PW-19-544Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:03/18/2019
Location Address Parcel Number
973 NE 95TH ST, Miami Shores, FL 33138 1132060143130
Contacts
Perm NO.: PW-03-19-544
Permit Type: Public Works
Work CfasstftwtiAn: Public Works
Permit Stotuss Approved
Expiration: 09/09/2019
BRUCE & DEBORAH KORRAY Owner
973 NE 95 ST, MIAMI SHORES, FL 33138
Mobile: 3058072733
TECO PEOPLES GAS SYSTEM Contractor
JESUS VEGA
15779 West Dixie Hwy, North Miami Beach, FL 33162
Business:
305957385777247
Other:3059701783
Inspection Requests:
Description: PERMIT TO INSTALL A
NEW GAS SERVICE LINE TO
Valuation:
$ 0.00
305-7`9
REPLACE PW-6-18-1715
Total Sq Feet:
0.00
Amount Payments
Amt Paid
Date Paid
Fees
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 he foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating c nstrr ction and zoning. Fut rmore, I authorize the above named contractor to doAh�work stated.
Authorized Signature: Owner /' Applicant / Contractor / Agent
Date
March 18, 2019 Page 2 of 2
0
I
Miami Shores Village if�"
Public Works Department 4/
(305)795-2210 *4' /�
Public works forms are available from the building department, 10050 NE 2nd Ave., Miami Shores, FL 33138 jig?O V
�9
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property
Permit#: ZL — / �_ , -► ,
Name of Applicant (if utility see below):
Owner off the following described property:
Legal Description: Lot Block Subdivision
Folio #;
Address: 7� �� 9� yN'��ZialL �-S t—G.
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City:
Telephone:
State Certification or Registration #:
Email:
State:
ZIP:
Certificate of Competency #
CCTOR NAME:
er Authorized Agent: ,/f=src s �/�=g A
s:
City: State: C . ZIP: _ -3 J !o Z
Telephone: _�O� 9S%� 385� Email:
State Certification or Registration #: Certificate of Competency #:
Requests permission install (describe work, attach separate page if necessary) in the adjoining right of
way: lN�� sc �U� ':-� ,cI ,
41
Type of Work: ❑
Paving
❑
Utility
❑
Sidewalk
❑ Electric ❑ -Irrigation
❑
Landscape
❑
Antenna
❑
Other:
10
DESIGNER: Architect/Engineer:.
Address:
City:
Telephone:
Registration #:
Value of Work for this Permit:
State:
Email:
ZIP:
$ do Square/Lineal Footage of Work:
***** 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
wh
is personally known to me or who has produced
as
identification.
Sign:
Print:
SEAL:
Signature ��o V � A-
Company/Utility nt
The foregoing instrument was acknowledged before
me this Z day of I.. . 20 15 , by
o Q/.cS It ' 4 . who
s persona nown me or who has produced
as
identificati
Print:
SEAL:
MY COMMISSION # GG 104234
EXPIRES- Septomhar 11, 2021
APPROVED BY: cam" ublic Works Director, or Designee
2017-04-15
SYMBOLS:
® Work Area
• Channelizing Device (See Index No. 600)
[p Work Zone Sign
Flagger
Lane Identification t Direction of Traffic
. . ... . . . ...
.. .. . . . .. .. .
. . . . . . . . . .
. ... . . . . .. .
• • • ••• • •••
4B • • ufllr • • •
• • 6,r4e • • 25tt • t'
StY • • • • •
••• Tabl•1 1 ••• •• •
a .. ...r..� • a 43 to
'� • rk re b
• ••• ••
1 /1' /� 1 1 /" 1 I.,Device Spacing (See Table 1)
A
roaar ` l► / I `Taper Length
SD To log' * May Be omitted if ROAD WORK AHEAD sign is installed upstream within the project limits.
WITHOUT TEMPORARY RAISED RUMBLE STRIPS
GENERAL NOTES:
1. Special Conditions may be required in accordance with these notes
4. When a side road intersects the highway within the TTC zone, place
and the following sheets:
additional TTC devices In accordance with other applicable TCZ Indexes.
A Railroad Crossings:
S. The two Channelizing devices directly in front of the work area may be
a If an active railroad crossing is located closer to the Work Area than
omitted provided vehicles in the work area have high -intensity rotating,
flashing, lights
the queue length plus 300 reel, extend the Buffer Space as shown on
oscillating, or strobe operating.
Sheet 3'
b. // the queuing vehicles across an active crossing cannot be
6. When Buffer Space cannot be attained due to geometric constraints, use
avoided, provide a uniformed Cradle control officerlroad
a or the
the greatest attainable length, not less than 200 ft. for posted speeds
oagger it
highway -rail grade crossing to prevent vehicles from stopping within
vehicles from
greater than 25 mph.
the highway -rail grade crossing, even if automatic train warning
devices are in place.
7. ROAD WORK AHEAD and the BE PREPARED TO STOP signsy may be omitted it
B. If the Work Area encroaches on the Centerline, use the Layout for
all of the following conditions are met:
Temporary Lane Shift to Shoulder on Sheet 3 only it the Existing
Paved Shoulder width is sufficient to provide for an 11' lane
A Work operations are 60 minutes or less.
Reduce the posted speed when appropriate. between the Work Area and the Edge Existing Paved Shoulder.
B. Speed Ilm)[ is IS 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.
2. Temporary Raised Rumble Strips:
D. Vehicles in the work area have high -intensity, rotating, flashing, oscillating,
or strobe lights operating.
A Use when both or the following conditions are met concurrently:
E. Volume and complexity or the roadway has been considered.
F. If a railroad crossing is present, vehicles will not queue across rail tracks.
a. Existing Posted Speed Is 55 mph or greater;
b. Work duration Is greater than 60 minutes.
G. AFADs are not in use.
B. Use a consistent Strip color throughout the work zone.
C. Place each Rumble Strip Set transversely across the lane at locations
8. See Index 600 for general TCZ requirements and additional information.
shown.
D. Use Option 1 or Option 2 as shown on Sheet 2. Use only one option
9. Automated Flagger Assistance Devices (AFADs) may be used in accordance
throughout work zone.
with Specifications Section 102, 990 and the APL vendor drawings.
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.
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 If
Barricades/Panels/Drums
On
raper
On
Tan.on'
On
Taper
on
Tan ent
25
20,
so,
20'
597
2f150a
'
20V
100
155'
30
20'
so,
2O
50,
2'
200'
10O
200'
35
20'
50'
20'
SD
2'
200'
100'
2SO'
40
2D
50'
20'
5D
7'
200'
to&
305'
45
20
SO'
20
SD
3'
350
175'
360'
50
20'
50'
20'
too'
5'
500'
250
425'
55
20'
5D
20'
100,
2
1000,
500'
495'
60
20'
S0
20'
!0o'
2'
IOWSOD
570'
65
20'
So'
20,00'2
1000.
SOO
645'
70
20'
so,
20'
100'
2640'
I SOO
1000'
SOD'
730'
CONDITIONS
WHERE ANY VEHICLE. EOUIPMEN7,
WORKERS OR THEIR ACTIVITIES
ENCROACH THE AREA BETWEEN
THE CENTERLINE AND A LINE 2'
OUTSIDE THE EDGE of TRAVEL WAY.
LAST ..,.....t.w: FY 2017-18 INDEX SHEET
aLvrslDN FDOTT TWO-LANE, TWO-WAY, NO. NO.
01101116 � ter- DESIGN STANDARDS WORK WITHIN THE TRAVEL WAY 603 1 of 3