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PW-10-1207Protect Address 441 GRAND CONCOURSE Miami Shores, FL 1132060170310 Block: Lot: PRISCILLA BEATTY Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number 441 GRAND CONCOURSE MIAMI SHORES FL 33138 -2462 Contractor(s) Phone Cell Phone TECO PEOPLES GAS SYSTEM (305)957 -3857 (305)970 -1783 Scanning: 3 Fees Due CCF Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $150.00 $9.00 $0.80 $160.60 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. Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Pay Date Pay Type Amt Paid Amt Due Invoice # PW -7 -10 -38320 07/01/2010 Check #: 5997 $ 50.00 $ 110.60 07/09/2010 Check #: 6007 $ 110.60 $ 0.00 Applicant Valuation: Total Sq Feet: $ 900.00 20 1 July 09, 2010 Date Available Inspections: Inspection Type: Final Excavation 1 July 09, 2010 1 Scheduled Inspection Date: July 28, 2010 Inspector: Hernandez, Rafael Owner: BEATTY, PRISCILLA Job Address: 441 GRAND CONCOURSE Miami Shores, FL Project: <NONE> Contractor: TECO PEOPLES GAS SYSTEM Building Department Comments July 27, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 147577 Permit Number: PW -7 -10 -1207 For Inspections please call: (305)762 -4949 Permit Type: Public Works Inspection Type: Final Work Classification: Public Works Phone Number Parcel Number 1132060170310 Phone: (305)957 -3857 PROPOSED 20 OF 3/4 PLASTIC GAS SERVICE BORE TO GET TO RISER LOCATION WORKING ALLEY WAY. RESTORE ASPHALT TO CITY SPECIFICATIONS Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 13 of 31 Public Works Permit Application FBC 2004 Owner's Type: Public Works WATER 15 /YAP �� ^ rs Name (Fee Simple Titleholder) 'A7 ,o ��/� fit- � Owners ` O I.CJ/SS/�� -5. cit / eddi F State r� Tenant/Lessee Name Job Address (where the work is being done) / ` / �/� t 7 7/ ly l✓(✓ C,U O U � City Miami Shores Village County Miami Dade Zip ) 33 � �J Is Building Historically Designated: Contractors Company Name Contractors Address /5 779 city Architect/Engineers Name (if appli able) $ Value of Work For this Permit Submittal Fee i Notary: Scanning $ ct Code Enforcement $ Total Fee Now Due (Continued on opposite side) JUL WS?) 0 9 2010 gli Miami Shores Village BY' Public Works Department 10050 N.E. 2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax (305) 756.8972 YES ,..,amn- Fees It**It.1111**.1111..11.. Permit Fee $ NO f Phone d: Phase t Phone d: PenultNo. 10_ I20—) Zip 33 /3 g 17S,0 in (AS) tlitACIAA„ 305- 970 -1373 zip 3340 Phone S: Lineal Footage O/ Work l() '07s / a c4 Type of Work ❑ Addition ❑ New ❑ Repair/Replace ❑ Demolition Describe Watt <),/0,5e70 0 OF 3 9 &Vie G/vc &O c( &Re /V 6ET •s✓\. d l lfIMIINNlf ll MlWl .( Training/Education Fee $ 070 Radon $ Structural Plan Review $ CCF$ Zoning c <De CO/CC Technology Fee $ lv' • lTO Bard $ Bonding Company% Name (if applicable) Bonding Coinpanys Address City , State Mortgage Lender's Name (if applicable) Mortgage Lenders Address City Signature The foregoing Instrument was acknowledged before me this 3C My Commission Expires: APPLICATION APPROVED BY: 11/172005 Owner or Agent as identification and who did take an oath. LW) 1 State Application is hereby made to obtain a permit to do the work 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 regulating construction 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 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. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF 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 As a condition to this issuance of a Public Works permit with an estimated value exceeding $2500, the appfrcant 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 properly is subject to attachment Also, a certified copy of the recorded notice of commencement must be posted at the job she 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 a reinspeclion fee wit be charged ARY PUBLIC: My Commission Expires: Contractor • The foregoing instrument was acknowledged before me this 3 c) _ by 65 64 4-5 day of , 20,/ 6 by F.s •tom VE'C me or who has produced to me or has produced as identification and who did take an oath. Sign: Sig Print: Print Public Works Director or his designee. 0014 Hemrtdrtio Gonzalez P. E. t•y. Secretary of the Board ; 9t ' s-- • M and-Dede Caady retairo ®A property darts heredl CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY E1608 PEOPLES GAS SYSTEM INC DBA• J n, VEGAJESUS Is certified under the provisions of Chapter 10 of Mlaml -Dade County VALID FOR CONTRACTING UNTIL 09/30/2011 QUALIFYING TRADE(S) FUEL TRANS & DISTRI MI wrer.odaaddade. PRODUCER MCGRIFF, SEIBELS & WILUAMS. INC. P.O. Box 10265 Birmingham, AL 35202 800-476-2211 INSURED Peoples Gas System TECO Energy, Inc. PO. Box 111 Tampa. FL 33601 This is to certify that the policies of insurance described herein have been issued to the Insured named herein for the policy period indicated. Notwithstanding any requirement term or condition of contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by -CO 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. TYPE OF INSURAN POUCY NUMBER EFFECTIVE — — LT A A ACORD„, GENERAL UABtLITY X0521A1A09 D Commercial General Liability Self-Insured Retention D Ciattris Made D Occurrence 1,000,000 D Owners: and Connectors: Protection 0 Genemi Aggregate Limit applies per: 0 Polio/ D Project DI-oration AUTOMOBILE UABILITY D Any Automobile D All Owned Automobiles 0 Scheduled Automobiles rj Hired Automobiles D Non.owned Automobiles LJ WORKERS COMPENSATION AND EMPLOYERS° LIABILITY A EXCESS LIABILITY [I occurrence 123cretme Made CERTIFICATE HOLDER City of Miami Shores 10050 NE 2nd Ave Miami Shores, FL 33138 CERTIFICATE OF INSURANCE X0521A1A09 Selt-Insured Retention $250,000 X0521A1A09 This certificate is issued as a matter of information only and ccarfers no rights upon the Certificate Holder. This Certificate does not amend, extend or after the coverage afforded by the policies below CornPanY Associated Etectrk & Gas Ins Svcs. A Company B Company C Company D Company E EXPIRATION 07/01/2009 07/01/2010 COMPANES AFFORDING COVERAGE EACH OCCURRENCE FIRE DAMAGE MEDICAL EXPENSE PERS. AND ADVERTISING INJURY GENERAL AGGREGATE PRODUCTS AND COMP. OPER. AGG. 07101/2009 COMBINED SINGLE LIMIT 07/01/2010 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) COMPREHENSIVE COLLISION WC Statutory umit ottier F f EL EACH ACCIDENT EL DISEASE (Each employee) _ELOBEASE_BticyliM4 07/01/2009 EACH OCCURRENCE 07/01/2010 AGGREGATE Excess Liability policy provides insurance in excess of Peoples Gas System's Self-Insured Retention as stated above. 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 REPRESENWIVES. Authorized Representative .• LOUTS OF LIABILITY ISSUE DATE 06/30P2009 1,000,000 Page 1 of 1 Certiftede ID # NXSPUN61 ACORD. CERTIFICATE OF INSURANCE PRODUCER Associated Electric & Gas Insurance Semites Limbed 1 Meadowlands Rama East Rultierlonl„ N107073 INSURED Peoples Gas System Teco Energy. Inc. PO. Box 111 Tampa, FL 33601 ----- This is to certify that the poticies of insurance described herein have been issued to the brewed named herein for tive policy period indicated. Nribehdancting any requirement term or condition of conked Or other docurrterd with respect tu adds td* certificate new be Waled or raw pertain, the insurance afforded by the pinkies described herek subied to al the terms, conditions wad exclusions el such policies. Limits shown may have been ireduCed by paid claims. CO LT TYPE OF INSURANCE POLICY NUMBER EFFECTIVE EXPIRATION GENERAL LIABILITY Ceencerciai Genoa! Uablfty o Mims undo Occserenee o Owes' and Cententrs Protect= 0 0 Gertend Amass*, Lend appals per D Optzosti Dutra= AUTO/608�.B LIABILITY Ll Any duEnnolde o AE Owned Aseconables o o o ScitedstedAlitornades Wed tedernenges N...-emed Aummetees WORKERS" COMPENSATION AND EMPLOYERS' LABILITY EXCESS UM:WTI( °Mamma DIataints Meta EXCESS WC Excess Wfwere C.ornsersidien CERTIFICATE HOLDER City of Miami Shores 10050 NE 2nd Ave Miami Shores, FL 33138 CO52/A1M9 Tlds certificate is issued as a matter of Inlomudien only and confers no rights upon the Cerifficatie Holtler. This Certdcate does not amend, extend or after the coverage afforded by the paces below. emPanY Associat' ed Electric & Gas Ins Svcs ltd A Company Corry D Cornpany Company E 07/0 07/0112010 Authorized Representable a 9e 1 of I EACH OCCURRENCE ARE DAMAGE MEDICAL EXPENSE PERS. AND ADVERTISING INJURY GENERAL AGGREGATE PRODUCTS AND COMP. OPER, AGG. 12 LL COMBINED SINGLE Il PROPERTY DAMAGE (Per accident/ COMPREHENSNE COLLISION WC Standoni Um& I 1 Other EL EACH ACCIDENT EL DISEASE (Each email:Ir EL EACH OCCURRENCE AGGREGATE Each Accident or Each Employee for Disease SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAIKER TO MAIL 30 DAYS WRITTEN NOTICE TO TEE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 50 SHALL IMPOSE NO OBLIGATION OR UABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. CORWAPMES AFFORDRIG COVERAGE LIMITS OF LIABIUTY fLY LiJ L» moo) ISSUE DATE 06f30f2009 A IDS Ft. Lauderdale, FL *.'zaio'''...,cgn.a'FwgP.:=>nanrcdnnns e rican rya Sa has aft- --, ded th Florida Advanced Refresher Trai • Cours ereby recognizes t MAN TRAFFIC SAFETY VICES ASS*CIATION SAFER ROHS SHE LIVES This is to affirm that rD #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 .;:n a4 4;n14.VM•in1 • • " " • • '•4 14: ad—E5 Executive Director Training & Products Dept. e41 Sea WES WI 44 Rights fiasenert 7 — , - LITHO. IN U.S.A 4'XFULL LANE RESTORATION SCALE: NOT TO SCALE SOD RESTORATION DETAIL YST_ PtCv -Al PA1401ET3i TRENCH EA EFT1.L€D 114 6" COMPACTED LIFTS TO DO% OE MAT,LESUM DEDEFF1 PER AAS4TO T -140 i iErFrALITC 4`ERE:R1',1G TAPES SlT. 26 NOTAITED 24' s3Evie, FSt T A 'T, yr °. E 40 t REEE E RPECTEICARON 2320 r r _^; 3 F c R E€LE T IEEE !'1I_ESS OT ;;%E i t D :£LE D TER;AL :.L 6 FR OE �'" STC C LAE€CEi 1 3 /6` ETA 5.RITELEOE ALL 2 61E tEPREADES A' U 1-464 Fr(T€EFOREE R EEs. k L €'[.T 1111181: F^,.,1Yt iESTC 2 € O:at7 DF, 61 TWO 11r12S Ulti +;!p.SSL "i'r {; #iS•;kl421 _ 10" FAY. .1b!0 'I 2 6!1 -6ED Bd 4 1 6 1 1 1- 4 1 0 CCF1PRCC D TO 9(,E4 02 EVERIMUPA DENSITY PER AFSE110 RIGHT OF WAY TRENCH REPAIR, MILLING, AND OVERLAY TYPICAL TRENCH AND PAVEMENT RESTORATION FOR TRANSVERSE CROSSING 1€€ €Y€3 . I FL r,F P46)4ED SEDUM \ MAMMAL UP TO 4PF@I061 —LIEGE Of PIPE T 1-RPI€WEER CACKEIL(. !1- 061PACTLD Ili 1 46. 1R441'D3%4TIE %1REE S =I<< 1 STREETS .P.ECT ( _ ".. SURFACE RESTORATION IN R/W ABOVE THE PIPE ZONE SAW CUT & APPLY TARR COAT TO ALL `:0 1114 AND EGt,2', IE.O.P 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. PER COFTL 4. NO FM 5. NO WM, AIR PROFILES. 6. NO DRAINAGE. NO APPLICATIONS SUBMITTED FOR: 6. DEWATERING ( ABOVE W TABLE). 7. TRAFFIC STRIPS OR LOOPS. PROP BORE 3/4" PLASTIC GAS SERVICE FROM EXISTING 2 "B.S.E GAS MAIN TO RISER LOCATION 0 41.1 GRAND CONCOURSE MIAMI SHORES/WORKING IN ALLEYWAY PROP RISER METER 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 UTIUTIES. 3— MAINTAIN A MINIMUN VERTICAL SEPARATION OF 18" OF ANY CITY UTIUTIES. T.T/T.F/E.F/E.M0 GAS MAIN —,--MIAMI SHORES 441 GRAND CONCOURSE GRRMB£9N@6tiR3E PEOPLES GAS m r L N R/W S R/W GRASS SWALE 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 STING 2 "C.S GAS MAIN TECO / PEOPLES GAS - N. MIAMI OPERATIONS 441 GRAND CONCOURSE MIAMI SHORES WORKING IN ALLEYWAY PROPOSED 3/4" P.E. GAS SERVICE am � 1 SCALE: 1° = 50' I DATE 6/29/10 I SHEET 1 of 1 ' --' - - ' P • MHami Shiores Village APPRC)VED ZONING DEPT RI.. DG DEPT BY DATE nLII Cr_ UAJCL !TH ALL FEDERAL L27 F"" LEAF CD L1L Diameter 2 alerial: C3 Pressure Type: I -3 LocationDescription- 4 14 RW CC'S Located?: NO Job Name: Tuesday, Jun 29, 2010 01:35 PM f terror osighwr• 4cce-sd urrty ly PlAsit-C4arlivit4,.