY VEHICLE, EQUIPMENT, WORKERS
• OR THEIR ACTIVITIES ENCROACH ON THE
PAVEMENT REQUIRING THE CLOSURE OF ONE
• • • • • • •` • • ❑-~r■� TRAFFIC LANE, FOR WORK AREAS LESS THAN
• • • • • • • 000 • • j ■ • Work Area •
�7, 200' DOWNSTREAM FROM AN INTERSECTION
ll' FOR A PERIOD OF MORE THAN 60 MINUTES.
400' 100'' Le
ROAD
WORK ROAD
AHEAD WORK
AHEAD
200' 400'
CONDITIONS
J J � WHERE ANY VEHICLE, EQUIPMENT, WORKERS
OR THEIR ACTIVITIES ENCROACH ON THE
PAVEMENT REQUIRING THE CLOSURE OF ONE
• ■ • Work Area ■ b TRAFFIC LANE, FOR WORK AREAS 100' OR
MORE DOWNSTREAM FROM AN INTERSECTION
FOR A PERIOD OF MORE THAN 60 MINUTES.
40d � Sd
200'-11
200'
ROAD More Than
WORK 200'
AHEAD
DURATION NOTES
SYMBOLS GENERAL NOTES
® Work Area 7. 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
the opposing travel lane open to traffic. conditions are met
■ Channelizing Device (See Index 102-600) 6. The maximum spacing between devices shall be no greater than 25.'
2. When vehicles in a parking zone block the line of sight to TCZ a. Work operations are 6 r"" 5. ,
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 le ,
walkway, the signs shall be post mountetl and located in Index 102-600, C. No sight obstructions to' ,l .. oaching the wo�f are'd�.for
accordance with index 700-101. a distance of 600 feet. U
Flagger 8. The two channelizing devices directly in front and directly at the d. Vehicles in the work atC.1
=7R(t it3. Ifwork 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 kp atLane 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 ,�saq Gas tb e'on�con F`cd.
ROAD WORK AHEAD signs. Flaggers are not required, lights operating. FA
4. Flaggers shall be in sight or each other or in direct 9. Use Temporary Raised Rumble Strips in accordance with Index
-
communication at all times. 102-603. Placement of Rumble Strips and additional signs should
begin at FLAGGER sign location. �.,.. .
Vim! ]�.
LAST :tji DESCRIPTION:
REVISION 3 InFY 2019-20 INDEX
110117 �� STANDARD PLANS TWO-LANE, TWO-WAY, WORK NEAR INTERSECTION
101, 1of1
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II -
LOCATION MAP'
GENERAL NOTES
1. REPLACED BASE MATERIAL OVER DITCH SHALL BE TWICE THE
THICKNESS OF THE BASE. MIN. 8" AND MAX. 18"
2. BASE MATERIAL SHALL BE PLACED IN S- 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% (60X FOR LOCAL STREETS)
6. CONTRACTOR SHALL SOFT DIG TO VERIFY LOCATION OF EXISTING UTILITIES
I` �
3I ,
z
6"
�o
M
GAS MAIN
SOD RESTORATION DETAIL
SCALE NOT TO SCALE
N
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S
SCALE:1'=20'
LEGEND
t CENTER LINE
M 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. PLAS7IC
STM. SEW. STORM SEWER
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.
RESTORATION OF ROAD CUT
FOR UTILITY CROSSING
•.••
• ' ' 75' - 3
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Drawing File: G:\Documents\MIAMI.SHORESV21 NE 93RD ST MIAMI SHORES FL 33138 TO DO YET\321 NE 93RD ST MIAMI SHORESdwg 11/27/2013