PW-16-3430Project Address
Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
1095 NE 95 Street
Miami Shores, FL
Owner Information
Permit
Permit NO. PW -12-16-3430
Permit Type: Public Works
Work Classification: Public Works
Permit Status: APPROVED
Issue Date: 12/22/2016
Expiration: 03/22/2017
Parcel Number
Applicant
Address
Phone
Cell
JOEL PEREZ PEREZ
1095 NE 95 Street
MIAMI SHORES FL 33138-
1095 NE 95 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone CeII Phone
TECO PEOPLES GAS SYSTEM (305)957-3857 (305)970-1783
Valuation:
Total Sq Feet:
$ 1,000.00
0
Scanning: 1
Fees Due
CCF
DBPR Fee
DCA Fee
Education Surcharge
Permit Fee
Scanning Fee
Technology Fee
Total:
Amount
$0.60
$2.25
$2.25
$0.20
$150.00
$3.00
$0.80
$159.10
Pay Date Pay Type
Invoice # PW -12-16-62425
12/21/2016 Check #: 1124
12/22/2016 Check #: 1181
Amt Paid Amt Due
$ 50.00 $ 109.10
$ 109.10 $ 0.00
Available Inspections:
Inspection Type:
Final
Excavation
Review Plumbing
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 per.•.t I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for EL T ICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS A IDr IT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
cons .n . • zoning. Futhermore, I authorize the above-named contractor to do the work stated.
December 22, 2016
Auth. i ed Signature: Owner / Applicant / Contractor / Agent
Building Department Copy
Date
December 22, 2016 1
\212'L``(P
BUILDING
PERMIT APPLICATION
Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
DEC 1 2016
BY: 11
ipa) - 7- /t, - ZC?L
FBC 20 3430
Master Permit No. ?W \10
Sub Permit No.
❑BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION 0 EXTENSION RENEWAL
❑PLUMBING ❑ MECHANICAL PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
�J CONTRACTOR DRAWINGS
JOB ADDRESS:
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:
CONTRACTOR: Company Name: TECO PEOPLES GAS 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
❑ New ❑ Repair/Replace n Demolition
Description of Work: PERMIT RE -NEW FOR A GAS SERVICE LINE
Specify color of color thr u tile:
5a
Submittal Fee $
Scanning Fee $ -3 •
Technology Fee $ c•
Permit Fee $ CCF $ 0 • 6)0CO/CC $
Radon Fee $ a. (PR $ a./;L Notary $
Training/Education Fee $ '""' Double Fee $
Structural Reviews $
(Revised02/24/2014)
9
Bond $
TOTAL FEE NOW DUE $ t O • ( /
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 v00�
OWNER or AGENT
CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
day of , 20 , by 2 day of �� •
, who is personally known to
,_2Q
') El544- s ✓ 5 A-0' , who
me or who has produced as me or who has produced
identification and who did take an oath.
identific
NOTARY PUBLIC: NOTA
Sign:
Print:
Seal:
by
ersonally kno n
ho did take an oath.
N 4
s5_�
y c c O
0 n o Z
Z N a vz
Q c Z
J1 U x o
W N
x a E
E E'
iC o U o y
U •
o ] CO
n
tttt
b0.l.
Seal:
***********************************************************************sss*************************
APPROVED BY -'3J (f Plans Examiner
Structural Review
(Revised02/24/2014)
Zoning
Clerk
000423
Local Business Tax Receipt
Miami—Dade County, State of Florida
-THIS IS NOT A BILL - DO NOT PAY
1133248
BUSINESS NAME/LOCATION
PEOPLES GAS SYSTEM INC
15779 W DIXIE HWY
NORTH MIAMI BEACH FL 33162
RECEIPT NO.
RENEWAL
1133248
EXPIRES
SEPTEMBER 30, 2017
Must be displayed at place of business
Pursuant to County Code
Chapter 8A - Art. 9 & 10
OWNER SEC. TYPE OF BUSINESS
PEOPLES GAS SYSTEM INC196 SPECIALTY ENGINEERING CONTRACT PAYMENT RECEIVED
BY TAX COLLECTOR
Worker(s) 60
E1608
$195.00 08/22/2016
FPPU11-16-015470
This Local Business Tax Receipt only confirms payment of the Local Business Tax. The Receipt is not a license,
permit, or a certification of the holder's qualifications, to do business. Holder must comply with any governmental
or nongovernmental regulatory laws and requirements which apply to the business.
The RECEIPT NO. above must be displayed on all commercial vehicles - Miami -Dade Code Sec 8a-276.
For more information, visit www.miamidade.gov/taxcollector
Municipal Contractor's Tax Receipt
M iami-Dade County, State of Florida
-THIS IS NOT A BILL - DO NOT PAY
CC NO: E1608
BUSINESS NAM E/LOCATION
PEOPLES GAS SYSTEM INC
15779 W DIXIE HVW
NORTH MIAMI BEACH, FL 33162
OWNER
PEOPLES GAS SYSTEM INC
MIAM
RECEIPT NO.
7489501
TYPE OF BUSINESS
9:ECIALT(ENGINEER1NG
CONTRACTOR
MC
EXPIRES
SEPTEMBER 30, 2017
Pursuant to County Code
Sec 10-24
PA YM ENT RECEIVED
BY TAX COLLECTOR
175.00 08/30/2016
0233-16-001721
This receipt is not valid in thefcllowing Municipalities: Aventura, Doral, Iialeah, Key Biscayne,
Miami Gardens, Miarri Lakes, Palmetto Bay, Rnecrest, Sunny Isles Beach, Town ofCutler Bay.
Rx more information, visit www miamidade.gav/taxcollector
TIE IN SVC TO A GAS MAIN
WITH T/T/T. F. / E. F. V
ALLEY WAY (ASPHALT)
• .•
• . •••• • .• i
• • •
• i • • •
• • • •
• •
• ..f!•�,
• /�
• • ( • •
•. •
PRS• .` 3/4:.1x. STIC •••
CAC..SVC. DrREC•IIONAL••
SORE • .•••
•
F"
—•40040:
EX. 2" BSE.
CS. GAS MAIN N R/W
CCNCR!"?F
41'
. LO 30
Bt. •► 81
••
• • •
• • •a• • ••
s . •
"MOP. RISER'VITH 3•/4"
PLASTIC G•A•S"SVC.
4.
%..
•
20.
50.00'
LOT 31
BLOCK 81
BUILDING
,#1095
(
24.1' 1
411•111..10-
4 s 23.1
7 AC
E.O.P.
e.P.----
-S R/W
CONCRETE --4"'
tnn M'
S PA.
gENERAL NOTES
1. REPLACE BASE MATERIAL OVER DITCH SHALL BE TWICE THE
THICKNESS OF THE BASE, MIN. 8" AND MAX. 18"
2. BASE MATERIAL SHALL BE PLACE IN 6" MAX. (LOOSE MEASUREMENT)
LAYER AND EACH LAYER THOROUGHLY ROLLED OR TAMPED TO 98% OF
MAX. DENSITY PER AASHTO T-180
3. ASPHALT CONCRETE PAVEMENT JOINTS SHALL BE MECHANICALLY SAWED
4. SURFACE MATERIAL SHALL BE CONSISTENT WITH SURROUNDING SURFACE
MATERIAL
5. BASE MATERIAL SHALL HAVE A MIN. LBR. 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 SHALL COMPLY WITH INDEX
310.
, 50 0
AC
4'
110'
NE 95th STREET
LEGEND
CENTER LINE Q
MONUMENT UNE
RIGHT OF WAY R/W
PROPERTY UNE P/L
EDGE OF PAVEMENT E.O.P.
TAPPING TEE T.T.
EXCESS FLOW VALVE E.F.V.
SERVICE UNE SVC
WATER MAIN WM.
15'
o=
c:Jt
g o d
o<
F�
Miarni
Shores Viilage
V D BY 1 DATE
•h!G DEPT
1 a DEPT
I:.'I C T TO COMPLIANCE WITH ALL FEDERAL
I
I
) co! INWYR l rSAnn REM. ^r' FULL WE
SURMCE
SURFACE REPLACOENT
ALL EXISTING UTILITIES SHOWN ON
THESE PLANS ARE TO BE
CONSIDERED APPROXIMATE &
SHOULD BE VERIFIED BY THE
CONTRACTOR PRIOR TO THE
START OF WORK OPERATIONS.
SAW CUT ASPHALT
()
REPLACEMENT BASE
(NEW MATERIAL)
D
12' .,vacs 12'
JUL 192016 RESTORATION OF ROAD CUT
FOR UTILITY CROSSING
BY:
8
-----------15'
o_ $
EX. GRD
1 0_
1'KUP. 3/4" "LASTTC
CAS EVC. TO BE
z
L`1
w
IIn
4
36"
MIN•
4
•
r,As-6„,s
EX.2 B
E. CS
I
0
GAS MtIN
0
I
1
1
L_
PROFILE ALLEY WAY
: (V) ' 1:5 (H) NTS.
a
w
NO. 07 MOTS • 1
SEM No.: 1
Drawing File: C: \Users\stbxj\Desktop\Marlen Cabrera\JOBS\1095 NE 95th STREET MIAMI SHORES FL 33138\1095 NE 95TH STREET MIAMI SHORES 33138.dwg
07/06/2016
• •••• •
•• •• • • • •
• • • • •• •• ••
• • •• •
•••
• • • • •
• • •••
•• •• •
•. • ••
• • •
•
• • •
JL
J�
200'
• • ••• • • • • •••
J La J
• • • • •
•• • • •• •
• • • • • • •
• •• • • •
• • • • •
••• •• ••• •
CONDITIONS
• • • 1 WHE•E ANS •EHICer,•EOUIPNtI r, WORKERS
• • O1,2THP1R 1<CTAITI!S ENC1 ACH ON THE
• • : PAIEM:NT:li/1RI:le THE CCOiURE OF ONE
• • TP4FFI` LrJOE, jOR•WORK AREAE LESS THAN
••
J L J
b
SYMBOLS
MWork Area
• Channelizing Device (See Index No. 600)
Work Zone Sign
ET Flogger
b Lane Identification + Direction of Traffic
ft
r
200'
50'
Work Areal.
real.
■ ■ ■ ■
200'
7 Work Area /
More Than
200'
11
r=> • • • • • 200'(pOWN•TRT■9M igD.I A• INTERSECTION
GENERAL
1. Work operations shall be confined to one travel lane, leaving
the opposing travel lane open to traffic.
2. When vehicles in a parking zone block the line of sight to TCZ
signs or when TCZ signs encroach on a normal pedestrian
walkway. the signs shall be post mounted and located in
accordance with Index No. 17302.
3 If work area is confined to an outside auxiliary lane, the work
area shall be barricaded and the FLAGGER signs replaced by
ROAD WORK AHEAD signs. Flaggers are not required.
4. Flaggers shall be in sight of each other or in direct
communication at all times.
NOTES
5. The FLAGGER legend sign may be substituted for the symbol sign.
6. The maximum spacing between devices shall be no greater than 25.'
7. For general TCZ requirements and additional information, refer to
Index No. 600.
8. The two channelizing devices directly in front and directly at the
end of the work area may be omitted provided vehicles in the work
area have high-intensity rotating, flashing, oscillating, or strobe
lights operating.
9. Use Temporary Raised Rumble Strips in accordance with Index 603.
Placement of Rumble Strips and additional signs should begin at
FLAGGER sign location.
FOR A PERIOD OF MORE THAN 60 MINUTES.
CONDITIONS
WHERE ANY VEHICLE, EQUIPMENT, WORKERS
OR THEIR ACTIVITIES ENCROACH ON THE
PAVEMENT REQUIRING THE CLOSURE OF ONE
TRAFFIC LANE, FOR WORK AREAS 200' OR
MORE DOWNSTREAM FROM AN INTERSECTION
FOR A PERIOD OF MORE THAN 60 MINUTES.
DURATION NOTES
I. ROAD WORK AHEAD sign may be omitted if all of the following
conditions are met:
a. Work operations are 60 minutes or less.
b. Speed is 45 mph or less.
c. No sight obstructions to vehicles approaching the work area for
a distance of 600 feet.
d. Vehicles in the work area have high-intensity, rotating,
flashing, oscillating, or strobe lights operating.
e. Volume and complexity of the roadway has been considered.
LAST
REVISION
07/01/15
DESCRIPTION:
2016
DESIGN STANDARDS
TWO-LANE, TWO-WAY, WORK NEAR IINTERSECTIION
INDEX
NO.
605
SHEET
NO.
1 of 1