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PW-15-2348 Miami Shores Village REcr, v � Building Department SEP 15 2015 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 Tel:(305)795-2204 Fax:(305)756-8972 BY: INSPECTION LINE PHONE NUMBER:(305)762-4949 FBC 20,i1-�`h° BUILDING Master Permit No. PERMIT APPLICATION Sub Permit No. ❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL ❑PLUMBING ❑ MECHANICAL OPUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOBADDRESS: 450 NE 94 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: t� CONTRACTOR:Company Name: TEC PAS Phone#: 954-453-0806 Address: 5101 NW 21 AVE. STE. 460 City. FT. LAUDERDALE State: 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 K New ❑ Repair/Replace ❑ Demolition Description of Work: INSTALLING A NEW GAS SERVICE LINE BY DIRECTIONAL DRILLING Specify color of color thru tile: Submittal Fee$ -5t.'®Z� 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$ (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 A- -,�. 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 �� J by who is personally known to l/� ���� who s personally known to me or who has produced as me or who has produced as identification and who did take an oath. identificatio nd w o did take an oath. NOTARY PUBLIC: NOTARY P BLIC: ussy ANION IM01>EN Onoi41 papuog 6L9Eb0 3d#uolsslwwoo od° �fds L10Z'll dag saildx3•wwo0 AW Sign: Sign: eniinu in Z3NnIN lW3onlH Print: Print Seal: Seal: APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised02/24/2014) Tmddt-Q"M(Vjftq Good 13USINeSS CERTIFICATE OF COMPETENCY E I ol 398 PEOPLES GAS SYSTIEM INC MBA; VEGA JESUS 13 t-V"Um Under thu provisims ut Chapter i a of mmmi-Nde cwvmly o., Ba\ a n I C f-MUrYING MADE(S) 001.1 PUrml TRANS 01,85TRI Cr, (MMID IY ACoR CERTIFICATE OF LIABILITY INSURANCE DATE 0630/20115 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 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). NTACT PRODUCER O NAME. MCGRIFF,SEIBELS&WILLIAMS,INC. P.O.Box 10265 AIC NNo Ext): FAX A/C No): Birmingham,AL 35202 E4WWL 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 33602 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:KUPY3T4E 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 ADDL SU R POLICY EFF POLICY EXP LTR TYPE OF INSURANCE N D POLICY NUMBER M/DD MM/DD LIMITS B X COMMERCIAL GENERAL UA131UTY XL5129405P 07/01/2015 07/01/2016 EACH OCCURRENCE $ Self-Insured Retention 1,000,000 X CLAIMS MADE OCCUR $1,000,000 DAMAGE TORENTEU PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 POLICY❑jECOT- F—]LOC PRODUCTS-COMP/OP AGG $ OTHER: $ B AUTOMOBILE LIABILITY XL5129405P 07/01/2015 07/01/2016 COMBINED 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 NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS PeraccideM B UMBRELLA LIAB OCCUR XL5129405P 07/01/2015 07/01/2016 EACH OCCURRENCE $ 1,000,000 X EXCESS LIAR Hx CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION$ $ A WORKERS COMPENSATION Excess Workers'Compensation: 07/01/2015 07/01/2016 X I PER I OTH- B AND EMPLOYERS'LIABILITY Y/N EWS9318597-04(Statutory Limit is —STATUTE ER ANY PROPRIEfOR/PARTNER/EXECUTNE excess of$35,000,000 Insured by LM E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ElNIA Insurance Corporation) 1,000,000 (Mandatory in NH) Employers Liability:XL5129405P E.L.DISEASE-EA EMPLOYEE $ H es,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ C Excess Workers'Compensation EWS-64N-004918-125 07/01/2015 07/01/2016 Each Accident or Each Employee for Disease $ 35,000,000 $ $ $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached K 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 DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Miami Shores AUTHORQED REPRESENTATIVE 2nd Ave Miami Miami Shores,FL 33138 Page 1 of 1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD ... . . . ... . . • • • • • • • • • • • • • • • • SYMBOLS: ® •rk Area ■ chm memeznmg Dlence rsee Bmdec Wc.w8fi . •• • •• • • • • TOS MD 6 •• • • •• • • • • • • �B Work zone-1.9. • • • • •• . • 0— Flagg- • • • • • '! •0. • • ,♦ AWOV&ed F/ag4-Assnsaasme De— —wife:Spare IAFA00®nth Fade See Yatt".¢II � Harte Ide:mnddcatumnu�®drectnam of Fnadfic �" B ® A • • • •r* • • •• EJ ——————————————————————————————— •• • • • • -----------� r r ——————————————————— � ■ ■ ®®.k,roam ■ � I A � E � Tamed @✓auri:a�a1i Taper LLeromTapas*"0' S�TaA+a B 56'r6 WW S6 res Bim' Aair Bar ma kw lid MAO slow MOEAV s gr ns msra7w aFofeas wfma the aroledt prions. am u4`, �. GENERAL LAYOUT am SHORM Wb Xk GENERAL NOTES: B.Speva/conditions Wray He regmsred r�acr-dsmce Warn these mres:ad 7.•lrem suffer Space&amen de arrmaead doe w Tmmffir(:amrmrraimds..arse TASU D the fallo 'v sheets. the greatest atta6ar We demgfM.roar Bess rhea 2m fr. DEVISE SPAMG 2.If Byre IW6rk Area emarozedres my Fere eenrerrn'ne.arse Bhe Dayawm Ior IF.Rawproad erosv%s: Oftt�e Tepvrary Lata Sdn'Ir to Shmm➢der on Sheer 2 or*0 rhe Exnsrdmg Pared a.If am aah''e raaifraad ewossdrrg is rmmated vows t6 Case U-..Hraj /41®vfim m sPi■mmmlmmo mg a sparia9 of 5lroelder midrh is saa7firi"t6 P—ide Foe art Dl'/acre Hemareem the thea the 499M lern¢rh p6rs ma fee "I/ d V*alfter 59"as Pam ani S - Ty®e I or Types N selmmw sapper Work Area and the Edge of Ex s*irtay Pavee SOmml'drm.Redarme rhe passed 00rr6 on Shear 2. std Ira&der mW kers fPana/sisr6mrs SION Space Speed when appr6prdate. h.It rhe queoing and vehicfes arras a aaa na0rad ermssmg door be aoardsd,pravddr a axmdarmeKu rrafree cormraaofficer or 0hi a 0M,a am,a 00. 3.Tropsrary"sod'Ranr$+e Srrrp.: flaggmr at aw hio-A sail grade'armssamg dm Rrev'amrweHr epos T F -raw Tam—v v A a e DI a.Use whem bob of the lmlivvimQ car'04iams are mer cmnrmarearfAp: lra stsppnrg witha'a rhr ruiglasay-rad0¢made crossing,ewem of 25 2F S6' 26' 36 206' z66 206' 406 /53' d. Ezdsrdmg Posted Speed m 56'rank ar g:carer: "mock rraim wxm6'W devices are im;,$we. ii.Work d'aratdmo is grteader them 6O a imres. - 2W S®' 26 -W 266 P66' 24'6 8619 206 h.Use a eansnste'2 Sapp ear-thr-0-a rhe—v Zama. S'.ROA®VURK AHEAD and the MPREP4UO To STaP signs may He 35 27 56 20' S0" 206' 266' 266 I66' 256 C.Place each 04=6,"a Strap Set rraa ersaay arrays rhe"—ac mnsrrtead if ado of the 000m,40emmdivsm are mer: 4tID 2Dl' SW' 26 ST 266' 2W 266 VW MY lma:arimms stroma. a.mask oparffieors are 60-mem or rens. d.Use Option I-6p0emn 2 as shoat mo Shear 2.Use army a e opliaas h.Speed'piaci is 65 maph-fess. g6' 3s6' 336' 356 I75' me rhfauylmaa wore Zama. e.Thane awe ma sdgam mttsr'bouaha to reficovZ appraachdrgy rhe work S6 2BD' So, 26 006 566' 366' 506' 256' 425' area far a aysngwe a 4m'd to rhe suffer Spaces smote ch Tahoe V. 55 221 5aD' 26 066 2646` I5W 1666 566' 499 4.Adddremal was-way cotta§ .y me prao 4 rP.fod(�awr:ra3 mmai�: d.�7efale➢es cru far mark--his hrg9d yinfamsarg..rmeatdag,dBaashaing•, 69 27SAr 26r B67 2Sx16 D5 ➢666 S6aB' 576 a.FW'amrynm5 rehire: rrs.10&mg.-stradhe 0#ts aprr 'mm. H.011iced wed¢cre: e.wamasme and ammpvl cif mf the raw I[ajy�Hees comweA ed. 65 2W W BID' B@rID' 2Y46' BSm6'➢006' 566' 645' e.Pilot vethkles: 0.DIF a'x*t mad arossdn is pre s-r---defter nariU-t Q—ar✓rass P6 26' SID' 21ID' D06 2B4iP' H566 P60rD' 506 7-' d.Trafree vgaaks. ra0 rna:ks. g.AFAOs are amt im rrra. ¢Unset flawets are Me .0--y centrad,rhe r0asgers must me rm sngrm of each m"mr ar do dnnesr comcarnicaasn ar app rri>Bs. BO.Ser IMA"606 fpr germral Tez ne rememrs trod-%ht'.oa/ emf-w.temm. $ 5.BWheo a side road emte rseas rB.migfasag-far'rn treks TTe soar,pdaee CONDITIONS aelddionaI Tre deveces r'on areordamee aft mrlear aRRdnc"e Tez fmd'ry . III.Avramate g F➢ayyer Azssstaree Demes DAFADs➢orad He o T'eo ium aeeardacrce math He Moto m r Sneer 3. WHERE ANY VEHICLE.EGMPId?E40E, 6.The two ehamnmvn fflg dernees aff—17y n6 From ad tF.mark alae w.ag Hr WORKERS 6R THrElm ACTDUrms amm"ed promded wukr A�®rhe owt area Wau g dlashdag.6seiG0aedmg,ar srnaHr BligEms agm+*atim3. CE Cl/THE � 67 TWEE Tom TI¢SFAfFEALAND A•®A flBBfE 2' OMS06E THE EDGE OF TRAVEL WAr. 2 LAST 2 Ol:SCRPPPION: INDSE% SNIFFY REVISION FDOT� 2016 TW®- m TWO WAY, 90. 90. o!lml1s �- DESIGN STAND RDS W® VEL WAS 603 I of 3 TV D R ,T $AM OUT ASMALT N SEP 5 2015 L I BY C ®1610"x+ I ar OITP91 M6M `I.b •!•• V CWQ S UMAIM-• affik tr g" W E PARKWAY. 1 -- CAS MN ~ IS v111� tII' O REST® ATI®®LI� OF R®A® CUT SOOT R€STOWMN DETAIL sem: 10m80, � F® UTILITY CROSSING - — - -- - SCALE: IST T®SC/IlE �: N.6.94th STR6 —75' ��— {r$'Tom RM a,AsFwLr I�Awwwr TIE IN SVC. TO GAS MAI AaArsAS XI ST .6" PE. WITH T.T/EF.V - GAS MAIN a a x 1 4 6' GENERAL NOTES LEGEND a I 1, REPLACED BASE MATERIAL OVER DITCH SMALL BE TWICE THE CENTER LINE TTHyjI OF THE BASE, MIN, S" AND MAX, 1S" vowimr UNE 6 7 ••••••2, BASS IAL SMALL BE PLACED IN 8" MAX. (LOOSE MEASUREMENT) •••• y� RMP OFwAl° 59 • • •••••• •••••• LAYER Solt pAND E CA LAS TO T�80 LY ROLLED OR TAMPED TO 98TS OF A � �— 9 R „ PHIYL� COW P �L • • •••••..'b. A • CCIS d MENT JOINTS SHALL BE MECHANICALLY SAWED E @.P, EDGE OF PAVEMENT I •• • •• • • • • • 4, SURFACE MATERI L BE CONSISTENT WITH SURROUNDING SURFACE T,T, TAPPING TEE Ovt _ ••••• •••• •••�•• i••••i MAI�RIAL (1,3 dikk Tfi1ClZNESS) ERV EXCM FLOW VALVE u�" •••••9t • • • • w'b. BASS MATRR1AL SHAltt HAVE A MIN, LBR, OF 100 AND A MIN, CARBONATE 51 StRVIfGE LINE 23' I ' ••• •• ••••• �EIdOF FOR LOCAL STREETS) ' ......••• • i•••i• • ,3 • • • 8. CONTRAC SHALL SOFT DIG TO VERIFY LOCATION OF EXISTING UTILITIES PE PLASTIC TWO STORY 1 sees • •.�;�. ••••• ••• • •••••• 1 • • • • • S1iA SE►K STCRJrI SEYlER RESIDENCE I � �, � see ' • • • • PROP. RISER WI t®� ji 1g� 1 t®�a I rAs ba ®� ••0 • p� •••••• • • • • �G •••••• J/4" PLASTIC GAS ` �` ®r •••••• • • • SVC. TO BE atter' I •••••• • • • • ••• • • •• DIRECTIONAL BORED � 11 ,� • • • •• • • •• na- a •• • • ••• • • • ALL EXISTING UTILITIES SHOWN ONe��" "x I �••• THESE PLANS ARE TO BE ✓> - CONSIDERED APPROXIMATE & SHOULD BE VERIFIED BY THE � ado, CONTRACTOR PRIOR TO THE RM START OF WORK OPERATIONS. WA I Q ,y, S•M6@E I N w J 0 Big 75' ! �� 1 W GRD. FSP 100v now El L1, tWk IAy = d g W ROP. 4'V.PLASTIC r5'ar v 36" MIN, DIRECTIONAL BOREDi Asrxu r vAamasvr : EXT 6" PE. GAS I 4 Miami Sh9e ApP130VED BY DATE ?CRffNG DEPT M or s ® C �=`!DG DEPT" .,,_ �.. % 23 .� PROFILE CROSSINP NE, 94th ST, SCALE: (V) 1;5' (H) NTS. ; ' No,; 1 Drawing Fee: \\browardfs\volt\USERS\PGMXC\Documents\RESIO TIAL\2015\NE 94 ST, 94 ST IAMI SHORES, FLdwg 09/11/2015 'r✓UN',Y r3LIL=S ANDREGULATIONS 'pe it rM PW-9"1 48 Miami Shores Village 7"ye:Pa > c €r :, 10050 N.E.2nd Avenue NES Itrcatiti» Public-Miami Shores,FL 33138-0000 . Works cif Statr : 0FtQVEQ SA Phone: (305)795-2204 R ��: E I* > .'Ctfltt2tl'f5 Expiration: 1 12015 Project Address Parcel Number Applicant 450 NE 94 Street 1132060140320 JOHN AND KELLY MOORE Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell JOHN AND KELLY MOORE 450 NE 94 Street MIAMI SHORES FL 33138-2924 450 NE 94 Street MIAMI SHORES FL 33138-2924 Contractor(s) Phone Cell Phone Valuation: $ 1,000.00 TECO PEOPLES GAS SYSTEM (305)957-3857 (305)970-1783 i _.......... . ..._... . ._._...._v_ _..., ._ ,. ._ __ _....__..,,..... Total Sq Feet: 00 Scanning:3 Available Inspections: Inspection Type: Final Excavation Review Building Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.60 DBPR Fee Invoke# PW-9-15-57095 $2.00 10/01/2015 Check#:5780 $64.60 $50.00 DCA Fee $2.00 Education Surcharge $0.20 09/15/2015 Check#:5766 $50.00 $0.00 Permit Fee $100.00 Scanning Fee $9.00 Technology Fee $0.80 Total: $114.60 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict 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,.I-LUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work. OWNERS Szin'.� at II the foreg ' g information is accurate and that all work will be done in compliance with all applicable laws regulating constructioermore I a horiz h abo - a ed contractorto do the w 7, October 01,2015 Authorizeignat e:Owner / Applicant / Contra or / Agent Date Building a rtment Copy October 01,2015 1