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PL-15-740 s t, Miami Shores Village F' Resi€l0 us 10050 N.E.2nd Avenue NE Miami Shores,FL 33138-0000 ' 'i '"R; �u't'5�t`JC�f�iLdCt, Gas , Phone: (305)795-2204 $taAPPROVED , Is sueiat+�:4111215 Expiration: 1010712015 Project Address Parcel Number Applicant 474 NE 95 Street 1132060140440 ANNE&NESTOR MORALES Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell ANNE&NESTOR MORALES 474 NE 95 Street (305)283-7233 (305)733-6534 MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 TECO PEOPLES GAS SYSTEM (305)957-3857 (305)970-1783 .: ...... .... Total Sq Feet: 0 Type of Work:INSTALLING A NEW GAS SERVICE LINE B Available Inspections: Type of Piping: Inspection Type: Additional Info: Final Bond Return: Press Test Classification:Residential Scanning:3 Review Plumbing CA UU1/I Fees Due Amount Pa Dae P T Amt Paid Amt Due Pay t ay Type CCF $0.60 1 DBPR Fee $2.60 Invoice# PL-4-15-550 8 DCA Fee $2.00 04/10/2015 Check#:4928 $64.60 $50.00 Education Surcharge $0.20 04/01/2015 Check#:4917 $50.00 $0.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.60 In consideration of ,We issue to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto nd in ' t 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. April 10, 2015 Authorized Signature:Owner / Applicant / Contractor / Agent Date Building Department Copy April 10,2015 1 Miami Shores Village Building Department APR 01 2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 BY: j INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 201) BUILDING Master Permit No.?L'(5 --� "40 PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL F-1 PLUMBING ❑ MECHANICAL OPUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 474 NE 95 ST. City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes NO X Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER:Name(Fee Simple Titleholder): RIGHT OF WAY Phone#: Address: City: State: Zip: Tenant/Lessee Name: Phone#: Email: m I E CONTRACTOR:Company Name: TECO PEOPLES GAS 4 phone#: 954-453-0806 Address: 5101 NW 21 AVE. STE. 460 city. FT. LAUDERDALE State: FL Zip: 33309 Qualifier Name: JESUS VEGA Phone#: 954-453-0806 State Certification or Registration#: E1608 Certificate of Competency#: DESIGNER:Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit:$ 1000 Square/Linear Footage of Work: Type of Work: ❑ Addition ❑ Alteration 0 New ❑ Repair/Replace ❑ Demolition Description of Work: INSTALLING A NEW GAS SERVICE LINE BY DIRECTIONAL DRILLING Specify color of color thru tile: 0 Submittal Fee$ Permit Fee$_ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Notary$ Technology Fee$ Training/Education Fee$ Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ CD < <O (Revised02/24/2014) .r. Bonding Company's Name(if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name(if applicable) Mortgage Lender's Address City State Zip 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 ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES,BOILERS,HEATERS,TANKS,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 the issuance of a building permit with an estimated value exceeding$2500, the applicant 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 property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site 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 reinspection fee will be charged. Signature Signatures OWNER or AGENT CONTRACTOR The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of ,20 by day of 20 1-!�— by who is personally known to who is personally known to me or who has produced as m4'cati ed as identification and who did take an oath. idid take an oath. NOTARY PUBLIC: N Sign: Si Print Print: �!��� HUBERT NUNEZ L Notary u i - Seal: SeMy Co'nm.Expires Sep 11,2017 Commission#FF 043679 Banded Through National Notary Assn. APPROVED BYPlans Examiner Zoning Structural Review Clerk (Revised02/24/2014) A� CERTIFICATE OF LIABILITY INSURANCE DA07/29/2014m THIS CERTIFICATE IS ISSUED ASA 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 policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terns 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. NAME. P.O.Box 10265 PHC N Ext):600-476-2211 FAX No Birmingham,AL 35202 E-MAIL ADDRESS: INSURERS 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 33602 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:LACEQQUC 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 SUER POLICY EFF POLICY EXP LIMITS LTR IN POLICY NUMBER MM/DD MM/DD B GENERAL LIABILITY XL5129403P 07/01/2014 07/01/2015 EACH OCCURRENCE $ 1,000,000 Self-Insured RetentionDAMAGE O REN X COMMERCIAL GENERAL LIABILITY $1,000,000 PREMISES Ea axurrence $ X CLAIMS-MADE 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 PRQ LOC $ B AUTOMOBILE LIABILITY XL5129403P 07/01/2014 07/01/2015 Ee aecd rDitSINGLE 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 NON-OWNED PROPERTY DAMAGE $ 1HIRED AUTOS AUTOS PeraccideM B UMBRELLA LIAB OCCUR ;Insurance L5129403P 07/01/2014 07/01/2015 EACH OCCURRENCE $ 1,000,000 X EXCESS UAB X CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ $ A WORKERS COMPENSATION xcess Workers'Compenation: 07/01/2014 07/01/2015 X WOC STATU- OTH- B AND EMPLOYERS'LIABILITY Y/N WS9318597-03(Statutory Limit IS ANY PROPRIETOR/PARTNER(EXECUTNE xcess of$35,000,000 insured by LM E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? NIA Corporation) 1,000,000 (Mandatory in NH) Employer's Liability:XL5129403P 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-004918-124 07/01/2014 07/01/2015 Each Accident or Each Employee for Disease $ 35,000,000 $ $ $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space Is required) Excess Liability policy provides Insurance in excess of Peoples Gas System's Self-Insured Retention as stated above. Jesus Vega is the qualifier for TECO Peoples Gas. 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 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 CTOB Construction pualifying Board ' BUSINESS CERTIFICATE OFC6MPETENCY El 608 PECaPLES GAS SYSTEM INC [A�A,W:DB.A.. " UQVIQ-JO. VELA JET66 Is certified under the Provisions of Chapter 10 of Miami-Dade County '-'ALIO FOR-CONT RACTING UNTIL 09/3012015 North Miami Contractor ID Number: 160800000 Town of Bay Harbor Island Contractor ID Ntimber, CONT-0613-2004-0-9 QUALIFYING TRADE(S) 0014 FUEL TRANS& DISTRI cmdes Danger P.E. Secretary It.evam 6ii tT BE ROAD TO OPS ONE LANEeOEo�s WORK ROAD O¢■ AHEAD PRESENT AHEAD END ROAD WORK Buffer Space D See Table SO. 250 C B A CO C a a b Wo■■ // ■ • Work Area T ■ A B C h ROAD D Device Spacing-Tangen[ 500 END WORK See Table 1 ROAD WORK AHEAD Device Spacing-Taper [ fig ONE LANE See Table/ ROAD BE AHEAD PREPARED TO STOP DISTANCE BETWEEN SIGNS TABLE I DEVICE SPACING BUFFER SPACE SpeedSpacing(ft.) Max.Distance Between Devices(ft.) Speed Dist. (mph) A B C D (mph) (/t.) 40 or less 200 200 200 100 Speed Cones or Type 1 or Type if 45 350 350 350 ]75 (mph) Tubular Markers Barricades or Vertical 25 755 Panels or Drums 30 200 50 500 500 500 250 55 or reatc 1640 1640 1000 500 Taper Tangent Taper Tangent 35 250 15 to 45 20 50 10 50 40 305 The ROAD WORK 1 MILE sign may be used as 50 to 70 20 50 20 ]00 45 360 an alternate to the ROAD WORK AHEAD sign. s0 425 •'500 beyond the ROAD WORK AHEAD sign or GENERAL NOTES DURATION NOTES 55 495 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 �65 570 open to traffic. be omitted if all of the following conditions are met: 645fo PREPARED TO STOP sign may be omitted a.Work operations are 60 minutes or less.for speeds of 45 MPH or less. 2.Additional one-way control may he effected by the following means: b.Speed limit is 45 mph or less. 730 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 When/loggers are the sole means of one-way control,the/loggers shall be in e.Volume and complexity of the roadway has been considered. used,but not less than 200 ft. sight of each other or in direct communication at all times. ® Work Area 3.The ONE-LANE ROAD signs are to be fully covered and the FLAGGER signs either Sign With 18"x 18" (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. ■ Channel/zing Device(See Index No.600) 4.When a side road intersects the highway within the TTC zone,additional TTC CONDITIONS devices shall be placed in accordance with other applicable TCZ Indexes. WHERE ANY VEHICLE,EQUIPMENT, x Work Zone Sign WORKERS OR THEIR ACTIVITIES 5.The two channelizing devices directly in front of the work area and the one ENCROACH THE AREA BETWEEN []� Flogger channelizing device directly at the end of the work area may be omitted provided THE CENTERLINE AND A LINE 7 vehicles in the work area have high-intensity rotating,flashing,oscillating,or OUTSIDE THE EDGE OF TRAVEL WAY. Automated Flagger Assistance Devices strobe lights operating. (AFAR),With Gate R —!, Lane Identification+Direction of Traffic 6.For Temporary Raised Rumble Strips,general TCZ requirements and additional q � information,refer to index No.600. LAS 1111M, DESCRIPTION: ry.�� INDEX SHEET REV/S10N 2015 TWO-LANE,®'LA�TII�it TW®'WL�Yt NO. NO. 07/01/]4 —"" DESIGN STANDARDS W®I� WIITII�[IIIoT THE TRAVEL WAY 603 1 of 2 N.E. 5th AVENUE \" soy DO N CD mPROP. 3/4" PLASTIC a SCALE: 1"=20' 0 GAS SVC DIRECTIONAL BORE. cr •Z 0 c)r 1- p 1 11z AO'Ob ,9L8Z6 'i POOM.9 v 1 1 z �s •; N 1 W 00£4 ,00 Z I• ca c 1 1= s ea4 1 fig` Uo 8 0O C3 AlT1t Z t]p °O�, £6'� 1 GAS GAS g�GAS S®GAS G SF- T GAS r LL .09V 6' �� x J 1I1 _ 1.1) v m I �. 1 q 1 �00'9Z CJtr'L L 4:0 79 D_ 1 5' - 3' 1 w ----------- " ----- --.� --------------- - 1 54'0 o�s g x o W g oco «� e _ 2i s O� o ,Zox - i 1 z M o vi y q Lo N�10 a0 iQ. e C7 1 Q GAS MAIN a 1 o ~ 06 9 ami �` 1 cti N 41 I LOx 1 (� o0 069 M #474 °- � I SOD RESTORATION DETAIL *so* . .CJS S 1 SCALE: NOT TO SC LE • • CO I.� • e • •••• egos• Y c x 1 1s \ ...... ...•� �'• 1 2)8Y.1lla�,Z e �Q C'J J o A0'. e 1 C c e••i•O • : ••• C1 0 — 1 A9'Otr X0004 h' m 4 N °�. L _ ••se •s•• sties• � • • • �— � A9'trl• � .00'94 .c 0 0 � �, _ J e•s.' gee• • ��� U �� LLj Q xe� - Vie• O� cv >C C gees•• • e • • ro ami �- ` eee•O � U � .00'9 � �,I � � =�" ••'•gs • a%j' j•• iv x x x x x x x ' 0 1 LEGEND ...... • A "e:• 00'0tr x ,S18Z6 j'1'O'tr qq r� � CENTER UN6 i 6 �'y�e• V U p I k1 MONUMENT YNE . •Osseo d, ••• • 1 N ti R/W RIGHT OF WAl:.• i •i \ " \ �N _ - P/L PROPERTY UNE •' o • • •• . 0; � I a 75e E.O.P. EDGE OF BUILDING a J m I T.T. TAPPING TEE �i E.F.V. EXCESS FLOW VALVE a SVC SERVICE UNE t1 Q =LL WM. WATER MAIN V _ N v W W coGEN AL NO- 5 0 15' FULL uv� w ^SURFACE��+T 1. REPLACE BASE MATERIAL OVER DITCH SHALL BE TWICE THE ILn�.z SAM CUT ASPHALT O . GRD.O27. SURFACE (TTRCAL) THICKNESS OF THE BASE. IN. 8" AND MAX 18" 4J 2 BASE MATERIAL SHALL BE PLACE IN 6" MAX. (LOOSE MEASUREMENT) I LAYER AND EACH LAYER THOROUGHLY ROLLED OR TAMPED TO 98%OF Z 1 ---- _ 1 y $ G MAX. DENSITY PER AASHTO T-180 PROP. 314 PLASTIGAS SVC, TO RF 3. ASPHALT CONCRETE PAVEMENT JOINTS SHALL BE MECHANICALLY SAWED !2�7 ITCH 4. SURFACE MATERIAL SHALL BE CONSISTENT WITH SURROUNDING SURFACE DIRECTIONAL BORED 36" MIN. ° MDTM • MATERIAL I S. BASE MATERIAL SHALL HAVE A MIN. U3R. OF 100 AND A MIN. CARBONATE CONTENT OF 70%(60%FOR LOCAL STREETS) 6. CONTRACTOR SHALL SOFT DIG TO VERIFY LOCATION OF EXISTING UTILITIES 7. ALL ROADWAY RESTORATION WITHIN F.D.O.T R/W MALL COMPLY WITH INDEX O 4 I I I 4 310. Ir VARIES RESTORATION OF ROAD CU7BY: RTNT' ; ALL EXISTING UTILITIES SHOWN ON FOR UTILITY CROSSING THESE PLANS ARE TO BE 0 o R 01 ��15 CONSIDERED APPROXIMATE & SHOULD BE VERIFIED BY THE PROFILE CROSSING THE ALLEY SCALE: (V) 1:5' (H) NTS. CONTRACTOR PRIOR TO THE NO.OF 6�:1 START OF WORK OPERATIONS. SHM NO.: 1 Drawing File: \\browardfs\volt\USERS\PGM XC\Docu men ts\RESIDENTI AL\2015\NE 95 ST. 474, MIAMI SHORES, FL\474 NE 95 ST.MIAMI SHORES, FL.dwg 03/30/2015