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PL-10-872Project Address Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number 1183 NE 91 Terrace Miami Shores, FL 33138- 1132050010200 Block: Lot: ANTHONY FERNANDEZ 1 Address Contractor(s) Phone Cell Phone TECO PEOPLES GAS SYSTEM (305)957 -3857 (305)970 -1783 Phone ANTHONY FERNANDEZ 1183 NE 91 Terrace MIAMI SHORES FL 33138- I Type of Work: GAS MAIN Type of Piping: GAS Additional Info: PLUMBING Bond Retum : Classification: Residential , , Fees Due CCF Education Surcharge Permit Fee - AdditionslAlterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $150.00 $3.00 $0.80 $154.60 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy , Amt Paid Amt Due Pay Date Pay Type Invoice # PL -5-10 -37913 05/26/2010 Check #: 5598 $ 104.60 $ 50.00 05/17/2010 Check #: 5396 $ 50.00 $ 0.00 Applicant Valuation: Total Sq Feet: $ 600.00 0 1 Available Inspections: , Inspection Type: Final Press Test ROW 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 and zoning. Futhermore, I authorize the above -named contractor to do the work stated. May 26, 2010 Date CeII May 26, 2010 1 Inspection Number: INSP - 143596 Permit Number: PL -5 -10 -872 Scheduled Inspection Date: June 18, 2010 Inspector: Hernandez, Rafael Owner: FERNANDEZ, ANTHONY Job Address: 1183 NE 91 Terrace Miami Shores, FL 33138- Project: <NONE> Contractor: TECO PEOPLES GAS SYSTEM Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments June 17, 2010 For Inspections please call: (305)762 -4949 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Gas Phone Number Parcel Number 1132050010200 Phone: (305)957 -3857 Page 3 of 8 05/17.1Z010 11:45 2.5 (lb WILDING PERMIT AP LICATION FBC 2004 Permit Type (circle): Building Electrical Owner's blame (Fee Simple Titleholder) ' ' 1 , /a Owner's Address // 83 N-4 // Sr . 7E44. City....41.e1,,., • J State P/ Zip 33r 3k T i nt'Leasee Name • Phone # • (FAX) P.0011002 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (30S) 756.8972 • Permit No. Master Permit No. ' Plumbing 1Vfechanicaal Roofing Phone # ?8'6 87d Sr «a Job Address (where the work is being done) / 1 A/ 1 1 sr re - City _ , M i a m i S h o r e s County y l a m i - D a d e zip 3 3 1 3 8' FOLIO /PARCEL# // 326Soo/ QZ.00 • Is Building ITietorlcafy Designated YES NO Contractor's Company Name 7E ts; CO /d S Contractor's Address / r 9 �✓�sr 7 7 Phone # City A/a ar7/- M..js,,• Rd/ State �"/ Zip /o Architect/Engineer's Name (if applicable) Value of Work For this Permit S Type of Work: [Addition Qualifier Name 1/ Phone # 9a S SZo 1373 State Certificate or Registration No. Certificate of Competency No. / 6 6 $ ❑Alteration ONew Describe Work • i�• 4 i30• t= Aft .F1 p /A3nc_ Phone # Square / Linear Footage Of Worlc • 24 en& i.v 42a.$S Swa -Co 3o g' 97o /973 ❑ Repair/Replace ❑ Demolition .k12 v&e-1 tom L rr.r7 2� `t c-2 /0 Go-rw."—) t� drL Ic. / i is �to�pS �t�Q, p Submittal Fee $ Permit Fee $ Notary Training/Education Fee $ C� Scanning $ a � Rados $ Technology Fee $ ^ ITC S . Zoning S Bomd $ Code Enforcement $ Structural Review. S CO /CC Double Fee $ Total Fee Now Due 5 e, L ( • L See Reverse side —• 0511212010 11:45 Bonding Compaq's Name (if applicable) Bonding Company's Address City Mortgage Lender's Name (if applicable) Mortgage Lender's Address , City State Zi Application Is hereby made to obtain a•pentit to do the work and Installations as indioatpd, 1 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 regulating construotion in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS. and AIR CONDITIONERS, ETC..... • 'OWNER'S AFFIDAVIT: I citify that alt' the foregoing Information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OP COMMENCEMENT MAY RESULT IN YOUR PAYING • TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, .CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant,' Asa condition to the issuance of a building permit with an estimated value exceeding $2500, 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 attachment Also, a versified 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 building permit is issued • In the absence of such posted notice, the inspection will not be approved and o reinspection fee will be charged SignatureS+o Owner or A . prod The forego day of who is parse orw As rdentl 1 n NOTARY PUBLIC Sign: ?tint: My Commission Expires: ***** +v********e4fY************* ** ********a►4,e***hM*erae***** *A***9F ********* ******* *********Stands **it***** *******a APPLICATION APPROVED BY: (Revised 02/08/06) Zip Contractor /y The foregoing instrument was a • , wled , 'ore me this ' ° day of �// . 20 J b who is personally lino , to me o has produ -i who did take an oath. identWScation and who take an oath. NOTARY ' UBLIC: flOO SmEMMIMIM P.0021002 Plans Examiner Engineer Zoning ACORD„ PRODUCER MCGRIFF, SEIBELS & WILLIAMS, INC. P.O. Box 10265 Birmingham, AL 35202 800 - 475.2211 INSURED Peoples C System TECO Energy, Inc. PO. Box 111 Tampa, FL 33601 TYPE OF INSURANCE GENERAL LIABILITY © Commercial General Liability 0 Ciaime Made ❑ occurrence ❑ Owners' and Contractors' Protection O General Aggnagale Limit applies per: PoBCy 0 Protect Ostia, A AUTOMOBILE LIABILITY 0 Any Automobile ❑ All Owned Automobiles ❑ Scheduled Automobiles [] Hired Automobiles ri Non•owned Automobiles U WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY A EXCESS LIABILITY El Occurrence ® Claims Made CERTIFICATE HOLDER City of Miami Shores 10050 NE 2nd Ave Miami Shores, FL 33138 X0521A1A09 POLICY NUMBER EFFECTIVE EXPIRATION X0521A1A09 Self-Insured Retention 1,000,000 X0521A1A09 Self - Insured Retention $250,000 FIRE DAMAGE MEDICAL EXPENSE ISSUE DATE 1.000, 1,000,000 1 1,000,000 CERTIFICATE OF INSURANCE This certificate is issued as a matter of information only and comers no rights upon the Certificate Holder. This Certificate does not amend, extend or after the coverage afforded by the policies below Co A nY Assodated Electric & Gas In Svcs Company B Company Company • D Company E This is to certify that the policies of insurance described herein have been issued to the Insured named herein for the potfcy period hxficated. Notwithstanding any requirement, term or condition of contract or other document with respect to which this certificate may be issued or may pertain, the Durance afforded by the policies described herein is subject to all the terms, conditions and exclusions of such policies. Limits shown may have been reduced by paid claims. 07/01/2009 EACH OCCURRENCE 11100,000 07/01/2010 07/01/2009 07/01/2010 07/01/2009 07/01/2010 COMPANIES AFFORDING COVERAGE Authorized Representative Excess Liability policy provides insurance in excess of Peoples Gas System's Self- Insured Retention as stated above LIMITS OF LIABILITY PERS. AND ADVERTISING INJU GENERAL AGGREGATE PRODUCTS AND COMP OPER. AGG. COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accide ) PROPERTY DAMAGE (Per accident). COMPREHENSIVE COLLISION WC Statutory LtmitJ Other 1 F EL EACH ACCIDENT EL DISEASE (Each employee) EL DISEASE (Policy Limit) EACH OCCURRENCE AGGREGATE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Page of 1 Certificate ID to NXSPUN61 ACORD. 1 PRODUCER Associated Bach* & Gas Insurance Services Untried 1 Meadowlands Plaza East Rutherford, IQ 07013 INSURED Pimples Gas System Teco Energy. Inc. P.0.13ax 111 Tampa, FL 33091 WORKERS COMPENSATION AND EMPLOYERS LIABILITY EXCESS LIABILITY El OCCUVeritia Dc atnre esfette EXCESS WC Excess Wereers' ContpePesten CERTIFICATE HOLDER City of Miami Shores 10050 NE and Ave Miami Shores. FL 33138 CERTIFICATE OF INSURANCE CO521A1A09 This certfficate is issued as a mattered information only and confers no rights won the Certificate Hader. This Certhicate does Mt amend. extend or alter the coverage afforded by the pohcies below. Company Consery Company Company E 07/0112009 07/01/2010 WC COMPANIES AFFORDING COVERAGE Ccim Associated Electric & Gas his Svcs Ltd This is to certify that the pohcies of insurance desaibed herein have been issued to the Insured named herein for the poky period Medalled. Nabudhstamfang any requirement. term or condition of costract or other document whh respect to which this cedificate array be issued es may pertain, the insures= afforded by the policies described hack' h sidled to al the terms carnations and exclusic of such statics. Limits shown maw have been reduced by paid claims. CO TYPE OF INSURANCE POLICY NUMBER EFFECTIVE LIMITS OF LAMM° LT EXPIRATION GENERAL LIABILITY EACH OCCURRENCE G L o IM* FIRE DAMAGE 0 Mans Made 0 onciswirice MEDICAL EXPENSE o Owners" and Ontimars Prated= o PERS. AND ADVERTESING INJURY GENERAL AGGREGATE appgas pee PRODUCTS AND COMP OPER. AGO. $ Pelkbrinal Elligicasa AUTOISOBILE IJABILITY E Any AA:made Ali Crewed Autealgebtlas 0 &kedged AarinacheTas Riled AtIties PROPERTY DAMAGE Per aceiderili L temP-awned Automobiles COMPREHENSIVE COLLISION COMBINED SINGLE LIMIT BODILY INJURY Per person) EL EACH ACCIDENT EL DISEASE Mach employee) EL EACH OCCURRENCE AGGREGATE Each Accident or Each Employee for Disease ISSUE DATE 1 013fJ0i2009 1,000,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCIaLIED BEFORE Athorized Representative u THE EXPIRATION EWE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO ANY MO UPON THE INSURER TS AGENTS OR REPRESENTATIVES. , I MAIL. 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED 10 THE LEFT, BUT MILIURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF 4 1 -44.kk....o P 39e 1 of 1 Corti tz) o 1051t87XP CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY E1608 PEOPLES GAS SYSTEM INC D.B.A.: VEGA JESUS Is certified under the provisions of Chapter 10 of Miami -Dade County VALID FOR CONTRACTING UNTIL 09/30/2011 QUALIFYING TRADE(S) 0014 FUEL TRANS & DISTR! Herrninio Gonzalez P F Secretary of the Boaro Mlam -Dade County reams ell or.P.tv Nitta herein =SI www.nae9dPde. UldIngood! Location has attended the Florida Advanced Refresher Training Course 5frreiby recojitizes t AMERICAN TRAFFIC SAFETY SERVICES ASSOCIATION BAHR p un mEs This is w affirm that ID #37 Mr. Steven Mitchell has satisfactorily completed the Florida Advanced Work Zone Traffic Control Refresher Course Date Completed:9/10/2009 Status:Passed Final Location:Ft. Lauderdale, FL Instructor: Ms. Catherine G. Witt Date Refresher Course Required:9/10/2013 rainrng & Products Dept Director .Y.Weae4.746tori . ti.`,McitYtniX6' ef• '*' 0,t 11 Table II Taper Length - Shoulder Speed Y3L (ft) Cones or Tubular Markers (mph) 8' I0' 12' Notes 25 Shldr. Sh ldr. Shldr. 50 25 28 35 42 50 30 40 50 60 L= WS2 35 55 68 82 60 40 72 90 107 45 120 150 180 50 133 167 200 55 147 183 220 60 160 200 240 L= WS 65 173 217 260 70 187 233 280 Table I Device Spacing Speed m ( P Max. Distance Between Devices (ft.) Cones or Tubular Markers Type I or Type !1 Barricades or Vertical Panels or Drums Taper Tangent Taper Tangent 25 25 50 25 50 30 to 45 25 50 30 50 50 to 70 25 50 50 100 DISTANCE BETWEEN SIGNS Speed Spacing (ft.) A B 40 mph or less 200 200 45 mph 350 350 50 mph or greater 500 500 // f3 iLi="e .0 Sr- ; S *�� SYMBOLS ® Work Area Sign With 18" x 18" (Min.) Orange Flag And Type B Light 0' b Work Zone Sign END ROAD WORK ROAD WORK AHEAD SPEEDIND FINES DOMED SEEN TONERS PRESENT ■ ■ ■ ■ ■ ■ ■ ■ ■ • • • / / / / / / / /// ■ Taper Length = %L Work Area j See Table 1 / / / / / / / / /// / Device Spacing -Toper Device Spacing - Tangent See Table I END ROAD WORK * 500' beyond the ROAD WORK AHEAD sign or midway between signs whichever is less. ■ Chonnelizing Device (See Index No. 600) Lane Identification * Direction of Traffic => 7—C,t/7-T- See Table GENERAL NOTES 1. When four or more work vehicles enter the through traffic lanes in a one hour period or less (excluding establishing and terminating the work area), the advanced FLAGGER sign shall be substituted for the WORKERS sign. For location of floggers and FLAGGER signs, see Index No. 603. 2. WORKERS sign to be removed or fully covered when no work is being performed. 3. SHOULDER WORK sign may be used as on alternate to the WORKER symbol sign only on the side where the shoulder work is being performed. 4. When a side road intersects the highway within the TTC zone, additional 7TC devices shall be placed in accordance with other applicable TCZ Indexes. 5. For general TCZ requirements and additional information, refer to Index No. 600. b to DURATIOIK —'N B -47-" 1. Signs and c anndliimgdevi es ay mifted={f all of the following conditions ale 1 a) Work operations are minutes or less. b) Vehicles in the work area have high - intensity, rotating, flashing, oscillating, or strobe lights operating. 2010 FOOT Din Standards 8' minimum shoulder width %3L= Length of shoulder taper in feet W= Width of tato!shoulder in feet (combined paved and unpaved width) S= Posted speed limit (mph) TWO -LANE TWO -WAY, WORK ON SHOULDER CONDITIONS WHERE ANY VEHICLE, EQUIPMENT, WORKERS OR THEIR ACTIVITIES ENCROACH THE AREA CLOSER THAN 15'BUT NOT CLOSER THAN 2' TO THE EDGE OF TRAVEL WAY. Revis i on Shoot No. 07/01/07 1 of Index No. 6 02 1183 N,E.91 MIAMI SHO T TERR ES END OF GAS MAIN 3' MAX SOD RESTORATION DETAIL SCALE: NOT TO SCALE w 1 0 0 DETAIL GS PROP 3/4 " PER COFTL 4. NO FM 5. NO WM, AIR PROFILES. 6. NO DRAINAGE. PROP RISER METER SET LOCATION G/S EXIST, 2 "CS GAS MAIN NOTES CONSTRUCTION 1. LOCATE AND PROTECT ALL UTILITIES IN AREA OF CONSTRUCTION. SUNSHINE # 1 -800- 432 -4770 2. RESTORE ALL AREAS TO PRIOR CONDITIONS 3. ALL CONSTRUCTION TO FOLLOW JURISDICTIONAL GOVERNMENT AND TPG STANDARDS. NO APPLICATIONS SUBMITTED FOR: 6. DEWATERING ( ABOVE W TABLE). 7. TRAFFIC STRIPS OR LOOPS. C. B. S WALL LEGEND R/W RIGHT OF WAY P/L PROPERTY LINE T/T TAPPING TEE EFV EXCESS FLOW VALVE SVC SERVICE LINE SP STEEL PLASTIC COAT PE POLYETHELENE E.O.P E.O.P j rI V v . ( i N 1183 ME 81ST TERF MIAMI, SHORES GRASS END OF 2 "CS GAS MAI GRASS SWALE NO SIDE WALK Q1 EXISTING 2" CS GAS MAIN T prop riser /meter set location PROP BORE 3/4" PLASTIC GAS SERVICE / RISE LOCATION 2" CS GAS TO RISER t R LOCAT10P1 ®118 N.E.91ST .E.91ST 81ST TEE RR MIAMI SHORES WORKING IN GRASS SWALE T.T/T.F/E.F /E.M4) GAS MAN N R /W_ • L N -94S TE GRASS SWALE NO SIDE WALK PRIOPBMB OAS rT 1 Shores \ i!1 ,7, 7.0`.' _ I P 1 . 7 3 DTPT =CT O CCrviPLIAI‘dCE WITH ALL FECE ,AL ... _._ Cr _,F1t.I sY ∎-?! (I Ff, AFJD PRO, J ATI( wa— ar— ao— ea— on— ao— ®— ®— ae- tee.— co —ea —a� �.a.— NO LANE OF TRAFFIC TO BE BLOCCKED OR DISTURBED 1— CONTRACTOR SHALL SOFT DIG TO VERIFY LOCATKIN OF EXISTING UTIUTIES, 2— MAINTAIN A MINIMUN HORIZONTAL SEPARATION OF 5' FROM ANY CITY UTILITIES. 3— MAINTAIN A MINIMUN VERTICAL SEPARATION OF 18" OF ANY CITY UTILITIES. 183 N.E.9IST TER MIAMI SHORES WORKING IN GRASS SWALE PROPOSED 3/4" P.E. GAS SERVICE tritilOrei S R/W SY TECO / FEOPLES GS - N. NAM OPERAT1O'1S SCALE: 1' = 5 i i D A T E 5 /12/IO Silkt I 1 O11 Na q I sr -ERR LEAIRVCD! LOS Diameter 2 IMIatexia1: CS Presswe Type: Y' Location Description Li'S Located?: NO job Nme: As- Buil: Wednesday, May 12, 2010 11:28 AM LEAKSRVCD: LD5 Diarneter 2 Mete:id: !S Presstue Type: I -3 Loc. tsonDescripticsn: GPS Located?: NO J u'o Name: .:s -Built: Wednesday, May 12, 2010 11:28 AM N 1183 N,E.91 ' T TERR MIAMI SHO ES END OF GAS MAIN 3' MAX SOD RESTORATION DETAIL SCALE: NOT TO SCALE CVS an w I 0 m .1 DETAIL PROP 3/4 PER COFTL 4. NO FM 5. NO WM, AIR PROFILES. 6. NO DRAINAGE. G/ S EXISTI 2 » CS GAS MAIN NOTES CONSTRUCTION 1. LOCATE AND PROTECT ALL UTILITIES IN AREA OF CONSTRUCTION. SUNSHINE # 1 — 800 - 432 -4770 2. RESTORE ALL AREAS TO PRIOR CONDITIONS 3. ALL CONSTRUCTION TO FOLLOW JURISDICTIONAL 6 " GOVERNMENT AND TPG STANDARDS. NO APPLICATIONS SUBMITTED FOR: 6. DEWATERING ( ABOVE W TABLE). 7. TRAFFIC STRIPS OR LOOPS. PROP RISER METER SET LOCATION C.B.S WALL LEGEND R/W RIGHT OF WAY P/L PROPERTY LINE T/T TAPPING TEE EFV EXCESS FLOW VALVE SVC SERVICE LINE SP STEEL PLASTIC COAT PE POLYETHELENE 1183 N.E 91ST TERR MIAMI SHORES GRASS E.O.P pp�� a TEu �R E.O.P END OF 2 "CS GAS MAI EXISTING 2" CS GAS MAIN pt,G PEOPLES GAS T i 0 'CC NIPI DANCE WITH ALL FEDERAL AND REGULATIONS 0 lam ! I S'nores prop riser /meter set location D ATE PROP BORE 3/4" PLASTIC GAS SERVICE FROM EXISTING 2" CS GAS MAIN TO RISER LOCATION 01183 N.E.91ST TERR MIAMI SHORES WORKING IN GRASS SWALE N R /W LAI S R/W T.T/T.F/E.F /E.M0 GAS MAIN N.E-9-1-ST—TERR NO LANE OF TRAFFIC TO BE BLOCCKED OR DISTURBED 1— CONTRACTOR SHALL SOFT DIG TO VERIFY LOCATION OF EXISTING UTILITIES. 2— MAINTAIN A MINIMUN HORIZONTAL SEPARATION OF 5' FROM ANY CITY UTILITIES. 3— MAINTAIN A MINIMUN VERTICAL SEPARATION OF 18" OF ANY CITY UTILITIES. ® —® eo ®—an - ee — ® as — I TECO / PEOPLES GAS -14. MIAMI OPERATIONS 183 N.E.91ST TERR MIAMI SHORES WORKING IN GRASS SWALE PROPOSED 3/4" P.E. GAS SERVICE SCALE: 1' ='SS' DATE S I12/1O SHEET 1 of 1