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PL-13-371 08-08-'13 06:43 FROM- T-645 P0003/0004 F-841 i Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax:(305)756-$972 Inspection Number: INSP-1966114 Permit Number: PL-2-13-371 Scheduled inspection Date:August 07, 2013 Permit Type: Plumbing -Residential Inspector: Diaz,Osvaldo Inspection Type: Final Owner: MARTINEZ,JUAN Work Classification: Gas Job Address:65 NE 907 Street Miami Shores, FL Phone Number Parcel Number 1121360070380 Project: <NONE> Contractor: TECO PEOPLES GAS SYSTEM Phone:(305)957-3857 I Building Department Comments gas lines Infractio Passe omments INSPECTOR COMMENTS False i Inspector Comments Passed CREATED AS REINSPECTION FOR INSP-186352. INSPECTION SCHEDULE Incorrectly F �,l3 Failed Correction Needed Re-Inspection D Fee No Additional Inspections can be Scheduled until re-inspection fee is paid. August 06,2013 For Inspections please call: (305)762-4949 Page 24 of 39 FED d3 {a . i Shores. /iltage u Public -orks Department 10056 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305}756.8972 2 Public Works Permit 7� Permit Application FBC 2004 Pen�it Typo: Public Works 1 Ownees Name(Fee Simple Titleholder) . .A .r . Phone A. Owners aka �S >C /d y. .f•L city ; .ter.c,g staled zta-� - -= . Tenard/Lessee Name Pawns r. .lob Address Wwre ft work is kxft dome) f-!r AlC ZAP !< JA city Nllaml snores vie Cat"" w'wrd Dade . / zip_„ I�/ W WHOM tflstarlc*Desigrmted: YES No V Cm tracb's Compatyr Name �C f n ..�,� iye-5 Pitt>rm A lY►S�_/ YJ,�`0 9 9 5� Comtra;tnes Address [,7/b city slaw zip Arch CVEngineers Name(If appt le) Phone S.. . E Velue.of Work For this Permit o4io5 Lkwal F atepOf Work. Type of Work: E)Aftw Qataratl� ,. CJ:R _. _. Describe Work I-aL� e9 • dwe. _16e. X6.5 SQ.rv:�tY ...,.....�..,..,,..Few _ SubmtBal Fee f Permit Fee$ CCF S CO= Notary$ TrainlroMdusadon Fee$ Technology Fee: Scanning S Radon$ zoning Bor4$ Code Enforaamamt$ sbuc war Pmt Raetear$ Total Fee,NOw Due$ J09 . 10 (Continued on opposite aide) i Bonding Companys Name(if applicable) Bonding Cceapanys Address WA City State zip Mortgage Lenders Name(if applic ) N/A Mortgage Lenders Address City State zip Application is hereby made to obtain a permit to do the work and installations as indicated.l certfijr Thad 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 conshuckan in the jurisdiction.I understand that a separate permit must be secured for ELECTRICAL WORK,PLU [BING,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 Midi be done in compliance with all applicable laws regulating.construction and zoning. "WARNING TO OWNER:YOUR FAILURE TO RECORD A NOTICE OF Ca NCEMENT MAY RESULT IN YOUR PAYING TWICE FOR WaIROVEMENTS TO YOUR PROPERTY.IF YOU]INTEND TO OBTAIN FINANCING,cQNSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Ak ffie to Aftw t As a cordition to this issuance of a Public Works permit with an esibnated vahm exceeding$2500,tine appffcaaf moat promise at goad fait;that a copy of go notice of convnermement and consbuc tian Ran law broahme w9 be delivered to the person whose properly is subject to atachment Aisn a carttfied copy of the recorded notice ot cormmeroer wd mustbe posted at ft job sft lards diet inspection which occurs seven(7)rays after tie buildh►g permit a issued In tits absence of surd►posted notice,the frWachm wfN not be approved and a reinspection tee wN be charged. Signature Signature Owner or Agent [ t`.orttrerxnt The foregoing Instrument was advowledged before me tafs-2-6 The foregoing instrument was before me flora day ofr'- 20A° by day of 20_,by who is personalty known ttoo me orw who has produced Whom know to me or hes produced__, . as klentifiration and who did take an oath. as kleaffication and who cfo talcs an oath: NOTARY.PUBLIC: NOTARY PUBLIC Sign: Sion; Print Ptirhk .4"~n 4 ' My Commission Expkas: MY ;f NAMOW JEW 74"F da In i a i w WIMIN APPLICATION APPROVED BY: ;- Public Worke Dicer or his designee. • 11/17/2005 V l Oi" c=uuoum Tram {t -Q Board BUSINESS CERTIFICATE OF COMPEMNIC; { ,: E1608 s P90PLES GAS INC VEGtA JESUB Is Q=urww.the aff.Astow of 70 of CamlY QUALIFYING TRADE(S) 0014 FUEL TRANS DISTRI etmof ftNI , . DATE(MMlDD/YYY1r) A ° CERTIFICATE OF LIABILITY INSURANCE DA06/29/2012 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 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 SUEROGATION 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. NAME' P.O.Box 10265 A/C No Ext:800-476-2211 A No: Birmingham,AL 35202 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC># INSURER A Zurich American Insurance Company 16535 INSURED INSURER B Associated Electric$Gas Ins.Svcs. Peoples Gas System TECO Energy,Inc. INSURER C:LM Insurance Corporation 33600 702 North Franklin Street Tampa,FL 33601 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:YL5N7YFU 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 TYPE OF INSURANCE ADDL S B POLICY EFF POLICY EXP LIMITS LTR g POLICY NUMBER MIDD B GENERAL LIABILITY XL6129401P 07/01/2012 07/01/2013 1,000,000 Self-insured Retention EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY $1,000,000 PREMISES Ea occurrence $ X CLAIMS-MADE D OCCUR MED EXP(Arty one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG -$- POLICY PRO- LOC $ B AUTOMOBILE LIABILITY XL51294 1 P 07/01/2012 07/01/2013 O BI dED SINGLE LIMIT 1;000,000 Self-Insured Retention $ X ANY AUTO $250,000 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident B UMBRELLA LIAB OCCUR XL5129401P 07/01/2012 07/01/2013 Self-Insured Retention EACH OCCURRENCE $ 1,000,000 X EXCESS LIAR X CLAIMS•MADE $1,000,000 - AGGREGATE $ 1,000,000 . DED RETENTION$ $ A WORKERS COMPENSATION EW 931.8593-01' 07/01/2012 07/01/2013 X wC STATU- OTH- B AND EMPLOYERS'LIABILITY YIN XL5129401 P T RY LIMRS , ANY PROPRIETOR/PARTNER/EXECUTIVE - E.L.EACH ACCIDENT- - -$ 1,000,000 OFFICERIMEMBER EXCLUDED? NIA - (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1;000,000 If yyeess describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C EXCESS WC EW5-64N-004918-122 07/01/2012 0710112013 Each Accident or Each Excess Workers'Compensation Employee for Disease $ 35,000,000 $ $ $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attech 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. WC Statutory Limit is excess of$35,000,000(insured by Liberty Insurance Corporation) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED.POLICIES BE CANCELI_Eb.BEFORE THE EXPIRATION DATETHEREOF,NOTICE WILL*BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Miami Shores AUTHORIZED REPRESENTATIVE 10050 NE 2nd Ave Miami Shores,FL.33138 �"""� '•'L°s'J� Page 1 of 1 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD TIE IN SVC TO GAS MAIN EXIST. 2" CS WITH T.T. / E.F.V. 5' S OF C/L '�•' f- > FED 013 0 25 50 w g IL r -- . Fe'et Q M iani hores Villa e N M k a ' APPROVED_ BY DATE (� o > DEPT — u r .r � 70NING z x :" .I m in w d N { _DG DEPT Q Q _ - ALLY _ 20' 0 R W SUBJECT i O CCNIPI.IPMCE WTrH ALL FEDERAL R/W - i` "` / z a .�.. r ,ATE AN U(I1N i r4bLES ND REGULATIONS. z a _ — 6� ° 7_�� � � G ALLEY P PROP. 90' OF 3/4" PLASTIC r " N5 Lj GAS SVC TO BE DIRECT_IONAL r" a 3 3:: .g BORED �- `n D: OA W to. to z F 2 ta7 C L e ai. R/W Q cc s W �RO< NE Q 7TH ST ix .*I u C/L ilw a WIN Fs Xj 0 Q �R/W w a s se POP 3 4" PE BO E w _ ! 2" CS G M N DA)r- 02-18-2013 SCALE: 1"= 10' HORIZONTAL AOT.• 1 5' VERTICAL 603 RESTORATION OF ROAD CUT LEGEND: FOR UTILITY CROSSING REY/S/OMB FLEA LANE f.• R/W - RIGHT OF WAY GENERAL NOTES: ADDITIONAL NOTES SURFACE S1gACE SAW CUT ASPHALT P/L PROPERTY LINE } 1. REPLACED BASE MATERIAL.OVER DITCH SHALL BE TWICE .THE 6. CONTRACTOR SHALL SOFT DIG TO VERIFY LOCATION C/L - CENTERLINE THICKNESS OF THE BASE, MIN. 8" AND MAX. 18" OF EXISTING UTILITIES 2T � S 2. BASE MATERIAL SHALL BE PLACED IN 6" MAX. (LOOSE MEASUREMENT) 7. MAINTAIN A MINIMUM HORIZONTAL SEPARATION OF 1"= 50' E.O.P. — EDGE OF PAVEMENT LAYER AND EACH LAYER THOROUGHLY ROLLED OR TAMPED TO 98% OF 5' FROM ANY CITY UTILITIES BASE (KEW MATERIAL) Ns' DITCH irIDT1N (er) Ns• E.O.B. – EDGE OF BUILDING MAX. DENSITY PER AASHTO T=180 8. MAINTAIN A MINIMUM VERTICAL SEPARATION OF 18" SYEET T.T. – TAPPING TEE 3. ASPHALT CONCRETE PAVEMENT JOINTS SHALL BE MECHANICALLY SAWED FROM ANY CITY UTILITIES tea. (; ITY COP 4. SURFACE MATERIAL SHALL BE CONSISTENT WITH SURROUNDING SURFACE E.F.V. – EXCESS FLOW VALVE MATERIAL 1 OF 1 5. BASE MATERIAL SHALL HAVE A MIN. LBR OF 100 AND A MIN. CARBONATE SVC – SERVICE LINE CONTENT OF 70% (60% FOR LOCAL STREETS) Na°M12" a v_ PREPARED ROAD` �ONEIANE SREDI'm rolls �% WORK TO STOP/r" � 02M HERS AHEAD ' EPiG - r PRESENT Iii p'nD-.NGav" I�" 1 Buffer Space D See Table ' SO 250 C B A a• • - Work Area / b' A B C f j t ROAD — D 1 Device Spacing-Tangent SOp =117 WORK � AHEAD Device spacing-Taper 1,Ng ONE LANE — See Table I �, ROAD BE .AHEAD PREPARED TO STOP . DISTANCE BETWEEN SIGNS TABLE i DEVICE SPACING BUFFER SPACE Speed Spacing fftJ Max.Distance Between Devices(ft.) Speed Dist. (mph) A B C D -(mphl (ft.) 40 or less 200 200! 200 100 Speed I Cones or Type f or Type if. Barricades or vertical - ZS" 155 45 350:350 350 175 -- (mph) Tubular Markers Panels or-Drums 200 50. 500 500 500 250 .Taper Tangent Taper Tangent -35 250 55 or rester 2640 7640 1000' 500 a 25 to 45 20 50 20 50 - _ 40_ 303 +The ROAD-WORK 1 AIILE sign may be used as $01.70 20 - 50 20 100 -45 360 an alternate t0 the ROAD WORK AHEAD sign. - ..--S6 425 • 5001 beyond the ROAD WORK AHEAD sign or GENERAL NOTES. DURATION NOTES 55 494 midway between signs whichever is less. );Work Operations shall.be confined t0 One traffic lone,leaving the opposite lane I.ROAD WORK AHEAD end the BE PREPARED TO STOP signs may "60 570 ••"BE'PREPARED TO STOP sign may be omitted open to traffic. be omitted If all of the following cond)tions are met: 'BT 645 _ for speeds of 45 MPH or less. a.Work operations are 60 minutes or Joss. 70 730 2.Additional one-way.control may be effected by the following means: b.Speed limit is 45 mph or/a". 4 - 1.Flag-tarrying vehicle; c.No sight obstructions to vehicles approaching the work area When Buffer Space cannot Z Off/dal vehicle; for a distance equhl to the buffer space. be attained due to geometric -3.Pilot vehicles: d.Vehicles In the work area have hlgh-Odenslty,rotating, .constraints,the greatest 4.Traffic signals. flashing,oscillating,or strobe lights operating. attainable length shall be 4 SYMBOLS e.Volume and complexity of the roadway has been considered. used,but not less.then 200 ft. 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 16•x 16° (Min.) 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 ■ fhannellzing Device(See Index No.600) 4.When a side road intersects the highway within the TTC zone.additional TTC " 3 devices shall be placed In accordance with other applicable.TCZ Indexes. WHERE ANY VEHICLE,EGUIPMENT, ^. Wort Zone Sign - WORKERS-OR THEIR ACrIVIriES 5.Me two channellzfng devices directly In front.of the work area and the one ENCROACH THE AREA BETWEEN Flagger chanhelizing device'directly at the end or the work area may be omitted provided ."THE'CENrERUNE AND A LINE 2 Automated Flagger Assistance Devices vehicles In the work area have high-Intensity rotating,flashing,oscillating,or .OU751DE 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 $ DRSCRTrtoN: F DESIGN"STANDARDS 1NDEx slierr REVIS/oN TWO-LANE, TWO-WAY, NO.. No. 07/01/08 FY.201212013 WORE WXTFIIRN THE TRAVEL WAY" 603 1