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PW-14-1819 mew�E �I �('21J Miami Shores Village 4 VED Building Department 2® Z014 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 [: AUGe Tel:(305)795-2204 Fax:(305)756-8972 INSPECTION LINE PHONE NUMBER:(305)762-4949 nFBC 2010 BUILDING Master Permit No.�✓/�(� /��� PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL F-1 PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: 1022 NE. 91 TER. City: Miami Shores County: Miami Dade Zip: 33/39" 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: CONTRACTOR:Company Name: TECO PEOPLES GAS Phone#: 954-453-0806 Address: 5101 NW 21 AVE. City: FT. LAUDERDALE State: FL Zip: 33309 Qualifier Name: JESUS VEGA tfPhone#: 954-453-0806 State Certification or Registration#: E160 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 New ❑ Repair/Replace ❑ Demolition Description of Work: INSTALLING ANEW GAS SERVICE LINE Specify color of color thru tile: r Submittal Fee$ Permit Fee$ 100 - � _J CCF$ l� . CO/CC$ Scanning Fee$ �_ CO Radon Fee$ 00 DBPR$ Notary$ Technology Fee$ Training/Education Fee$0 . 92. ,I Double Fee$ Structural Reviews$ Bond$ TOTAL FEE NOW DUE$ (Revised02/24/2014) 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature OWNER or AGENT CONTRACT R The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of ,20 ,by (� _ 20 a!y ,by who is personally known to sssss����� who is to me or who has produced as me or who has produced as identification and who did take an oath. identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: Seal: Seal: MAX.J.C"AMORRO Notary PWft•$W of Florldat APPROVED BY Plans Examiner ' ' Zoning Structural Review Clerk (Revised02/24/2014) Frzi-iy CTOB Construction Tra BUSINESS CERTIFICATE OF'COMPETENCY El 608 PEOPLES GAS SYSTEM INC A .D.B.A.: J4. VEGA JESTS Is certified under the provisions of Chapter 10 of Miami-Dade County VALID FORCONTRACTINGUNTIL 0913012015 North Miami Contu--ictcx IE) Number: 160800000 Town of Bay Harbor Island Contractor ID Nun-iber: CONT-0613-2004-Or QUALIFYING TRADE(S) 0014 FUEL TRANS& DISTRI MIAVIf Charles Danger P F MAD Secretary of the 13� "anrrt- "'le-dde III iiviiiii_ A� CERTIFICATE OF LIABILITY INSURANCE DAT7/29/20141 07/29/2014 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 BY THE 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 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 ac°No Ext):800-476-2211 C No): Birmingham,AL 35202 E-MAIL ADDRESS: 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 0: 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 SUBR POLICY EFF POLICY EXP LIMITS LTR INSINSR Wvo POLICY NUMBER MM/DD (MMIDDNYYYi B GENERAL LIABILITY XL5129403P 07/01/2014 07/01/2015 EACH OCCURRENCE $ 1,000,000 Self-Insured Retention X COMMERCIAL GENERAL LIABILITY $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ X CLAIMS-MADE F—I 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 PRO-- LOC $ B AUTOMOBILE UA81UTY XL5129403P 07/01/2014 07/01/2015 Ee eBBII1NdEeD 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 NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per ac= dent B UMBRELLA LIAROCCUR XL5129403P 07/01/2014 07/01/2015 EACH OCCURRENCE $ 1,000,000 X EXCESS UAB X CLAIMS-MADE AGGREGATE $ 1,000,000 DED I I RETENTION$ $ A WORKERS COMPENSATION Excess Workers'Con: 07/01/2014 07/01/2015 )( WC STATU-LIMS OTH- B AND EMPLOYERS'LLAsiLrrY YIN EWS9318597-03(Statutory Limit ISER 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: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 OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 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 ol+Q •1G•�� 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 BE ROAD TO STOP ONE LANE WE=Eu NES WORK ROAD wrcN HERS AHEAD AHEAD PRESENT END ROAD WORK Butler Space D �• See Table Sd 250' C B A i 41 41 10 a 4� b ■■ //// ■ • Work Area � ■ D B C v A ROAD D Device Spacing-Tangent 501 END WORK See Table 1 ROAD WORK AHEAD Device Spacing-Taper � Eo NEs ONE LANE See Table/ ROAD BE AHEAD PREPARED TO STOP DISTANCE BETWEEN SIGNS TABLE I DEVICE SPACING BUFFER SPACE Speed spacing(ft.) Max.Distance Between Devices(ft.) Speed Olst. (mph) A I B I C D Type 1 or Type 11 (mph) (ft.) 40 or less 200 200 200 100 Speed Cones or Barricades or Vertical 25 155 45 350 350 350 775 (mphl Tubular Markers Panels or Drums 30 200 50 1 500 1 500 1 500 1 250 55 or greater 126401 16401 10001 500 Taper Tangent Taper Tangent 35 250 25 to 45 20 50 20 50 40 305 The ROAD WORK 1 MILE sign may be used as 50 to 70 20 50 20 700 an alternate to the ROAD WORK AHEAD sign. 45 360 50 425 501 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 60 570 BE PREPARED TO STOP sign may be omitted ).ROAD WORK AHEAD and the BE PREPARED TO STOP signs may open to traffic. be omitted if all of the following conditions are met: 65 645 fo ^" for speeds of 45 MPH or less. 2.Additional one-way control may be effected by the following means: a.Work operations are 60 minutes or less. 1 70 730 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 Z.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 f/aggers shall be in e.Volume and complexity of the roadway has been considered. used,but not less than 200 1t. ® sight of each other or in direct communication at all times. Work Area 3.The ONE-LANE ROAD signs are to 6e 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 v Orange Flag And Type B Light open to two-way traffic. ■ Channelizing 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, s Work Zone Sign WORKERS OR THEIR ACTIVITIES S.The two channelizing devices directly In front o/the work area and the one ENCROACH THE AREA BETWEEN [J- Flagger channelizing device directly at the end of the work area may be omitted provided THE CENTERLINE AND A LINE 2' vehicles in the work area have high-intensity rotating,/lashing,oscillating,or OUTSIDE THE EDGE OF TRAVEL WAY. Automated Flagger Assistance Devices strobe lights operating. (AFAR),With Gate �=J Lane Identification+Direction of Traffic 6.For Temporary Raised Rumble Strips,general TCZ requirements and additional information,refer to Index No.600. LAST 28 DESCRIPTION: I2015 INDEX SHEET REVISION Z, FDOT TWO-LANE, TWO-WAY, NO. NO. 07/01/14 a �� DESIGN STANDARDS WORK WITHIN THE 'Il'][tAVEL WAY 603 l Of 2 � e O� FULL LANE is SURFACE REPLACEMENT SAW CUT ASPHALT C SURFACE (TrPicAL) RAWR/W I w 5' CON. SWK 1 `- REPLACEMEU BASE (L+fl+MATERIAL) ,.s' OM MIDTN ,s SWALE 9 SWALE o 0 u 0 a � ,r v __ AR�s d � --- ' =50 �a-------- q o 7------------------------ AAL -------------_- - Go - � ------- ---- RESTORATION OF ROAD CUT q Q N FOR UTILITY CROSSING EXIT. 2" BSE. GAS MAI N. E. 9 / S r TERRA i TIE IN SVC TO GAS MAIN R,4 CE, WITH T/T•/E.F.V. w 3 ---I 28.20 ASPHALT PAVEMENT c q q 1 EO.P. .so R - - WATER It ALL EXISTING UTILITIES SHOWN ON CORNER 11 tl SWALE 5.10' PARKW N E.O.P. THESE PLANS ARE TO BE o •�,°� ® ® ® o Mrx z CONSIDERED APPROXIMATE & • ' ° ' 6" SHOULD BE VERIFIED BY THE 85.00 M 65.00(PXM S' CO SWK z M CONTRACTOR PRIOR TO THE RAW r 0 F.LP.1/2"-�-- R GAS MAIN START OF WORK OPERATIONS. 6' •ti 5 ' a W w o¢ a SOD RESTORATION DETAIL N� AUG V 2014 SCALE: NOT TO SCALE oo ;A < �� 5.01' 2.8 w7z 12.45' GENERAL NOTES ►• 11,0 L� c 17.0 0.00' 0 LEGEND cn � 1. REPLACE BASE MATERIAL OVER DITCH SHALL BE TWICE THE ��' PLANTfA K 0 1E CENTER LINE THICKNESS OF THE BASE, MIN. 8" AND MAX. 18" ^ 19.50' 84' I ILI MONUMENT LINE 2. BASE MATERIAL SHALL BE PLACE IN 6" MAX. (LOOSE MEASUREMENT) LAYER AND EACH LAYER THOROUGHLY ROLLED OR TAMPED TO 98% OF ro R� RIGHT OF WAY a .+ MAX. DENSITY PER AASHTO T-180 W P/L PROPERTY LINE 3. ASPHALT CONCRETE PAVEMENT JOINTS SHALL BE MECHANICALLY SAWED o E.O.P. EDGE OF BUILDING 4. SURFACE MATERIAL SHALL BE CONSISTENT WITH SURROUNDING SURFACE 2' % T.T. TAPPING TEE MATERIAL N N O -�. v; ONE STORY E.F.V. EXCESS FLOW VALVE 5. BASE MATERIAL SHALL HAVE A MIN. LBR. OF 100 AND A MIN. CARBONATE SVC SERVICE UNE CONTENT OF 70% (60% FOR LOCAL STREETS) `.� Z 6. CONTRACTOR SHALL SOFT DIG TO VERIFY LOCATION OF EXISTING UTILITIES O ~O p RESIDENCE o O o t; .. W N # 1022' c h N m J w w 0 h ROP.RISER WITH r cn 3/4" PLASTIC m `3 30.60' GAS SVC. TO BE M 3 50' 3 0.00' X r w DIRECTIONAL BORED m 'u GRD. ��'h CONCRETE, 000 s I O O I •c•• � 3� " w ' . GAS SVC. TO BE ---- ----------W —•-------- --- --- ' 12.9' 4 OIR cnoNAL BOR e a Z 4 7.0 r N Zo' r ��2 O 36" MIN, • ® P SAN iTy —OAs—GAS ws 17.05' O ' z"Bs . GAS MAIN I 0 c law• pP �� P� OAS , PR FILE CROSSING NE. 91 TER. SCALE: (V) 1:5' (H) NTS. — 0'20' ^ 0.20'00 F.I.P.1/2" 65.00'(P)(M) I.P NO.OF SEEM.i 0 OO c c ssr':er NO.: 1 Drawing File: \\browardfs\voll\USERS\PGM XC\Docu men ts\RESI DEN TI AL\2014\N E 91 TER. 1022, MIAMI SHORES, FL\1022 NE 91 TER.MIAMI SHORES, FL.dwg 08/16/2014