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PW-13-1551 08-23-'13 06:14 FROM- T-684 P0003/0003 F-933 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores,FL Phone: (305)795-2204 Fax: (305)758-8972 Inspection Number: INSP-195035 Permit Number: PW-7-13-1551 Scheduled Inspection Date:August 22,2013 Permit Type: Public Works Inspector: Diaz,Osvaldo Inspection Type: Final Owner: STANLEY SUMMER,ANASTASIA Work Classification: Public Works e: u..ne Job Address:408 co GRAND Concourse Miami Shores, FL 33138-2463 Phone Number 30617582542 Project: <NONE> Parcel Number' 1132060170090 Contractor: TECO PEOPLES GAS SYSTEM Phone:(305)957-3857 Building Department Comments NATURAL GAS INfractio Passe Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction Needed Re-Inspection ❑ Fee No Additional Inspections can be scheduled until re-Inspection fee Is paid. August 21,2013 For Inspections please call: (306)7624949 Page 11 of 38 Bonding Compartys Name(it applicable) Bonding Company s Address NIA City . State zip Mortgage Lenders Name(If applicable) NIA Mortgage Lenders 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 instadatm has commenced prior to the issuance of a permit and that all work vA be performed to meet the standards of an laws regulating construction in this jurisdiction,l understand that a separate permit must be secured for ELECTRICAL WORK,PLUMBING,SIGNS,WELLS,POOLS, FURNACES,BOILERS,HEATERS,TANKS and AIR CONDITIONERS,ETC.... OWNEWS 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 AppliCarrt As a c ond0on to this issuance of a Public Works permit with an estimated vakre exceeding$2=,time applicant must prwnise in good faith that a copy of the notice of comrawmement and construction ken law bmrhwe will be dehered to No person whose property is sttbf d to attachment Alm a cerfflbd copy of lice recorded notice of oornmenceirmst must be posted at the job ske for Ire Aist inspection which occurs seven(7)days after the building permit is issued.M the abseru a of such posted notice,the kapertion.w>7f not be approved and a rebrspection fee w$I be charged. Signature Signature Owner or Agent -I«pr The foregoing Instrument was aclumMedged before me this The foregoing Instrument was advowledged before me this day of 20 by day of .20_1'2 by who is personalty known to me or who has produosd Who is personally know to me or has produced,; as Identification and who did take an oath. as Werdification and who did take an oath. NOTARY PUBUC: NOTARY Sign: Sign: Print: Print My Commission Expires: k c CWM*SjW b My Commission Fires. Ex C ww-6.2013 C/ APPLICATION APPROVED BY: 15 Pubk yyodm Direct"or his designee. 11117I2tm5 Co �i T 6i l3aard lautrNES earl eat COMPETENCY. El 608 PEOPLES GAS SYSTEM{ INC* v Jn VEGA JE"L`368 is aarW"unft ft ommum of cftw W of QUAUFYIN®TRADE(S) 0014 FUEL TRANS&DISTRI t - ChuMa Conger RE. t��f » Sea�t'y�UtiBoaM ... A� CERTIFICATE OF LIABILITY INSURANCE 6/21/2013m 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 certi sate holder Is an ADDITIONAL INSURED,the policy(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 Ileu of such endomement(s). PRODUCER CONTACT MCGRIFF,SEIBELS&WILLIAMS,INC. �E' P.O.BOX 10265 PHC No Ext:800 d76 2211 C No): Birmingham,AL 35202 E-MAIL ADDRESS: INSURE s)AFFORDING COVERAGE NAIC E 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 33602 INSURER D: INSURER E; L] 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 POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MIDD M/DD LIMBS B GENERAL LIABILITY XL5129402P 0710112013 07/0112014 EACH OCCURRENCE $ 1,000,000 Self-Insured Retention X COMMERCIAL GENERAL LIABILITY $1,000,000 PREMISES Ea occurrence $ X CLAIMS-MADE F]OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY I I PRO LOC $ B AUTOMOBILE LIABILITY XL5129402P 07101/2013 07/01/2014 COMBINED SINGLE LIMIT Self-Insured Retention Ea scddeM 1,000,000 X ANY AUTO $250,000 BODILY INJURY(Per person) $ �OOSWNED SCTOESDULED BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ I AUTOS Per accident B UMBRELLA LIAR OCCUR XL5129402P 07/01/2013 0710112014 EACH OCCURRENCE $ 1,000,000 X EXCESS LIAR X CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ $ A WORKERS COMPENSATION Excess Workers'Compensation: 07/01/2013 07101/2014 X oCY uM s 0 R B AND EMPLOYERS'LIABILITY YIN EWS9318597-02(Stadrtory Limit is ANY PROPRIETOR/PARTNEREXECUTIVE excess of$35,000,000 insured by LM EL.EACH ACCIDENT - $ -1,000,000 OFFICER/MEMBEREXCLUDED? NIA Insurance Corporation) 1,000,000 (Mandatory m NH) Employer's Liability:XL5129402P E.L.DISEASE-EA EMPLOYEE $ If yes, escribe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 C Excess Workers'Compensation EW5.64N-004918-123 07101/2013 07/01/2014 Each Accident or Each Employee for Disease $ 35,000,000 $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks schedule,B 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 OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Miami Shores AUTHOREMD REPRESENTATIVE 10050 NE 2nd Ave Miami Shores,FL 33138 Page 1 of 1 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD t � JUL 11 M3 Miami. Shores Viltage . Public Works Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 JJAJ Public Works Permit Application FBC 2004 Pemnit Type: Pubrec Works Owswes Name(Fee Simple Meho deq eL .$ on.+,. Pimna a Ds) 776-.2 S/S/3 Owrors CRY 45&.._: �� s State zip Tem"wU sseeName PhoaaS Job Address Www ere wmk Is babes does) C o...tra axy tNfaml Steotes vina9e exur" M ono oade ZIP_a.?3l3 Is Mftft Itlato$04 Des*mtet YES NO Cw*acWes Cwnpww Name G C 0 AC,./.-.c (!PLSc� Phone* 1:w f Z3, -0 79V Conti mes Address Pot 4,1,U Mr ice' State zip s�0} Ard*ed/Ensineers Na—.(If aP ) PAons S: $Vakte of Wotk Far this Parmft /dtsa ad iJreeet Fmtage 0I Work 6D` Type of Wotk: ��❑' Aditw Q Anwbe taw ❑RwR�e ❑ off,; Desdibe Wok: �Ln Q �� i[•,H tl` rAs�.� I isG rrC 9Gr'VfG t Submittal Fee$ pown Fes$ CCF$ CO= Notary s TrainlnWEducadw Fee`. Tedm togy Fee$ Scanning$ Radon$ T.onWg Bond$ Code Erdurcoment$ _��/� /�' �y Sbuctural Pkut Re $ Total Fee Now Due$ �jo a . L (Continued on opposite side) N 20' 0 25 SO V) s v R/W W m a s m _ Feet W " a M V M ooa La 0 ° L) O�G _ a ce PROP. 60' OF 3/4 PLASTIC GAS ` SVC TO BE DIRECTIONAL BORED EXIST. 2" PE 7' W OF C/L W /r - �✓ 0 - '"i" g Q -- vi.v~i -• R/W JUL 112013 Q TIE IN SVC TO GAS MAIN C/L WITH T.T. / E.F.V. -- ae PEI ° ��` NE J 6TH ST - --- Miami Shores Village R/W APPPOVEO.. BY DATE a m ZONING DEPT W BLDG DEFT o O CCNIP1 I"MCE WISH ALL FEDERAL DATE- L P ° .L,Pv i r r{(.,L_:S AD REGULATIONS 07-03-2013 AND tJ i°1, MOT.• 613 RESTORATION OF RO CUT LEGEND: FOR UTILITY CROSSING REi�/S/DNS.• PULL LANE R/W - RIGHT OF WAY GENERAL NOTES: ADDITIONAL NOTES: SURFACE REPLACEMEW ?.• SAW cur AsaN&T P/L - PROPERTY LINE ) I. REPLACED BASE MATERIAL OVER DITCH SHALL BE TWICE THE 6. CONTRACTOR SHALL SOFT DIG TO VERIFY LOCATION J C/L - CENTERLINE THICKNESS OF THE BASE. MIN. 8" AND MAX. 18" OF EXISTING UTIITIES 2T E SG,4LEr 2. BASE MATERIAL SHALL BE PLACED IN 5" MAX. (LOOSE MEASUREMENT) 7. MAINTAIN A MINIMUM HORIZONTAL SEPARATION OF "_ 50' E.O.P. - EDGE OF PAVEMENT ��A=-.. DYER AND EACH LAYER THOROUGHLY ROLLED OR TAMPED t0 98X OF 5' FROM ANY CITY UTILITIES (NEW MATERIAL.) �• mm" �) 1•s• E.O.B. - EDGE OF BUILDING MAX. DENSITY PER AASHTO T-180 B. MAINTAIN A MINIMUM VERTICAL SEPARATION OF 18" 3. ASPHALT CONCRETE PAVEMENT JOINTS SHALL BE MECHANICALLY SAWED FROM ANY CITY UTILITIES No CITY opy T.T. - TAPPING TEE 4. SURFACE MATERIAL SHALL BE CONSISTENT WITH SURROUNDING SURFACE ' OF ' E.F.V. - EXCESS FLOW VALVE MATERIAL 5. BASE MATERIAL SHALL HAVE A MIN. LBR Q� 100 AND A MIN. CARBONATE SVC - SERVICE LINE CONTENT OF 70X (6OX FOR LOCAL STREETS) _ 12' 12' a a ca s� Table 11 Buffer Space and Taper Length rap Length Median—� speed Space-_ er nZ Lateral Transition) D D D ! (A)") Dist. -. L Notes b White Reflectorized Pavement Markings =C� (ft.) (ft.) (Merge) b w b 25 155 123 33 3 D w ti I 3 250 245 _ L.= 60 "C�^ �A B C Taper h=L Buffer Space �S68 40 1 305 326 ROAD See Table 11 See Table It END l ARK •• ROAD RORK 45 380 - 540 AHEAD Device Spacing-Taper Device Sped -Tan ent IW - 50 425 . 600 RIGHT LANE \ .� /) See Table I See Table I 53 495 660 L=WS SPEEDING FINES oA so 570 Tao DOUBLED \ % 65 645 780 WHEN WORKERS Table 1 70 730 840 PRESENT Device Sawing When Buffer Space cannot be attained Max.Distance Between Devices fit.) due to geometric constraints,the Type I or Type t/ greatest attainable length shall be used, Speed cans or Barricades or Vertical but not less then 200 ft. (-Ph) Tubular Markers Panels or Drums DISTANCE BETWEEN SIGNS GENERAL MOTES T T r T Far lateral transitions other then 1Z,use Speed Spacing(ft.) J.Work operations shall be confined to one traffic lane,leaving the adjacent lane open to fret/k. 25 25 5o 25 50 Where: A B C 30 to 45 25 So 30 50 L=Length of taper in feet m0 or less 200 200 200 2.On undivided highways the median signs as shown are to be omitted. SO to 70 25 SO So 100 W=Width of lateral transition In feet 45 m h - 350 330 1 330 5=Posted speed limit(mph) 5o mph 1 3.When work is performed in the median lane on divided highways,the chamielizing device plan is inverted •53 mph or greater T 1640 1000 and left lane closed and lane ends signs substituted for the right lane closed and lane end signs. 6 o 'The ROAD WORK 1 N1LE sign may be used The same applies to undivided highways with the following exceptions: DURATION NOTES as an alternate to the ROAD WORK AHEAD a.Work shall be confined within arts median lane.- - 1.Temporary white edgallne may be omitted for work operations less then 3 sign ant the RIGHT LANE CLOSED K MILE b.Additional'barricades,cones,or drums Well be placed along the centerline sixoI rg the work area and consecutive cafarAw days. sign may be used as an alternate to the' across the tral)ing end of the work area. RIGHT LANE CLOSED AHEAD sign. _ 2.For work operations up to approximately 15 minutes,signs,chamnelizing devices, When work an undivided highways occurs across the centerhrce so as to encroach on both median lanes, arrow board,and buffer space may be omitted If all of the following conditions SOO beyond the ROAD WORK AHEAD sign or the inverted plan is applied to the approach of both roadways. are met: midway between signs whichever is less. a.Speed limit Is 45 mph or less. 4.Signs and traffic control devices ore to be modified in accordance with INTERMITTENT WORK STOPPAGE b.No sight obstructions to vehicles approaching the work area for a distance details(sheet 2 of 2)when no work is being performed and the highway is open to traffic. equal to the buffer space and the taper length combined. c.volume and complexity of the roadway has been considered. S.The two channelizitg devices directly In front of the work area may be omitted provided vehicles in the d.The closed lane Is occupied by a class 5 or larger,medlum duty truck(s)with work area have high-intensity rotating,(lashing,oscillating,or strobe lights operating. a miWmum gross weight vehicle rating(GWVR)of 16,001 ib with high-intensity, rotating,flashing,oscillating,or strobe lights mounted above the cab height SYMBOLS 6.When paved shoulders having a width of 8 ft.or more are closed,chananlizing devices shall be used to, and operating. close the shoulder in advance of the merging taper to direct vehicular traffic to remain within the travel - ® Work Area Way. See index No.612 for shoulder taper farmWas. 3.For work operations up to 60 minutes,arrow board and buffer - space may be omitted If conditions a,b,and c in DURATION NOTE 2 g� Sign With 18,x for(Nin.) 7.When aside road Intersects the highway within the TTC zone,additional TTC devices shall be placed in are amt,ad vehicles in the work area have high-intensity. v Orange Flag And Type B LION accordance with other applicable TCZ Indexes rotating,flashing,oscillating,or strobe lights operating, ■ Channefizing.Device(See Index No.600) 8.This TCZ plan does not apply when wok is being performed in The middle lane(s)of a six or more lane [p Work Zone Sign highway. See Index No.614. CONDITIONS 9.For general TCZ requirements and additional information,refer to Index No.610. WHERE ANY VEHICLE.EQUIPMENT, o Advance alarming Arrow Board WORKERS OR THEIR ACTIVITIES ENCROACH OM THE LANE ADJACENT R TO EITHER MOULDER AND THE R AREA Z OUTSIDE THE EDGE OF TRAVEL WAY. eEVLAST .DESCRn>rroN: FOOT DESIGN STmii m--DS MIILTILANE, WORK WMUN TRAVEL WAY —No. 'ON 07/01/ FY.2012 12013 MEDIAN OR OUTSIDE LANE 613 1