PW-15-3206 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-250209 PermitNumber: PW-12-15-3206
Scheduled Inspecti ate: January 05,2016 Permit Type: Public Works
Inspector: ligue5,jelge Inspection Type: Final
Owner: KURLANDSKI, GUY&SELIN Work Classification: Public Works
Job Address:9301 N BAYSHORE Drive
Miami Shores, FL Phone Number
Parcel Number 1132050270560
Project: <NONE>
Contractor: TECO PEOPLES GAS SYSTEM Phone: (305)957-3857
Building Department Comments
INSTALL 2" PLASTIC GAS MAIN AND 3/4"GAS SERVICE Infractio Passed Comments
INSPECTOR COMMENTS False
PW 14-2376 PERMIT RENEWAL
Inspector Comments
Passed
Failed
Correction ❑
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-inspection fee is paid.
January 04,2016 For Inspections please call: (305)762-4949 Page 30 of 45
Permit NQ. PW4,2-'1 0 '
Miami Shores Village Public Works
10050 N.E.2nd Avenue N
Works
Miami Shores,FL 33138-000P0 PUblic
Per Wt Status:APPROVED
Phone: (305)795-2204
Issue
Date: 11412016 Expiration: 04/03/2016
Project Address Parcel Number Applicant
9301 N BAYSHORE Drive 1132050270560
Miami Shores, FL Block: Lot: GUY&SELIN KURLANDSKI
Owner Information Address Phone Cell
GUY&SELIN KURLANDSKI 9301 N BAYSHORE Drive
MIAMI SHORES FL 33138-
15811 COLLINS Avenue
SUNNY ISLES FL 33160-
Contractor(s) Phone Cell Phone Valuation: $ 2,000.00
TECO PEOPLES GAS SYSTEM (305)957-3857 (305)970-1783
Total Sq Feet: 0
Scanning: 1 Available Inspections:
Inspection Type:
Final
Excavation
Review Plumbing
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $1.20
Invoice# PW-12-15-58193
DBPR Fee $2.00
DCA Fee $2.00 12/30/2015 Check*6119 $50.00 $60.20
Education Surcharge $0.40 01/04/2016 Check#:6122 $60.20 $0.00
Permit Fee $100.00
Scanning Fee $3.00
Technology Fee $1.60
Total: $110.20
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,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFI AVI I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction an zoni g. Futhermore,I authorize the above-named contractor to do the work stated.
�ET LOAJe z January 04,2016
Auth ized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
January 04,2016 1
Miami Shores Village
Building Department DEC 9 0 20 5
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 1'
BUILDING Master Permit No. �l/ f 2v 016
PERMIT APPLICATION Sub Permit No. -
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION [:]RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: - 73Ce f 6 11-x/ _54®a c 'biz,
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: gz6i) /J
City: !/v" el-7w State: Zip:
a
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: TECO PEOPLES GAS Phone#: 954-453-0806
Address: 5101 NW 21 AVE. STE. 460
city. FT. LAUDERDALE State: FLZip: 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:$ 01000 Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration Q New ❑ Repair/Replace ❑ Demolition
Description of Work: d c AJ 1&-j G
Specify color of color thru tile:
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$
(Revised02/24/2014)
'+Iv
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lenders Name(if applicable)
Mortgage Lenders 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 -J�, b
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 ofT>-Ie 20 /S by
who is personally known to ry'C-Sus V2E�,4s who is personally known to
me or who has produced as me or who h produced as
identification and who did take an oath. identificati n a d who id aV a o th ;�•,
NOTARY PUBLIC: NOTARY P BLI "Ay py'e", HUBERT NUNEZ
Notary Public State of Florida
_•; ; My Comm.Expires Sep 11,20'1
Commission # FF 04367'x.
Sign: Sign. %%;�F F`� RnndpdThrmigh Nationalatan;
Print: Print:
Seal: Seal:
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
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1
STREET 99 ' '.t •
1 I 49 21 t
MAIN (DIR. BORE/36 _ s „
MIN COV.) i� V 36 MIN.
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00,
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mom 9a O t ttwm
:
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�Po. - I roll' PLA 8 W a. 59 us ea
e•
a. SHAM*4
QUEEZE OFF AND DIRECT TIE—IN (
AT END OF EX. 2" PE MAIN IN
I SWALE AREA
R/W R
N. BAYSHORE DR.
NOTES
s 49 6
36" MICONSTRUCTION
1 N.
---------------------
_--------'----- ----------- _ _ _ 1. LOCATE AND PROTECT ALL UTILITIES IN AREA OF
3 3 CONSTRUCTION. SUNSHINE # 1-800-432-4770
` 2. RESTORE ALL AREAS TO PRIOR CONDITIONS
0 p `- 3. ALL CONSTRUCTION TO FOLLOW JURISDICTIONAL
t t GOVERNMENT AND TPG STANDARDS.
-3 3
PROP 2" PE G.M<
DESIGNED BY: A. ROCHE '° OiOw SHEET
DRAWN BY: A. ROCHE TECO-PEOPLES GAS PROPOSED 2" PE GAS MAIN AND 3/4" SERVICE NO.
15779 W. DIXIE HIGHWAY amu. 9301 N. BAYSHORE DR.
"'
SCALE: 1" - 0' PEOPLES cN. MIAMI BEACH, FL
as 1-800-43-4770 eueffi SHORES, F. 1 of 1
J
ROAD
WORK
END AHEAD
ROAD WORK
A
■ ■ ■ ■ ■ to
e 1 Taper Length=//j! Work Area h'�
See Table It ENO Table II
ROAD ROAD wORK Ta er Length - Shoulder
WORK Device Spacing-Taper Device Spacing-Tangent 500
See Table! See Table f ysL(ft)
AHEAD SPEEDING PINES (Ph! g l0 12' Nates
DWBLED Speed
IMEN WRRERS Shldr. Shltlr. ShIdr.
PRESENT
25 28 35 42
Table I 30 40 50 60 L=ws=
Device Spacing 35 55 68 82 60
Max.Distance Between Devices(ft.) 40 72 90 107
Speed Cones or Type 1 or Type!! 45 120 150 180
(mph) Tubular Markers Barricades or Vertical 50 133 167 200
DISTANCE BETWEEN SIGNS Panels or Drums
Spacing(ft.) Taper Tangent Taper Tangent 55 147 183 220
a Speed A 25 25 50 25 50 60 160 200 240 L=WS
M1 40 mph or less 20 30 to 45 25 50 30 50 65 173 217 160
y3� 45 mph 35 50 to 70 25 50 50 ]00 70 187 233 280
50 mph or greater 50014
8' minimum shoulder width
'6L= Length of shoulder taper in feet
Y
SYMBOLS GENERAL NOTES DURATION NOTES w= width of total shoulder in feet
(combined paved and unpaved width)
vj ® Work Area 7.When four or more work vehicles enter the through traffic lanes in a one hour 1.Signs and channelizing devices may be omitted If all of the
period or less(excluding establishing and terminating the work area),the advanced following conditions are met: 5= Posted speed limit(mph)
Sign With 18'x 18'(Min.)Orange FLAGGER sign shall be substituted for the WORKERS sign.For location of flaggers a.Work operations are 60 minutes or less.
Flag And Type B Light and FLAGGER signs,see Index No.603. b.Vehicles in the work area have high-intensity,rotating,
flashing,oscillating,or strobe lights operating.
■ Channelizing Device(See Index No.600) 2.SHOULDER WORK sign may be used as an alternate to the WORKER symbol sign only
on the side where the shoulder work is being performed.
D Work Zone Sign 3.When a side road intersects the highway within the TTC zone,additional TTC
devices shall be placed in accordance with other applicable TCZ Indexes.
c� Lane Identification+Direction of Traffic CONDITIONS
§ 4.For general TCZ requirements and additional information,refer to Index No.500. WHERE ANY VEHICLE,EQUIPMENT,
WORKERS OR THEIR ACTIVITIES
_ ENCROACH THE AREA CLOSER
THAN 15'BUT NOT CLOSER THAN
2'TO THE EDGE OF TRAVEL WAY.
R
LAST JZDESCRIPTION:
REvrs,oN ° FDOT DESIGN STANDARDS INDEX SHEET
1�1NO.
07/01/07 FY 2012/2013 7CW0"II't11�TE, TWO-WAY, W®ice ®IV SHOULDER 602 ]