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PW-13-2447 t 1BY;-----�_moo Miami Shores Village Public Works Department 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795.2204 Fax:(305)756.8972 u Public Works Permit NJU i 3 Permit Application FBC 2004 Permit Type: Public Woks WATER�J /� Owner's Name(Fee Simple Tdtefw{der) J/t/0 j'1'Ci" l.O�JC(70-S Phone S: Owner's Address 11/0 4)Iff /00 SP— city /",/,'ei a,- State L G . zip TenanvLessele Name Pltona* 7rl� -3d o- rias Job Address(where the wait is being dote) /VG /04 x7- City Miami Shores---- County Miami Dade Zip Is Building Histories Designated: YES NO X ContractoesConpartyName �CCJ i7�O / Piratet �-Sy -y�3 - o✓®� Contractees Address .5'/61/ -v4 f city A- state G ZtP Archked/Engi►r�s Nam(if ap�t�) "-/ /Q�c, �dYpj'2� Phone III. $value of work For this PermR DOC Lmees Footage Of work: Type of work: ❑ dfbor I]Aftrattort ® New RepaidReptece ❑ Demow. Describe work jr✓�F/ Fees Submittal Fee "0 Pemdt Fee i CCF S Co= Notary S Tralning/Educatfon Fee$ Technology Fee$ Scanning$ Radon$ zonk9 Band$ Code Entorceinent i Strrtsttrrai Plan Review S Total Fee Now Due$ t/V (Continued on opposite side) i Bonding Company's Name(if applicable) Bonding Co apanys Address WA City _,_ State zip Mortgage Lender's Name(if applicable) WA Mortgage Lenders Address City State Zip Application is hereby made to Main 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 conshuction 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 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 fAAPROVEMENTS 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 pem*with an estimated value exceeding$2500,ft applicant must promise in good faith that a copy of the notice of commencement and duction lien law brochure will be delivered to ft pecan whose Properly is subject to attacirment Also,a certified copy of fire reconded natiae of commencemard must be posted at ft job site for the fust inspection which occurs seven(7)days after the buildmg permit is issued.In the absence of such pasted notice.the inspection wN not be approved and a reinspection fee will be charged. Signature Signature r Owner or Agent Contractor The foregoing instrument was acknowledged before me this The foregoiwas acknowledged before me day of 20_,by day of -dc rt f oa.s A who is personally known to me or who has produced personally kno rod as identification and who did take an oath. an NOTARY PUBLIC: NOT P96.NOV goo Sign: Sign . Print Print My Commission Expires: My Commission Expires: APPLICATION APPROVED BY: Public Works Director or his designee. 11117/2005 CTQB Construction Traded Qua]Nng Board BUSINESS CERTIFICATE OF COMPETENCY f E1608 PEOPLES GAS SYSTEM INC VEGA JEStS la cedW under the proWsIons of Chapter 10 01 Miami-Dade County ''AUL) FOR CONTRACTING UNTIL09130/20,15 North Miami Contractor ID Number: 160800000 Town of Bay Harbor Island Contractor ID Number: CONT-0613-2004-05 QUALIFYING TRADE(S) 0014 FUEL TRANS&DISTRI C,.r,Da P L TE A CERTIFICATE OF LIABILITY INSURANCE DA06/21/20113 n 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 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 lieu of such endorsement(s). PRODUCER CONTACT MCGRIFF,SEIBELS&WILLIAMS,INC. NAME: P.O.Box 10265 AIFA C No Egli:600 476 2211 1 IX C No): Birmingham,AL 35202 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Zudch 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: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. ILTRR TYPE OF INSURANCEJUM POLICY NUMBER ADDLSUBR POLICY EFF MMIDDY EXP LIMITS B GENERAL LIABILITY XL5129402P 07/01/2013 07/01/2014 EACH OCCURRENCE $ 1,000,000 Self-Insured Retention DA A13E RENTED X COMMERCIAL GENERAL LIABILITY $1,000,000 PREMISES Ea occurrence $ X CLAIMS-MADE F—I OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ 1,000,000 GEN'-AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PECT O LOC $ B AUTOMOBILE LIABILITY XL5129402P 07/01/2013 07/01/2014 Ea BIN D 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 LIAR OCCUR XL5129402P 07/01/2013 07/01/2014 EACH OCCURRENCE $ 1,000,000 X EXCESS LIAB X CLAIMS-MADE AGGREGATE $ 1,000,000 DED I I RETENTION$ $ A WORKERS COMPENSATION Excess Workers'Compensation: 07/01/2013 07/01/2014 X WC STATU- OTH- B AND EMPLOYERS'LIABILITY Y/N EWS9318597-02(Statutory Limit is TORY LIMBS ANY PROPRIETOR/PARTNER/EXECUTIVE excess Of$35,000,000 insured by LM E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/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 07/01/2013 07/01/2014 Each Accident or Each Employee for Disease $ 35,000,000 $ $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,I 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 ..,a. 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 - ------- --- -� aE ROAD <�' y • TO STOP ONE LANE WORK meas AHEAD ROAD AHEAD PncgNT BROAD WORK Buffer Space D •y 0 -.- See Table d '♦ 250' C B A y, YJ 'D 10 YI 'D t�, rt7�, � rt��,, rt��,, tt77,, • Wor ■T r7, b D' LY IY Ly Lr ■ r lY N A B C ROAD DEND Device Spacing-Tangent 500' WORK See Table I ROAD WORK AHEAD Device Spacing-Taper ONE LANE • See Table I ROAD PAr ' AHEAD PREPARED TO STOP e A DISTANCE BETWEEN SIGNS TABLE 1 DEVICE SPACING 'r: BUFFER SPACE Speed spacing(ft..1 Max.Distance Between Devices(ft.) T�l tt. Speed Dist. (.Ph) A B C D 4 It (mph) (ft.) 40 or less 200 200 200 100 speed Cones or Barricades or Vertical ° < 25 ]55 45 350 350 350 175 (mph) Tubular Markers Panels or Drums a 1� 7 30 200 50 500 500 500 250 55 or greater 264011640110001 500 Taper Tangent Taper I Tangent p _� C " 35 250 25 to 45 20 50 20 50 a Q1.) 40 305 a The ROAD WORK I MILE sign may be used as 50 to 70 20 50 20 100 I� 45 360 gg4 an alternate to the ROAD WORK AHEAD sign. t F 6 Sp 425 G �• 500 beyond the ROAD WORK AHEAD sign or GENERAL NOTES I DUR OTES 55 1 495 midway between signs whichever Is less. I.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 BE PREPARED TO STOP sign may be omitted open to traffic. be omitted if all of the following conditions are met: 65 645 for speeds of 45 MPH or less. a.Work operations are 60 minutes or less. 70 730 5 2.Additional ore-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 5 3.Pilot vehicles; d.Vehicles In the work area have high-intensity,rotating, constraints,the greatest 14 4.Traffic signals. flashing,oscillating,or strobe lights operating. attainable length shall be SYMBOLS e.Volume and complexity of the roadway has been consideredused,but not less than 200 ft. 9 When tiaggers are the sole means of ore-way control,the floggers 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 IS- (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. ■ Channelizing Device(See index No.600) q.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, D Work Zone Sign WORKERS OR THEIR ACTIVITIES S.The two channellzing devices directly in front of the work area and the one ENCROACH THE AREA BETWEEN 0- Flagger channelizing device directly at the end of the work area may be omitted provided THE CENTERLINE AND A UNE 2' Automated Flagger Assistance Devices vehicles in the work area have high-intensity rotating,flashing,oscillating,or OUTSIDE THE EDGE OF TRAVEL WAY. R (AFAD).With Gate strobe lights operating. -C> Lane Identification f Direction of Traffic 6.For general TCZ requirements and additional information,refer to Index No.600. LAST 2 DESCRIPTION: REVISION -°n FDOT DESIGN STANDARDS TWO-LANE, TWO-WAY, IxNox 5No 07i0110j FY 2012/2013 WORK WnWXN THE TRAVEL WAY 603 1 � � b -�` > ► cd'.. '�t'�`�,.�`. 4 ws � e � � r i *�t r Gss �i°rC�S"T'��^ r- N . AjA wr PAL LAM om.,. ,,� _..r r u fiAl � �'„ r " T ;+ b, !Y tl�,�,,.-i r. .-•� r .t C Slili<kCC e0IJ109fiAT SASWNZ W Off '.,, j oil � �y`'s _O �, r""y. .. j�,•�z Gull'Y^ a �v _,.a �* �. '� n �.. laftegum B� w �_ r" MAI (law W1WrJ011L) , HM�1 , E ;, cas' v, A m J A " q ,t'`? �.�: s' TIE IN SVC 0 N "nk. ,, _ g $ � WITH T.T.IEF.V. �• GP � r� - � � s -- - L------------------- - NE. 100 - - ---- ------ — — - -- . _, � ` .. ��•u; tea, RESTORATION OF RpAD CUT ` ' �� FOR UTILITY CROSSING _ ®o ------------------- VX --------- — -- — r a t a PROP. 3/4" PLASTIC 'r c�► fir. GAS SVC. TO BE 15 EXIT. 2- S.P GAS MAI .. - "` DIRECTIONAL BORED !" t , 35' 3' - ' � h���_ iI� a� iI <• � x Ln j _ ; �_ ..b rl ` J� — �i�'� - I�Y�7•.��-r .J— Q _-fd j / ' . a+r' _ 6P2' w.s•Y ---�^ t _, V' u i:*. $ .;� � 4 � t li Y " At Z n c" a x' w- '-��' • bf' � '^ r i.`- °� • 'r'i c '� a« rA r. ._ w ��a 6 �' -� l' d •}• p ! °.} `- �. 3 3'I Y..—i„Yr 7 -, GAS Maw Y. � :;, kb . ' v • +. # r 4 r yl "3T uM }to . .. �. . ,"`� � rY a I a _ ,gyp SOD RESTORATION DETAIL SCALE: NOT To scA� �' i °' # 1110 .�� r.r . 54' k , . ' 6, - " tib ' r'jr fol rro j y I , � l J�' til � 'ryISO!•r_ � L dNY r'r' i� �� '�•Y4—"'"` .,'!, ��� � r` ..� rt '�� ^� s�` �^ � � �yyy - a 'r�cn may' a °_� �.►-. v'1� �f� /,'1 ypryWya�� J �r i s. ,{F i"� 'r ,#.f. 'm LJy ^ -3'a. iM'.a.Y iP,,..r •Y'r' r '�— ��kl"�i ; �` � -la � _..—....' �l r+'Y"ii. ��:��, �"`_ �q„wiA'• � `e��" e `1" iY. � .-... r *e" '- �I :.moi �,g ALL EXISTING UTILITIES SHOWN ON THESE PLANS ARE TO BE + " Y= _ �` �, •, CONSIDERED APPROXIMATE & vM SHOULD BE VERIFIED BY THE CONTRACTOR PRIOR TO THE ' a ' o 's' o e START OF WORK OPERATIONS. a '. Zak l9 �� 100' m 5 3 W Hi EX. GRD. Hi m d 8 W 6 8 Wag d nz H PROPX PLASTIC 36" MIN. ' ' DIRECDONAL BORED , u LEGEND NERAL NOTEs rk CENTER UNE 1. REPLACE BASE MATERIAL OVER DITCH SNALL BE TWICE THE THICKNESS OF THE BASE, MIN. 8' AND MAX. 18 III ARONUb1ENT UNE 2. BASE MATERIAL MALL BE PLACE IN 8- MAX. (LOOSE MEASUREMENT) 2-L.P. GAS MAIN O R/W RIGHT OF WAY LAYER AND EACH LAYER THOROUGHLY ROLLED OR TAMPED TO 8841 OF MAX. DENSITY PER AASHTO T-18 P�1 PROPERTY UNE 3. ASPHALT CONCRETE PAVEMENT JOINTS SHALL BE MECHANICALLY SAWED ' E.O.P. EDGE•OF BUILDING 4. SUMATERIRFACE MATERIAL SHALL BE CONSISTENT WATH SURROUNDING SURFACE T.T. TAPPING TEE g BASE MATERIAL SHALL HAVE A MIN. LBR. OF 100 AND A MIN. CARBONATE Q ' Q EF.V. EXCESS FLOW VALVE CONTENT OF 7OX(8041 FOR LOCAL STREETS) SVC SERVICE UNE 8. CONTRACTOR SHALL SOFT 010 TO VERIFY LOCATION OF EXISTING UTILITIES AB i —4 PROFILE CROSSING NE 100 ST SCALE: (V) 1:5' (H) N.T.S. —4 SSBT NO-- 1 Drawing Filer \\browardis\woll\USERS\PGMXC\Documents\RESIDENTIAL\2013\NE 100 ST, 1110 MIAMI SHORES, FL\1110 NE 100 ST.dwg 10/16/2013