PW-19-542Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 03/18/2019
Location Address Parcel Number
362 NE 95TH ST, Miami Shores, FL 33138 1132060136070
Contacts
Permit No.: PW-03-19-542
Permit Type: Public Works
Work Classification: Public Works
permit Status: Approved
Expiration: 09/09/2019
MICHAEL BROWN Owner
362 NE 95 ST, MIAMI SHORES, FL 33138
Other: 3053232133
TECO PEOPLES GAS SYSTEM Contractor
JESUS VEGA
15779 West Dixie Hwy, North Miami Beach, FL 33162
Business:
305957385777247
Other:3059701783
Valuation:
$ 1,000.00
Inspection Requests:
Description: TO INSTALL A NEW GAS SERVICE LINE 3/4 PLASTIC
BY DIRECTIONAL BORE
rOS-762-4949
TO REPLACE PW-4-18-873
Total Sq Feet:
0.00
Amount
Amt Paid
Fees
Payments
Date Paid
Public Works Permit Fee
$50.00
Total Fees
$50.00
Total:
Check # 3406
03/18/2019
$50.00
$50.00
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 accurate and that all work will be done in compliance with all applicable laws
regulating construction anal zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent Date
March 18, 2019 Page 2 of 2
RECEIVED
Miami Shores Village
Public Works Department MAR 12 2019
(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#:
-- Z
Name of Applicant (if utility see below):
Owner off the following described property:
Legal Description: Lot Block Subdivision
Folio #;
Address: "Z �p Z NZ IT � /""tt s ; Skd'eO& Z::z:-.
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City:
Telephone:
State Certification or Registration #:
Email:
State:
CONTRACTOR NAMED
ZIP:
Certificate of Competency #
uafier uthorized Agent: A
A s�97 �J �, x , P ,��y./ "'1 W 6 FL, 3 �D
r
City: State: ZIP:
Telephone: Email:
State Certification or Registration #: Certificate of Competency #:
Requests permission to install (de cribe work, attach separate page if necessary) in the adjoining right of
way: FEZ .c aze [J 1 c _
Type of Work: ❑ Paving ❑ Utility
* �❑ Landscape,❑ Antenna
t
DESIGNER: Architect/Engineer:
Address:
City:
Telephone:
Registration #:
State:
Email:
J J
❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Other: 12��
ZIP:
Value of Work for this Permit: $ 90O Square/Lineal Footage of Work:
***** Fees*****
Permit Fee $ 100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scann-inT$
Bond $ (if required) Total Fee Now Due $ �J�—
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
5 '
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.
0
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.
Sign:
Print:
SEAL:
Signature
Company/Uti Agent
The foregoing instrument was acknowledged before
me this :�Z day of W A,-r l .20 19 . by
C 3--5 VF A who
i sonally know o me or who has produced
_ n as
Sign:
Print:
SEAL:
MY COMMISSION # GG 104234
EXPIRES: September 11, 2021
** **** * ***** **************************
APPROVED BY: 1110 Public Works Director, or Designee
2017-04-15
SYMBOLS:
® work Area
• Channelizing Device (See Index No. 600)
[p Work Zone Sign
0 ' Flagger
b Lane Identification + Direction of Traffic
— — — — — — — — — — — — — — — — — — a
b n i
GENERAL NOTES:
IF,
D
t .0 41 41 * 10
A a
— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —
b
aE
I_ Tangent Device Spacing (See Table 1)
�sT� Taper Length
D 50 To 100' * May Be omitted if ROAD WORK AHEAD sign is installed Y g upstream within the project limits.
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
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 or the roadway has been considered.
F. If a railroad crossing is present, vehicles will not queue across rail tracks.
G. AFADs are not in use.
B. 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 I
Posted
Speed
DEVICE SPACING
Distance
Between
Signs
A B C D
Buffer
Space
Maximum Spacing
of Cones or
Tubular Markers
Maximum Spacing of
Type I or Type 11
Barricades/Panels/Drums
On a
Taper
On a
Tan ent
On a
Taper
On a
Tangent
25
20'
50'
20'
50'
200'
200'
200'
100
155'
30
20'
50'
20
50
1 200'
200'
200'
100
200'
35
20'
50'
20
50'
200'
200'
200'
1001
250'
40
20'
50'
20
50
200
200'
200'
100
305'
45
20
50
20
50,
350'
350'
350'
175'
360'
50
20
50
1 20
100
500'
500'
500
25C
425,
55
10
1 50'
20'
100,
2640'
1500'
1000'
500'
495'
60
20
50
20'
100
2640'
1500'
1000
500'
570
65
20
50
20'
!Do,
2640'
1500
Wool
500
645'
70
20
50
20'
100
1640'
1500
1000
500'
730'
CONDITIONS
WHERE ANY VEHICLE, EQUIPMENT,
WORKERS OR THEIR ACTIVITIES
ENCROACH THE AREA BETWEEN
THE CENTERLINE AND A LINE 2'
OUTSIDE THE EDGE OF TRAVEL WAY.
LAST J,.J
.111IVw: FY 2017-]8
INDEX SHEET
REVISION �, FDOTT TWO-LANE, TWO-WAY, NO. NO.
01101116 DESIGN STANDARDS WORK WITHIN THE TRAVEL. WAY 603 1 of 3