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PW-08-23-1929Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Permit NO.: PW-08-23-1929 Permit Type: Public Works Work Classification: Public Works Permit Status: Approved Issue Date: 09/20/2023 Expiration: 03/26/2024 Location Address Parcel Number 1200 NE 94TH ST, Miami Shores, FL 33138 1132050100230 Contacts Robert Netkin Owner PEOPLES GAS SYSTEM INC Contractor 1200 NE 94 ST, Miami Shores, FL 33138 ANGEL QUANT 5101 NW 21 AVE 460, FORT LAUDERDALE, FL 33309 Business: 9545580876 bertnunez2@aol.com Mobile: 9544530811 I_......._....._..._.................._......._....-_.......-......_._..._....._._.._._.-.,-.. -.... gInsect,on Requests: Description: TO INSTALL A NEW GAS SERVICE LINE (11/4) Valuation: $ 1,000.00PLASTIC VIA OPEN CUT 949� Total Sq Feet: 0.00 Fees Amount Education Surcharge $0.30 Public Works Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $10.00 Total: $119.30 Payments Date Paid Amt Paid Total Fees $119.30 Check # 4962 09/26/2023 $119.30 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 constructionand zoning. Futhermore, I aah9rize the above named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Date September 26, 2023 Page 2 of 2 ..�. Miami Shores Village FAUG4 ? --3 Public Works Department (305)795-2210Public works forms are available from the building department, 10050 NE 2"d Ave., Miam_Q--- PUBLIC WORKS PERMIT APPLICATION Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property I Permit#: PZ"�—�—R2-1 Name of Applicant (if utility see below): PEOPLES GAS SYSTEM Owner off the following described property: Legal Description: Lot 26 & 27 (30') Block Subdivision MIAMI SHORES BAY VIEW PB 40-16 Folio #; 11-3205-010-0230 Address: 1200 NE 94 ST MIAMI SHORES UTILITY NAME: PEOPLES GAS SYSTEM Qualifier/Authorized Agent: Angel Quant Address: 5101 NW 21 AVE. SUITE. 460 City: FT. LAUDERDALE State: FL ZIP: 33309 Telephone: 954-453-0806 Email: MCABRERA@TECOENERGY.COM f'&r2T ,,') " ..1 C Z. e ZQrt-0c.c4w• State Certification or Registration #: E2100068 Certificate of Competency # CONTRACTOR NAME: PEOPLES GAS SYSTEM Qualifier/Authorized Agent: Angel Quant Address: 5101 NW 21 AVE. SUITE. 460 City: FT. LAUDERDALE State: FL Telephone: 954-453-0806 Email: MCABRERA@TECOENERGY.COM State Certification or Registration #: E2100068 Certificate of Competency #: ZIP: 33309 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) VIA OPEN CUT. Type of Work: ❑ Paving ■❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation ❑ Landscape ❑ Antenna ❑ Other: DESIGNER: Architect/Engineer: TECO PEOPLES GAS Address: 5101 NW 21 AVE. City: FT. LAUDERDALE State: FL ZIP: 33309 Telephone: 954-453-0806 Email: MCABRERA@TECOENERGY.COM Registration #: Value of Work for this Permit: $ 100o Square/Lineal Footage of Work: 11 *****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: Signa e Company/Utility Age t The foregoing instrument was acknoy0ledged before me this `F day of ! -- , 20 Z-S, by 1-)9c'c A a7 who is personally known'to me or who has produced as identification. •" ' `�' ' �`M HUBL=RTNUNEZ FAY C01h? 1SSIOId # HFI 126865 NOTARY LI EXi'IF2ES: Se umber 11, 2.025 �r •� ,° F " Bonded Thru Notary Public UndeRwiters C<Vn'L'JS"A'RI80.Y•AGYYM•to deiC�----�&5�'lC. .-- Print: SEAL: ******************************************** APPROVED BY: a a-� �-1 Public Works Director, or Designee 2017-04-15 E m CO O 9ZD CO ~ J q 07 a N 0 o ti ¢ a; o s oCn — UJ e y w as rn o C7 L° v 4, W Z (v U Q vi4 �- CL u r z a J LF- - 0 tv G n W O C cu c° co Na b �: CD �_ Q Q W O . f O n u o o E o o o = r v r ca -F, CQ C y V �] �cn •- Y o c E cm co O ` yo y .. y mAwEa p U M NF- o U c v d_ _ O f= i 6 c Y 1 N « C y C> d q N C N O U O O C 9 S to (D a oN_ M E C O N O rn CD cr _o CD N C -- - cc Q La. O J C6 G i Q C o W O ��i a� Q b) r - J /az - W ►w • I MIAMI SHORES VILLAGE PUBLIC WORK EVIE APPROVED 0- �E � -OPEN CU T EX. 2" P.E. GAS MAIN (1-3) 94TH ST -----15" W.M.-- Residence #1200 46' 01 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 6" 6. CONTRACTOR SHALL SOFT STREETS) DIG TO VERIFY LOCATION OF EXISTING UTILITIES MAIN SOD RESTORATION DETAIL SCALE: NOT TO SCALE TIE—IN TO EX. GAS MAIN WITH T. T. / E. F. V. N R W 15' SWALE E.O.P. t - 21 —50' E.O.P. 14� SWALE — Q_ W I S R/W I T 0 `i wJ 94TH ST LOCATION MAP (N.T.S.) ff PROP. 1 1/4 LEGEND /� PLASTIC GAS SVC. 1' l' q M CENTER LINE MONUMENT LINE VIA OPEN CUT. RAW P/L RIGHT OF WAY PROPERTY LINE E.O.P. EDGE OF PAVEMENT PROP. RISER T. T. E.F. V. TAPPING TEE EXCESS FLOW VALVE LOCATION WITH 1 S SVC SERVICE LINE SCALE:1"-20' 1 /4" PLASTIC GAS SVC. r� 50' - I� --N �-- --- ----'! --X-. GRID. RD. 7 --------------------- -- 1 �z7 61— ----------------- - ----------- 5 ----- _ -TI 5 I 5 O 00 w z "2 a P c� 2 CO E �0 0 rn a x E. 0 0 a a I 1 c i 36" MIN. 5" W.M. i 4 3 cis4 1 ALL EXISTING UTILITIES SHOWN 2 EXISTING UTILITIES SHOWN ON THIS ON THESE PLANS ARE TO BE I X. 2" P.E. PLAN ARE FROM GPR INFORMATION CONSIDERED APPROXIMATE & 1 GAS MAIN (1-3) PROVIDED BY MI —TECH SHOULD BE VERIFIED BY THE CONTRACTOR PRIOR TO THE ROP. 1 114" PLASTIC 0 1 START OF WORK OPERATIONS. GAS SVC. VIA OPEN CUT PROFILE CROSSING 94TH ST 4 r W O a 3 o 5 Q 4m■ I 1 vWi � o � I0 law. 1 —1 NO. OR SHEM: 1 SCALE: 1 :40 (V) 1 "=1' (H) 1 "=2' gHM No. 1 N O SHEET TABLE OF CONTENTS I General Notes, TTC Tables Definitions Temporary Traffic Control Devices Overhead Work 2 Railroads Sight Distance Above Ground Hazard Clear Zone Widths For Work Zones Superelevation Length Of Lane Closures 3 Overweight/Oversize Vehicles Lane Widths High -Visibility Safety Apparel Speed Reduction Signing Flagger Control 4 Survey Work Zones Signs 5 Work Zone Sign Supports 6 Commonly Used Warning and Regulatory Signs In Work Zones Manholes/Crosswalks/Joints Truck Mounted Attenuators Signals 7 Channelizing Devices Channelizing Devices Consistency Advanced Warning Arrow Boards 8 Drop -Offs In Work Zones Business Entrance 9 Temporary Asphalt Separator Channelizing Devices Notes 10 Temporary Barrier Notes 11 Pavement Markings 1200 NE 94TH ST MIAMI SHORES FL 33138 GENERAL NOTES: 1. This Index contains information specific to the Federal and State guidelines and standards for the preparation of traffic control plans and for the execution of traffic control in work zones, for construction and maintenance operations and utility work on highways, roads and streets on the State Highway System. Certain requirements in this Index are based on the high volume nature of State Highways. For highways, roads and streets off the State Highway System, the local agency (City/County) having jurisdiction may adopt requirements based on the minimum requirements provided in the MUTCD. 2. Use this Index in accordance with the Plans and Indexes 102-601 through 102-680.Indexes 102-601 through 102-680 are Department -specific typical applications of commonly encountered situations. Adjust device location or number thereof as recommended by the Worksite Traffic Supervisor and approved by the Engineer. Devices include, but are not limited to, flaggers, portable temporary signals, signs, pavement markings, and channelizing devices. Comply with MUTCD or applicable Department criteria for any changes and document the reason for the change. 3. Except for emergencies, any road closure on State Highway System must comply with Section 335.25, F.S. TABLE I CHANNELIZING DEVICE SPACING Work Zone Speed (mph) Max. Spacing (feet) Cones or Temporary Tubular Markers Type I Barricades, Type 11 Barricades, Vertical Panels, or Drums Taper Tangent Taper Tangent < 45 25 50 25 50 >_ 50 25 50 50 100 TABLE 3 WORK ZONE SIGN SPACING "X" Road Type Min. Spacing (feet) Arterials and Collectors with 200 Work Zone S eed <_ 40 m h Arterials and Collectors with 500 Work Zone Speed z 45 mph Limited Access Roadways * 1,500 * For Limited access roadways with work zone speeds 55 mph, the minimum spacing may be reduced in accordance with the MUTCD and as approved by the Engineer. TABLE 2 TAPER LENGTH "L" Work Zone Min. Speed (mph) Length (feet) s 40 L = 60z >_45 L= WS Where: W = width of offset in feet S = speed in mph TABLE 4 BUFFER LENGTH "B" Work Zone Speed (mph) Min. Length (feet) 25 155 30 200 35 250 40 305 45 360 50 425 55 495 60 570 65 645 70 730 Note: When Buffer Length "B" cannot be attained due to geometric constraints, use the greatest length possible, but not less than 155 feet. LAST DESCRIPTION: FY 2023-24 INDEX SHEET REVISION �, FDOTT GENIERAL IINFORMATIION FOR TRAIF]FHC 11101120 w �r STANDARD PLANS CONTROL THROUGH WORK ZONES 102-600 ]of 11 NOTE: 1. This Index applies to Two -Lane, Two -Way and Multilane Roadways, including Medians of divided roadways, with work on the shoulder. 2. L = Taper Length X = Work Zone Sign Spacing B = Buffer Length See Index 102-600 for 'T", "X", "B", and channelizing device spacing values. 3. Where work activities are between 2' and 15' from the edge of traveled way, the Engineer may omit signs and channelizing devices for work operations 60 minutes or less. 4. When four or more work vehicles enter the through traffic lanes in a one hour period (excluding establishing and terminating the work area), use a flagger or lane closure to accommodate work vehicle ingress and egress. 5. For work less than 2' from the traveled way and work zone speed is greater than 45 MPH, use a lane closure. 6. The "Speeding Fines Doubled When Workers Present" signs (MOT-73-06) and "End Road Work" Signs (G20-2) along with the associated work zone sign spacing distances may be omitted when the work operation is in place for 24 hours or less. 7. Temporary pavement markings may be omitted when the work operation is in place for 3 days or less. B. Omit "Shoulder Closed" signs (W21-5a) along with associated work zone sign spacing distances for work on the median. 9. When there is no paved shoulder, the "Worker" sign (W21-1) may be used instead of the "Shoulder Closed" sign (W21-5a). SYMBOLS: ® Work Area ■ Channelizing Device (See Index 102-600) D Work Zone Sign Lane Identification and Direction of Traffic 1200 NE 94TH ST MIAMI SHORES FL 33138 MOT-73-06 (See Note 6) FDOTT This Certifies that �`� ORLANDO DAGER Has Completed a Florida Department of Transportation Approved Temporary Traffic Control (TTC) Advanced Course. Date Expires: 11/12/2024 Instructor: Juan Morales ATSSA Phone: 540-368-1701 15 Riverside Parkway Ste.100 Fredericksburg, VA, www.atssa.com jessica.scheyder@atssa.com G20-2 (See Note 6) END ROAD WORK 94TH ST ■■ ■ ��77, X X L/3 X LF ROAD RIGHT WORK SHOULDER �G20-2 AHEAD CLOSED W20-1F W21-5a (See Note 6) Certificate # 67357 FDOT Provider # 37 SAFER ROADS SAVE LIVES TWO-LANE ROADWAY SHOULDER WORK BETWEEN 2' AND 15' FROM THE TRAVELED WAY W20-I F W20-1 F ROAD WORK AHEAD N LAST I Z DESCRIPTION: FY 2023-24 INDEX SHEET REVISION FDOTT TWO-LANE AND MU LTIIILANE WORK ON SHOULDER 11/01/21 Uj �- STANDARD PLANCr S ' 102-602 1 of 2 _ 0= - t o Vki- 0 5 O o i > m w0w e � 0? O 0 02 rn 00 G] z F U F pq 0 Ea a.f r lw a g _ , w'�w"_„ a---•. -. +, sue` ��� � W W P'" O t a V �t a O ll 4i 'ar 0 u r �IL 3E eo _r w o � w z a o. NO. OF SHEETS: 1 SHEET NO.: 1 ClqConstruction Trades ualifying Board JSINESS CERTIFICATE OF COMPETENCY E2100068 'EOPL.ES GAS SYSTEM INC .B.A.: QUANT, ANGEL Is certified under the provisions of Chapter 10 of Miami -Dade County AcoR" CERTIFICATE OF LIABILITY INSURANCE DATD/YYYY) 5/21/2 5/21 /2023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). Marsh Canada Limited 120 Bremner Blvd Suite 800 , PHONE 1-866-616-0088 (A/C, No, Ext (A/C No): 416-349-4564 EMAIL Toronto, ON M5J OA8 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Associated Electric & Gas Ins. Svcs. AA-3190004 INSURED INSURER B: Associated Electric & Gas Ins. Svcs. AA-3190004 INSURER C: Associated Electric & Gas Ins. Svcs. AA-3190004 Peoples Gas System 702 N. Franklin St. Tampa, FL 33602 INSURER D: INSURER E: LM Insurance Corporation 42404 INSURER F: COVERAGES CERTIFICATE NUMBER: 23/24-035- GAEW REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYY LIMITS A X COMMERCIAL GENERAL LIABILITY X CLAIMS -MADE F—IOCCUR XL5692907P 06/01/2023 06/01/2024 EACH OCCURRENCE $1,000,000 DTo TED PREM SES Ea otccu"ence $ X MED EXP(Any one person) $ SIR $1,000,000 PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $1,000,000 PRO- POLICY JECT ❑ Lot -PRODUCTS - COMP/OP AGG $ $ OTHER B AUTOMOBILE LIABILITY AS 1-B71-171271-013 06/01/2023 06/01/2024 COMBINED SINGLE LIMIT Ea accident $1,000,000 X ANYAUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIREDAUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ C UMBRELLA LIAB OCCUR XL5692907P 06/01/2023 06/01/2024 EACH OCCURRENCE $1�000�000 X EXCESS LIAB X CLAIMS -MADE AGGREGATE $1,000,000 DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN Employers Liability: ER OTH- XISTATUTE I JER E.L. EACH ACCIDENT $1,000,000 Y PROPRIETOR/PARTNER/EXECUTIVE FFICER/MEMBER EXCLUDED? NO XL5692907P E Mandatory in NH) f yes, describe under ESCRIPTION OF OPERATIONS below N/A ExcessWorkers' Excess Workers' Compensation: 06/01/2023 06/01/2024 E.L. DISEASE - EA EMPLOYEE $1,000,000 EW5-B7N-171272-023 06/01/2023 06/01/2024 E.L. DISEASE -POLICY LIMIT $1,000,000 SIR $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) License #E1608 Excess Liability policy provides insurance in excess of Peoples Gas System's Self -Insured Retention as stated above. The above noted policy placements were made by Marsh USA Inc. Marsh Canada Limited has only acted in the role of a consultant to the client with respect to these placements, which are indicated here for your convenience. CEKT IFICATE HOLDER CANCELLATION Miami Shores Village Bldg. Dept. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE 10050 NE 2nd Ave EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH Miami Shores FL 33138 THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved.