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PW-12-20-2913, 9824 NE 5th Avenue RdMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address 9824 NE 5TH AVENUE RD, Miami Shores, FL 33138 Contacts JOSE & HELEN FERRE Owner 9824 NE 5 AVE RD, MIAMI SHORES, FL 331382466 joef@flotechllc.com Issue Date: 01/05/2021 Parcel Number 1132060172040 Permit NO.: PW-12-20-2913 Permit Type: Public Works Work Classification: Public Works Permit Status: Approved Expiration: 07/06/ 2021 TECO PEOPLES GAS SYSTEM Contractor JESUSVEGA 15779 West Dixie Hwy, North Miami Beach, FL 33162 Business: bertnunez2@aol.com 305957385777247 Mobile: 9545580876 Other:3059701783 � Inspection Requests: Description: TO INSTALL A NEW GAS SERVICE LINE (3/4') ; Valuation: $ 1,000.00 Inspection n Re 49 PLASTIC BY DIRECTIONAL BORE. Total Sq Feet: 5.00 Fees Amount Education Surcharge $0.20 Public Works Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $2.50 Total: $111.70 Building Department Copy Payments Date Paid Amt Paid Total Fees $111.70 Check # 4090 01/05/2021 $111.70 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 c�rtify that a th,' foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating co�iiction an ortyn�l Fut a rq%q�, I authorize the above named contractor to do the work stated. X / 7 Authorized Sig a ut re: Qwnek, / Applicant / Contractor / Agent January 05, 2021 Date Page 2 of 2 Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Permit No.: PW-12-20-2913 Permit Type: Public Works Work Classification: Public Works Permit Status: Approved Issue Date:01/05/2021 Expiration:07/06/2021 Parcel Number 9824 NE 5TH AVENUE RD, Miami Shores, FL 33138 1132060172040 Contacts JOSE & HELEN FERRE Owner 9824 NE 5 AVE RD, MIAMI SHORES, FL 331382466 joef@flotechllc.com TECO PEOPLES GAS SYSTEM Contractor JESUSVEGA 15779 West Dixie Hwy, North Miami Beach, FL 33162 Business: bertnunez2@aol.com 305957385777247 Mobile: 9545580876 Other:3059701783 Inspection Requests: Description: TO INSTALL A NEW GAS SERVICE LINE (3/4') Valuation: $ 1,000.00 305 762 4949 PLASTIC BY DIRECTIONAL BORE. Total Sq Feet: 5.00 Fees Amount Education Surcharge $0.20 Public Works Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $2.50 Tota I : $111.70 Payments Date Paid Amt Paid Total Fees $111.70 Check # 4090 01/05/2021 $111.70 Amount Due: $0.00 Applicant Copy For Inspections, Call (305) 762-4949 or Log on at https://bidg.miamishoresvillage.com/cap/. Requests must be received by 3pm for following day inspections. NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER additional restrictions applicable to this property that may be found in the GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS, public records of this county. STATE AGENCIES, OR FEDERAL AGENCIES. January 05, 2021 Page 1 of 2 d Miami Shores Village 2020 torrid Public Works Department RY: (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#: C p � — � 2 2d — 2913 Name of Applicant (if utility see below): TECO PEOPLES GAS Owner off the following described property: Legal Description: Lot 15 Block 4 Subdivision MIAMI SHORES SEC 4 Folio #; 11-3206-017-2040 Address: 9824 NE 5 AVE RD. 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: Qualifier/Authorized Agent: Address: City: Telephone: State Certification or Registration #: Email: State: ZIP: Certificate of Competency #: Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of way: TO INSTALL A NEW GAS SERVICE LINE (3/4") PLASTIC) BY DIRECTIONAL BORE Type of Work: ❑ Paving x Utility ❑ Sidewalk ❑ Electric ❑ Irrigation ❑ Landscape ❑ Antenna ❑ Other: DESIGNER: Architect/Engineer: Address: City: Telephone: Registration #: State: Email: rAlS Value of Work for this Permit: $1000 Square/Lineal Footage of Work: 5 *****Fees***** Permit Fee $ 100.00 Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $ Bond $ (if required) Total Fee Now Due $ 4 4 1 1570 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 Signature V J Applicant or Authorized Agent Company/Util Agent The foregoing instrument was acknowledged before The foregoing instrume t was acknowledged before me this day of 20, by me this I % day of i c e- 20 L , by who A ✓ES a who is personally known to me or who has produced is personally known to me or who has produced as as identification. identification. -----` i ' , •, HUBERT NUNEZ NOTARY PUBLIC: NOTARY P BLI ,, MY COMMISSION H GG 104234 11, 2K EXPIRES: Sep[nmber bonded Thai Notary Public Undomriiers Sign: Sign: Print: Print: SEAL: SEAL: APPROVED BY: 1 2r�I2�Z� , Public Works Director, or Designee 2017-04-15 N W rc E S LEGEND q CENTER UNE Id MONUMENT LINE R/W RIGHT OF WAY P/L PROPERTY LINE E.O.P. EDGE OF PAVEMENT I. I. TAPPING TEE E.F.V. EXCESS FLOW VALVE SVC. SERVICE LINE PE. PLASTIC STM. SEW. STORM SEWER LOCATION MAP �N_T.s.� 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 6" 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% (60% FOR LOCAL STREETS) 6. CONTRACTOR SHALL SOFT DIG TO VERIFY LOCATION OF EXISTING UTILITIES 3, s 6" M GAS MAIN SOD RESTORATION DETAIL SCALE: NOT TO SCALE RESTORATION OF ROAD CUT FOR UTILITY CROSSING 4' N R /W- - r — r'= 14'— 10' S R/W PROP.1 114" P.E.- GAS SVC. TO BE DIRECTIONAL BORED PROP. GAS RISER 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. 3 14' 3 Z I rL X. GIRD. tl I N 8 8 --- -- ------ ---J ROP. 1 1/4" PLASTIC EXT,2" PE I GAS SVC. TO BE GAS MAIN 36" MIN. DIRECTIONAL BORED 1-3 1 i 1 4 ' GAS I GAS -- GAS - GAS -- GAS -- S 4 0 0 N W E S SCALE: V=20' 28' LO T—I LO 66 I I � 13' 33' 1' TIE IN SVC. TO GAS MAIN WI TH T. TIE. F. V. — —AiLEY- 0 ti EXIST. 2" PE GAS MAIN 1-3 co is' s o o Op -- --- N P/L --- --T-- -- --- II i ��il ; FAA\ PUB(IC N4&- APB ,-- ,.' W. Two story 983Q ..... �� RESIDENCE #9824 .. : •. •.. • •. • torn** • I • qq •• s • • •••• 1 1 w -- -- --- S P/L ---�-- -- —` -- _� j1z 0 o LE NO. OF SHEM: SHFXT NO.: 1 G'7dyl��y Z�i`Lyl►[e1s1��1 J)UALL: �V) i:J fin) wIJ. Drawing File: C:\Users\Ikrupinski\9824 NE 5TH AV RD, MIAMI SHORES FL 33138\9824 NE 5TH AV RD, MIAMI SHORES.dwg 12/01/2020