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PW-11-13381 Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 Parcel Number Applicant 9343 NE 9 Place Miami Shores, FL 1132050070110 Block: Lot: MUSLIMA LEWIS 1 Owner Information MUSLIMA LEWIS Address 9343 NE 9 Place MIAMI FL 33138- Phone CeII Contractor(s) Phone Cell Phone TECO PEOPLES GAS SYSTEM (305)957 -3857 (305)970 -1783 Valuation: Total Sq Feet: Scanning: 1 Fees Due CCF DBPR Fee DBPR Fee DCA Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.60 $2.00 $0.00 $0.00 $2.00 $0.20 $100.00 $8.00 $0.80 $111.60 Pay Date Pay Type Invoice # PL- 7- 11-41547 07/25/2011 Check #: 1429 08/04/2011 Check #: 1443 Amt Paid Amt Due $ 50.00 $ 61.60 $ 61.60 $ 0.00 $ 900.00 Available Inspections: Inspection Type: Final Press Test 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. August 04, 2011 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy Date August 04, 2011 1 - `.1 L IUL. 6 2011 Miami Shores Village Public Works Department 10050 N.E. 2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax (305) 756.8972 Public Works Permit Application FBC 2004 Perron Type: Ptibffe Works WATER P-44144-15% phones: (Yr_f) (it 36 Zip Job Address (Where the work is being done) 0104.k 41 /A/ �& 0 cra/Cc4 AN E-4A,V. er, 73‘47 City Miami Shores Village County Miami Dade zip ,93 188' Is Building Historically Designated: YES NO . Contractoes Company Name /4"--49 Pqa165 Gr-1-5 Contractors Address /5-7 04 .2.47-44-71-/Ae0021,4- ,64k: phone*: 970 re7,- State Zip 33/4"0 Architect/Engineries Name (if appllcable) Phone t $ Value of Work For this Permit . # ?Oa " Ltheal.Footage Of Woric joo• Type of Work: Describe Work: t;7/;,50a Or a 7-0_ .12,:eec 770 /Itz A/ea- A/eA, 5twc' c.efo EY'r'-'r •," /1 .5 av14."5 sAzr-e., "A.1 ./-776,%/1--- "Ve. /g"./ 0 Addition CI Alteration Er New 0 Repair/Replace 0 Dernorttion .***14.11.0.1....1.1. Fee, 1 rHar.r1HHH..11.11... Submittal Fee $ Permit Fee $ 77 0 CCF $ CO/CC Notary $ Training/Education Fee $ Technology Fee $ Scanning $ Radon $ zoning Bond $ Code Enforcement $ Structural Plan Review $ Total Fee Now Due $ (Continued an opposite side) Bonding Company's Name (if applicable) Bonding.Company's Address N/A City State 7i Mortgage Lender's Name (if applicable) N/A Mortgage Lender's Address City State Tp 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 con�idion 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 CbNDmONERS, ETC .... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all appficabie 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 applicant must pnmrise in good faith that a copy of the notice of commencement and construction Geri law bmchwo will be cielivered to the person whose prapo►tyis subject M attachment Also, a certified copy of the recorded notice of commencement must be risked at the fob sde forihe brat inspection which occurs seven (7) days after the building pant* is. issued. In the• absence of such posted notice. Ure Inspection will not be approved end a reinspection fee will be charged Signature l Signature The foregoing instrument was a Owner or Agent Contractor ed be : me this 2Z The foregoing instrument was admowtedged before me this zZ TZC eXday of 7 Z , 2ll by `i7 hAff Who is personalty kn r me or has produced . n and who did take an oath. on and who did take an oath. APPLICATION APPROVED BY: 11/17/2005 My Commission Expires: Public Works Director or his designee. .NCO U® CERTIFICATE OF LIABILITY INSURANCE DATE (MMJDD/Y1FY6 06/29/2011 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 po Icyf(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement oh this certificate does not 'confer rights to the certificate holder in.IIou of such endorsement(s)... . PRODUCER MCGRiFF, SEIBELS 8: WILLIAMS, INC. P.O. Box 10265 Birmingham, AL 35202 CONTACT NAME:- P(A/C HONE No Exn: 800476_.2211 E-MAIL ADDRESS: FAX (A/C, No): INSURER(S) AFFORDING COVERAGE NAIC # INSURER A Associated Electric & Gas ins. Svcs. INSURED Peoples Gas System TECO Energy, Inc. P.O. Box 111 Tampa, FL 33601 INSURER B :Uberty Insurance Corp. INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES • CERTIFICATE NUMBER:FSZM/JAB 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 CONDITIONC)F 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 SUBR VVVD POLICY NUMBER POLICY EFF (M D/YYYY) GENERAL UABiIJTY COMMERCIAL GENERAL LIABILITY X I CLAIMS-MADE n OCCUR A GEN'L AGGREGATE LIMIT APPLIES PER: —] POLICY n ERC n LOG AUTOMOBILE:UABILiTY ANY AUTO' ALL OWNED AUTOS HIRED AUTOS A X0521A1A11 Self: Insured Retention $1,000;000 07/01/201.1 POLICY EXP (MMIDD/YYYY) 07/01/2012 I:iMirs EACH OCCURRENCE • DAMAGEIO.RENTED .PREMISES (Ea akun'ence). MEU•EXP (My one person). • PERSONAL & ADV INJURY . GENERAL AGGREGATE PRODUCTS- COMP/OP AGO . 1,000,000 $ 1,000,000 uMBRELLALb(B _ occuR X Excess LAB X cLNMB-MADE DED I I RETENTION $ X0521AIA11 $Self-Insured Retention X0521A1A1'f 07/01/2011 07/01/2012 COMBINED. SINGLE LIMIT (Ea actldent) . 1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Peraccldent) . 0770112011 01/01/2012 EACH OCCURRENCE AGGREGATE 1,000,000 1,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERiEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y/N N/A ORLS I I ETORY LIMITS R EL. EACH ACCIDENT EL DISEASE - EA EMPLOYEE EL. DISEASE - POLICY LIMIT B EXCESS WC Excess Workers' Compensation EW584N004918121 07/01/2011 07/01/2012 Each Accident or Each Employee for Disease $ $ $ 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEIUCLES (Attach ACORD 1b1, Additional Remarks Schedule, if more space Is required) Excess Liability policy provides Insurance In excess of Peeples Gas System's Self - Insured Retention as stated above. CERTIFICATE HOLDER CANCELLATION City of Miami Shores 10050 NE 2nd Ave Miami Shores, FL 33138 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEJVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) Page 1 of 1 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CTQB Construction Trades Qualifying Board BUSINESS CERTIFICATE OF COMPETENCY E1608 PEOPLES GAS SYSTEM INC D.B.A.: VEGA JESTS S Is certified under the provisions of Chaplet 10 of Miami-Dada County VALID FOR CONTRACTING UNTIL 09/30/2011 QUALIFYING TRADE(S) 0014 FUEL TRANS & DISTRI • vy 0 0 0,0. 0 . .0 :0:0: ; .0: 0 :0:0: : 0'0 0 0 .0 , . :0:0: . . 0 0 0 0 0 0 0 0 • .0:0 0: 0 ".0 0:0: 0' 0.0 0 . 0 : :0 :0: 0 :0 .0: 0 :0 .0. : 0', 0' 0'0,0'0: 0 '0 :0 • 0 '0: 0: : 0 SO 0:0'0'0 '0: 0: 0 :0:0 ; 0: 0:0: 0: 0 0 :0:0: 0 • 0 • ' • 0' RAFFS ;,t,i • -'0.11.ii.:40.":41f,,,i)-.;•;31.,(4-: kl] G° UTHO. N U.S.A. 0evide Spacing-Taper liBirle1CPBETWEB1 . ' Spes+i ..;i• 2 SHINS Spaying (ft.) Type d •or Type Il Barricades or Vertical Pants or Drums .. ! %: .:E21mm11mt® Tenor Tangent =raAP.T.0 °10 50 20. 50 £"fxsI1EEl .' 0 20 100 Te i7AA0':WfIRK :I;iiIILE egn.may be, used. oa rin'.atlatnate to :the 'ROAO'WEIRI( AHEAD • • • xac•..50o" titiyMd-dhe. ROAD .WORK AHEAD sear, s py,between- igns whichever *es BE. PREPARED ':TO 'E7W sign may be omitted lar- speeds :of 45 MPH or -lase. '!. Work dpenatra ..'.CQni7+mtl ^ta'.'•4ne::trttffir -open to. t!<af5c. • 2. AdottionsioneltWay-aantralia* be effeetewiftly;the. .111 Pegr.rapyiftg;wiiiiittlarif21.0fgaialitehiekit r.4) mot Miktat. 4) traffic signals. ,the .100171 tit ehe-WOY Sign: i tX 1 it t8" ar, nd Orange Flog Aid Type- B;bigttt e .CharentifflhglieticestStie Index No. 600) Qt luoi* Zane `Sign. Flogger. .AlitamatedF,ingger Assistance. Devices AFADl,:.% With -Bate Lane ldgatlffc 'than: i ..Din cs of Traffic 3 . the L -LvW &i.tlx•>3tT be logy <aovered ono tivik- G .s ;either r •or.futy core ed'`w* , ng"Arg1* 10.-Ifsing,P0forzied otaf -•the highway fs: toen to #ate- way'trattJa.. 4-When o-sttis ,Oad'fgtaraects ?htr-4.dgAaoy- whit, -the. TTC zorfe.:: d tfdfidf>T=TC-. ;desaces Shaiibe.`Woceet-In •accordace:-dth''eUr •app bl8 t62•,indexes. MITES 5. The two cnaeteLting devices directly in front of the work area and the one channefxing device drerby of the end of the work area may be omitted provided vehicles in the work area have high- intensity rotating. positing, oscillating, or strobe tights operating. 6. For general TCZ reennrements and addifionalinformation, refer to Index 14o. 600. DU?AT111■ NOTES 1. ROAD WORK AHEAD and the BE PREPARED TO STOP signs may lie omitted it allot the following conditions ore met of Work operations ore 50 minutes or fess- b1 Speed Emit is 45 mph or less. el No sight obstructions to vehicles approaching the -work area for o distance etxrat to the buffer space dl Vehicles in the work oreo hove high- intensity, roloting, tloshhrg, osc5loting, or strobe tights operating. at Volume and complexity of the roadway has been considered. BUFFER SPACE Speed Dist. :mph: I11. 25 155 200 250 0 c 45 50 55 50 360 425 495 1 570 65 645 70 730 1 When Butter Space cannot be attained due to geometric constraints, the greatest attainable length shaltbe used, but not less anon 200 ft. CONDITIONS WHERE ANY VEHICLE. EQUIPMENT, WORKERS OR THEIR ACTIVITIES ENCROACH THE AREA BETWEEN THE CENTERLINE ANC A L1I5 2• DOTS THE EEI F OF TRAVEL. WAY. 94'3 ,v 9' ' 4& WWi, iii 2010 FOOT ' Spes+i ..;i• 2 .... Iliec OJStpnae Between :devices tit.) Cones a . Tub 7".^ -' • Type d •or Type Il Barricades or Vertical Pants or Drums Tangent Tenor Tangent :25: tp 4S °10 50 20. 50 ..SO , to 70 %.:,, '•.: .' 0 20 100 '!. Work dpenatra ..'.CQni7+mtl ^ta'.'•4ne::trttffir -open to. t!<af5c. • 2. AdottionsioneltWay-aantralia* be effeetewiftly;the. .111 Pegr.rapyiftg;wiiiiittlarif21.0fgaialitehiekit r.4) mot Miktat. 4) traffic signals. ,the .100171 tit ehe-WOY Sign: i tX 1 it t8" ar, nd Orange Flog Aid Type- B;bigttt e .CharentifflhglieticestStie Index No. 600) Qt luoi* Zane `Sign. Flogger. .AlitamatedF,ingger Assistance. Devices AFADl,:.% With -Bate Lane ldgatlffc 'than: i ..Din cs of Traffic 3 . the L -LvW &i.tlx•>3tT be logy <aovered ono tivik- G .s ;either r •or.futy core ed'`w* , ng"Arg1* 10.-Ifsing,P0forzied otaf -•the highway fs: toen to #ate- way'trattJa.. 4-When o-sttis ,Oad'fgtaraects ?htr-4.dgAaoy- whit, -the. TTC zorfe.:: d tfdfidf>T=TC-. ;desaces Shaiibe.`Woceet-In •accordace:-dth''eUr •app bl8 t62•,indexes. MITES 5. The two cnaeteLting devices directly in front of the work area and the one channefxing device drerby of the end of the work area may be omitted provided vehicles in the work area have high- intensity rotating. positing, oscillating, or strobe tights operating. 6. For general TCZ reennrements and addifionalinformation, refer to Index 14o. 600. DU?AT111■ NOTES 1. ROAD WORK AHEAD and the BE PREPARED TO STOP signs may lie omitted it allot the following conditions ore met of Work operations ore 50 minutes or fess- b1 Speed Emit is 45 mph or less. el No sight obstructions to vehicles approaching the -work area for o distance etxrat to the buffer space dl Vehicles in the work oreo hove high- intensity, roloting, tloshhrg, osc5loting, or strobe tights operating. at Volume and complexity of the roadway has been considered. BUFFER SPACE Speed Dist. :mph: I11. 25 155 200 250 0 c 45 50 55 50 360 425 495 1 570 65 645 70 730 1 When Butter Space cannot be attained due to geometric constraints, the greatest attainable length shaltbe used, but not less anon 200 ft. CONDITIONS WHERE ANY VEHICLE. EQUIPMENT, WORKERS OR THEIR ACTIVITIES ENCROACH THE AREA BETWEEN THE CENTERLINE ANC A L1I5 2• DOTS THE EEI F OF TRAVEL. WAY. 94'3 ,v 9' ' 4& WWi, iii 2010 FOOT PROP RISER /METER SET LOCATION PROR DIRECTIONAL BORE 3/4" PLASTIC GAS SERVICE FROM EXISTING 2 PL GAS MAIN TO RISER LOCATION ® 9343 N.E. 9TH PLACE MIAMI SHORES 9343 N.E 9TH PLACE MIAMISHORE ZI 1 GRASS SWALE i _q N. €s ic€-� E.O.P E.O.P - GAS - GAS- aS -d{S- GRASS SWALE 't i T.T /E.F /E.M© GAS MAI RESTORE GRASS SWALE TO CITY SPECS NO SIDE WALK E R/W I w - E.O.P 4.-14 SEWER 0 E.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. GAS . GAS GAS - GAS.-- GAS - GAS - GAS - GAS - GAS likv NO SIDE WALK EXISTINI•; 2" PLASTIC GAS MAIN LEGE D 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 ra,11110LIRSBEFOREYW MIN R.ORIDN ITS T SLAM 1- 800 -43 -4770 8TATB ONB CALL OP R.OBmA OC W R/W 0 4' GRASS RESTORATION GRASS RESTORATION DETAIL SCALE: NOT TO SCALE 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 UTIUTIES. PEOPLES GAS TECO / PEOPLES GAS - N. MIAMI OPERATIONS 9343 N.E.9TH PLACE MIAMI SHORES WORKING IN GRASS SWALE PROPOSED 3/4" P.E. GAS SERVICE DRAWN SLM 1 SCALE: 1' = 50' I DATE 7 /22/11 SHEET 1 of 1 k: .T, ?. • �... &0. PROP RISER /METER SET LOCATION PROR DIRECTIONAL BORE 3/4" PLASTIC GAS SERVICE FROM EXISTING 2 PL GAS MAIN TO RISER LOCATION 9343 N.E. 9TH PLACE MIAMI SHORES • 9343 N.E 9TH PLACE MIAMISHORE ' hi ic GRASS SWALE * 17, II F • t•Li E R/W .•••■■■,0 NO SIDE WALK 0.P E.O.P V - GU GU OAS ea GRASS SWALE T.T/E.F/E.ME, GAS MAI RESTORE GRASS SWALE TO CITY SPECS 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. E.O.P Gas "tiA3 GIS OM Cia GM CAS GU NO SIDE WAU< — — — — EXISTING 2" PLASTIC GAS MAIN 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 W R/W 4' GRASS RESTORATION GRASS RESTORATION DETAIL SCALE: NOT TO SCALE 21 11-15,5 Miami Shores Village APPROVED BY DATE ZONING DEPT BLDG DEPT S1JBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND COUNTY RULES AleiREGUI ATIONS [ NO LANE OF TRAFFIC TO BE BLOCCNED OR DISTURBS) 1 -CONTRACTOR S3-IALL SOFT DIG TO VERIFY LOCATION OF EXISTING UTILITIES. 2-MAINTAIN A MINIMUN HORIZONTAL SEPARATION OF • FROM ANY CITY UTILFRES. 3-MAINTAIN A !AMUR VERTICAL OF ANY CITY UTILITIES. IT SCALE: 1° = 59' DATE 7 /22/11 SHEET 1 of 1