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PW-13-1775 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-196719 Permit Number: PW-8-13-1776 Scheduled inspection Date: November 12, 2013 Permit Type: Public Works Inspector: Diaz, Osvaldo Inspection Type: Final Owner: JULIANA MIRANDA,PAUL ADAN Work Classification: Public Works Job Address:500 NE 97 Street Miami Shores,FL 33138- Phone Number Parcel Number 1132060171540 Project: <NONE> Contractor: TECO PEOPLES GAS SYSTEM Phone:(305)957-3857 Building Department Comments INSTALLATION OF 300'OF 2" PLASTIC MAIN AND 50'OF Infractio Passed Comments 314" PLASTIC GAS SERVICE INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed ❑ ll'1Z''L Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-inspection fee is paid. November 08,2013 For Inspections please call: (305)762-4949 Page 7 of 37 1 r AUG 0a 6 cv i3 1 'aunt Shores Vi Public Works Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 Public woks pRXn-1 Permit Application FBC 2004 Permit Type: Pubrm works (h� Owner's Name(Fee Simple Tittehokl"er) /G u I�A Ptmne r C,2� 333-17J'7 owner's Address_ .diel A& :p7 � S� city state / L �J zip�.?3/.��61 TenwwLessee Name Pion d/�-- I Job Address(where the work is being dale, city litiami a—yltiage County, Wand Dade Zip :3VA? Is BuffdbV Hlatoricallyr Designated: YES NO �( contrac;toes company Name �EC� J',�,m.�/a s (7 t..: Pira,e s�,5_y y.S3-D79 S` Contractor's Address `s/Q e _AI V �/ s� ±.t�S-4, VS city z4- state I�cG rm 333 D 4 Archilect/Emgineer's Nam(ii applicable) Pion t $Vakre of Wok For thhr Permit 11x1 D a Linew Foote Of wall—Iibp Type of Work: ❑Addition Q Alteratfan New ❑R rtRepiaoe ❑ Dernam Describe Work: „►d se x- 02 t ....................Fees"'......'........" Submittal Fee$ permit Fee S ��� CCF$ Co= Notary$ Traioing/Education Fee$ Technology Fee$ Scanning$ Radon$ lotting Bond$ Code Enforcement i (F StarNAUral Plan Review$ Total Fee Nov Due$ t (Continued on opposite side) Bonding Company's Name(if applicable) Bonding Ce,,opany's Address NIA City State Zip Mortgage Lender's Name(if applicable) WA Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and'installations as indicated.l 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 an 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 an 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 appftsnt must promise in good faith that a copy of the notice of commencement and c onstnic ion then law brochure wHl be delivered to On person whose property is subjed to attachment Also,a certified copy of the recorded notice of commencement must be pasted at tee job sae for on fast inspection which occurs seven(7)days after the bwlffing permit is issued.In the absence of such posted notice,the inspechm well nd be approved and a reinspedion fee wfp be charged Signature Signature Owner or Agent Contractor The foregoing Instrument was acknowledged before me this The foregoing instrument was admmowlsdged before me this day of 20 i' ,y day of 20_-q by who is personally known to me or who has produced Wh rsonany know a or has produced as identification and who did take an oath. as iderilificallorm and who did take an oath. NOTARY PUBLIC: NOTARY C: Sign: Sign: Print: Print: My Commission Expires: �iyU p,ns RRO •, .Nt;`� twla�►I1111Ye-We of Florida •c Oct 6.2017 ° FF 27304 op. ,;• 01 I �na�aryorAssn. APPLICATION APPROVED BY: his designee. 11/17/2005 GamiTOB n T Oullitying wed a BUSINESS CERTIRCATE OF COMPETENCY E160 EOPLES GAS SYSTEM INC D.8A.. J4 VEGAJESOS Is oWWW urgW U a of C h 10 of MWW-Oodo my QUALIFYING TRADE(S) 0014 FUEL TRANS&DISTRI r1• ,'I r� . Charles Darvar P.E. m wwwarkormate.&ecectar g efhM Board BavPoaUdng. AIIC R CERTIFICATE OF LIABILITY INSURANCE DA 6/21203' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPONTHE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTERTHE COVERAGE AFFORDED BYTHE 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 pollcy(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 on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT MCGRIFF,SEIBELS&WILLIAMS,INC. PHONE FAX f P.O.Box 10265 AIC No Ext:800-476-2211 A/C No): Birmingham,AL 35202 ADDRESS: i INSURER(S)AFFORDING COVERAGE NAIC# INSURER A Zurich American Insurance company 16535 INSURED INSURERS Associated Electric&Gas Ins.Svcs. Peoples Gas System TECO Energy,Inc. INSURER c:LM Insurance Corporation 33600 702 North Franklin Street Tampa,FL 33602 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:N6LH82KL 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 ADDLSUBR POLICY EFF POLICY EXP LIMBS LTR TYPE OF INSURANCE I g WVD POLICY NUMBER M/DD MIDD B GENERAL LIABILITY XL5129402P 07/01/2013 07/01/2014 EACH OCCURRENCE $ 1,000,000 Self-Insured Retention X COMMERCIAL GENERAL LIABILITY $1,000,000 PREMISES Ea occurrence $ X CLAIMS-MADE OCCUR MED EXP(Arty one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ -1 JEcT E-1 POLICY PRO LOC $ B AUTOMOBILE LIABILnY XL5129402P 07!01!2013 07/0112014 COMBINED SINGLE LIMIT 1,000,000 Self-Insured Retention Ea accident X ANY AUTO $250,000 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NON-OWNED PP accident) DAMAGE $ HIREDAUTOS AUTOS B UMBRELLA LIAB OCCUR XL5129402P 07/01/2013 07/0112014 EACH OCCURRENCE $ 1,000,000 X EXCESS LU18 X CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ $ A WORKERS COMPENSATION Excess WOrkerS'Comp O ensaton: 07!01!2013 07/01/2014 X RY LATU of B AND EMPLOYERS'LIABILITY Y/N EWS9318597-02(Statutory Limit is T S ANY PROPRIETOR/PARTNERIEXECUTIVE excess of$35,000,000 insured by LM E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N 1 A insurance Corporation) 1,000,000 (Mandatory In NH) Employer's Liability:XL5129402P E.L.DISEASE-EA EMPLOYEE $ If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Excess Workers'Compensation EW5-64N-004918-123 07101/2013 07/0112014 Each Accident or Each Employee for Disease $ 35,000,000 $ $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Excess Liability policy provides insurance in excess of Peoples Gas System's Self-Insured Retention as stated above. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Miami Shores AUTHORIZED REPRESENTATIVE 10050 NE 2nd Ave Miami Shores,FL 33138 Page 1 of 1 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD P RE 'ROADS PREPARED `�'ONELANE sgeeot12 PINES „" WORK ����q� ■■■�fff j',TO STOP, ` ROAD r galeLr D / ',,% HEAD WHEN¢ � `AHEAD �. ' ROl+D WORK Buffer Space D See Table 5D 15D C B A b � . Work Area� b N END ROAD'— D Device Sparing-Tangent `� ROaD WORK WORK S..Table 7 AHEAD /i �I Device Spacing-Taper ONE LAW See Table 1 ROAD BE p7pN u Ens AHEAD, PREPAREDy� 'i� - - TO STOP ` DISTANCE BETWEEN SIGNS TABLE i DEVICE SPACING BUFFER SPACE Speed Spacing(ft.) Max.Distance Between Devices(R.) Speed Dist. (mph) A B C D (mph) (ft.) 40 or less 200 200 %0 100 Speed Cones or Type I or Type 17 45 350 350 35D 175 (mph) Tubular Markers Barricades or Vertical 25 155 Panels or Drums 30 200 50 500 500 500' 250 Taper Tangent Taper Tangent 35 150 55 or greater 2640 1640 1000 500 25 to 45 20 50 20 50 40 305 > *The ROAD WORK 1 MILE sign may be used as 50 to 70 20 50 20 100 45 360 ° an alternate to the ROAD WORK AHEAD sign. 50 425 •`.500'beyond the ROAD WORK AHEAD sign or GENERAL NOTES DURATION NOTES 55___!95 g midway between signs whichever is less. 1.Work operations shall be confined to one traffic lane,leaving the opposite lane 1.ROAD WORK AHEAD and the BE PREPARED TO STOP signs may 60 570 9 **•BE PREPARED TO STOP sign may be omitted open to traffic. be omitted if all of the following conditions are met: 55 645 for speeds of 45 MPH or less. a.Work operations are 60 minutes or less. 70 730 2.Additional one-way control may be effected by the following means: b.Speed limit Is 45 mph or less. 1.Flag-carrying vehicle; c.No sight obstructions to vehicles approaching the work area When Buffer Space cannot 2.Official vehicle; for a distance equal to the buffer space. be attained due to geometric 3.Pilot vehicles; d.Vehicles in the work area have high-Intensity,rotating, constraints,the greatest 4.Traffic signals. flashing,oscillating,or strobe lights operating. attainable length shall be <' SYMBOLS e.volume and complexity of the roadway has been considered. used,but not less than 200 ft. 93 When flaggers are the sole means of one-way,control,the flaggers shall be in Work Area sight of each Other or in direct communication at all times. 3.The ONE-LANE ROAD signs are to be fully covered and the FLAGGER signs either Sign With 18*x 18" (Ml..) removed or fully covered when no work is being performed and the highway is Orange Flag And Type B Light open to two-way traffic. CONDITIONS IN Channehzing Device(See Index No.600) 4.When a side road Intersects the highway within the TTC zone,additional TTC devices shall be placed in accordance with other applicable TCZ Indexes. WHERE ANY VEHICLE,EQUIPMENT, [p Work Zone Sign WORKERS OR THEIR ACTNITIES S.The two channeltzing devices directly In from of the work area and the one ENCROACH THE AREA BETWEEN ET' Flagger channeltzing device directly at the end of the work area may be omitted provided THE CENTERLINE AND A LINE Y Automated Flagger Assistance Devices vetdcles in the work area have high-Intensity rotating,flashing,oscillating,or OUTSIDE THE EDGE OF TRAVEL WAY. (AFAD),With Gate strobe lights operating. R Lane Identification+Direction of Traffic 6.For general TCZ requirements and additional information,refer to Index No.600. LAST 2 DESCRIPTION: INDEX SHEET REVISION ° FDOT DESIGN STANDARDS TWO-LANE, TWO-WAY, No. NO. 0 /01/09 FY 201212013 WORE W1TH3 THE TRAVEL WAY 603 1 iv d N - R/W C/L _ — �3' N L 17AU6 -~r---,7 6 �v I v) W a° N Y - AVE I a BY. I TIE IN P OP M IN POP T y v � 34" PE S TIE IN SV MAIN W p Vi r { K g , . PROP. 50' OF 3/4" PLASTIC GAS t s _' SVC TO BE DIRECTIONAL BORED a v * - PROP. 218' OF 2" PLASTIC GAS MAIN TO BE DIRECTIONAL BORED RO "_ E OR q R ALLEY SCALE: 1"= 50' woRlzoNTaL :3 20' wA _ 1"= 5' VERTICAL R v �q / W try yy 4 f A r V. ALLEY ° TIE IN SVC TO GAS MAIN I I � to { - � WITH T.T. / E.F.V. s 1 Y` �� �° TI I P OP M IN ` �k ' PROP. 81' OF 2" PLASTIC GAS ; Y A MAIN TO BE DIRECTIONAL BORED PR DP. 2 Ej B E in c"N A R ID i a 80' TIE IN PROP. GAS MAIN TO I I " u R/W EXIST. 2" PE E 24' E OF C/L EXIST. GAS'MAIN WITH DIRECT TIE IN 77r L,I a -.2-2013 NE 5TH AVE SCALE: 1 1.= S' CALL 603 Miami Shores VfflagO REt9s/ON.£ APPROVED By DATE a.- RESTORATION OF ROAD arc 70NING DEPT LEGEND: FOR UTILITY CROSSING 3 I.uft I 13L.DG DEPT$AFMU R/W - RIGHT OF WAY GDOMAL NOTM AooRIGt1At NOTES SWAM SWA S 9BRACEMM y »= 50' P/L - PROPERTY UNE SUBJECT TO COMPLIANCE WITH ALL FEDERAL I. REPLACED BASE MATERIAL OVER ARCH SHALL BE TWKS: THE B. CONTRACTOR SNAIL SOFT DIG TO VERIFY LOCATION T �� CA - CENTERLINE THICKNESS OF THE BASE. MIN. 8" AND MAX. 18" OF EXISTING UTILITIES Z. BASE MATERIAL SNALL BE PLACED IN B' MAX. (LOOSE MEASUREMENT) 7. MAINTAIN A MINIMUM HORIZONTAL SEPARATION OF 2T STATE AND COUNTY RULES AND REGULATIONS AtL E.O.P. - EDGE OF PAVEMENT tsWN wawa o LAYER AND EACH LAYER THOROUGHLY ROLLED OR TAMPED TO 98% � S' FROM ANY CITY UTILITIES (rta twE�tJ ts' Dm twIN M ts' E.O.B. - EDGE OF BUILDING MAX. DENSITY PER AASHTO T-180 8. MAINTAIN A MINIMUM VERTICAL SEPARATION OF 18" � �F T.T. - TAPPING TEE 3. ASPHALT CONCRETE PAVEMENT JOINTS SHALL. BE MECHANICALLY SAWED FROM ANY CITY UTILITIES 4. SURFACE MATERIAL SHALL BE CONSISTENT WITH SURROUNDING SURFACE E.F.Y. - EXCESS FLOW VALVE MATS 0 25 50 0 SVC - SERVICE LINE 5. BASE MATERIAL SHALL HAVE A MIN. LBR OF 100 AND A MIN. CARBONATE SVC • CONTENT OF 7OX (8056 FOR LOCAL STREETS) ts• tY Feet