14th Change Order 05/25/2018MEMORANDUM
TO: Board of County Commissioners
From: Assistant County Administrator
Date: May 24, 2018
RE: Change Orders
Attached is a proposed Change Order #14 Burke Construction Group, Inc., The
Redevelopment of Bernstein Park. The Contract Sum will be increased $15,127.59. The
date of Substantial Completion as of the date of this Change Order is March 30, 2018.
According to Ordinance No. 004 -1999 adopted by the Board of County Commissioners,
proposed change orders are to be presented to members of the Board of County
Commissioners at least 24 hours prior to approval, assuming they are within the
Administrator's prescribed limits. Change orders not within the Administrator's authority
are placed on the BOCC agenda.
mature
County Administrator
of
Kevin G. Wilson
Print Name
ONROE COUNTY /ENGINEERING/ PROJECT
M ANAGEMENT
CONTRACT CHANGE ORDER
PROJECT TITLE:
The Redevelopment of Bernstein Park
TO CONTRACTOR:
Burke Construction Group, Inc.
10145 NW 19 St
Doral FL 33172
CHANGE ORDER NO: 14
INITIATION DATE: March 26' 2018
CONTRACT DATE: April 20, 2016
The Contract is changed as follows::
The original ( Contract Sum (Guaranteed Maximum Price).. ......... _ ....... ....... $7, 921,975.00
Net change by previously authorized Change Orders....., ... ---- ...... ................$(86,614.84)
The ( Contract Sum (Guaranteed Maximum Price) prior to this Change order was ... $7,835,360,16
The ( Contract Sum) (Guaranteed Maximum Price) will be ( increased ) (decreased)
(unchanged) by this Change Order ...... $15,127.59
The new ( Contract Sum (Guaranteed Maximum Price) including thi Change Order is
... $7,850,487.75
The Contract Time will be (indr sd) (decreased
unchanged) y 00 Days
The date of Substantial Co t letio as of the date ot this� r ge Order is... March 30, 2018
Detailed description of change order and justification:
A dltion of door to s on classroom closet doors. Removal of umbo limbos and bou anville that
conflict with the maintenance of the ark. Addition of a concrete li at the bottom of the flood
P-a - 0 - e - Is - aLth e - entry doors to the rnaintenan e z h=t4 Increased size of Irrm tion meter fr�rr� t
Inch tt� Clne In ch..
0 111IIII 1 ' • ■ s r
ARCHITECT:
CONTRACTOR:
DIRECTOR PROJECT MANAGEMENT/
COUNTY /ASSISTANT ADMINISTRATOR f '
Roman Gatesl Kevin Wilson, Christine Hurley Date
Change Order Attachment per Ordinance No. 004 -1999
• Change Order was not included in the original contract specifications. Yes ® No ❑
If Yes, explanation: Concrete is needed at the bottom of the flood panels to assure a
watertight seal. Crash chains and kick down door stops will prevent the doors from hitting
walls and wall mounted fixtures.
• Change Order was included in the original specifications. Yes ® No ❑
If Yes, explanation of increase in price: Facilities recommended that the Bouganville and the
Gumbo Limbos be eliminated at the park since they will impact the field maintenance.
9 Change Order exceeds $50,000 or 5% of contract price (whichever is greater).Yes ❑ No
If Yes, explanation as to why it is not subject for a calling for bids:
• Project architect approves the change order. Yes ® No ❑
If no, explanation of why:
• Change Order is correcting an error or omission in design document. Yes ❑No
Should a claim under the applicable professional liability policy be made? Yes ❑ No
Explain:
Change
Order
Request
AIA Document G710
OWNER
ARCHITECT
CONTRACTOR
FIELD
SUBCONTRACTOR
PROJECT. Bernstein Park
6751 5th Street
Stock Island< Florida 33040
CONTRACTOR: Burke Construction Group, Inc.
10145 N.W. 19th Street
Doral, Florida 33172
M
BuKKE
Construction Group Inc.
CHANGE ORDER NUMBER:
037
DATE:
2/12/2018
CONTRRACTOR PROJECT #:
1611
Prime Contract Change Order #037: Concrete for Flood Panels
TO: Monroe County Engineering
FROM:
Burke Construction Group, Inc.
1100 Simonton Street
1 Concrete for Flood Panels
10145 NW 19th Street
Key West, Florida 33040
TOTAL:
Miami Florida 33172
DATE CREATED: 2/12/2018
CREATED BY:
Armando Silveira (Burke Construction Group,
Inc.)
CONTRACT STATUS: Pending - In Review
REVISION:
1
DESIGNATED REVIEWER: Armando Silveira (Burke Construction
REVIEWED BY:
Group, Inc.)
DUE DATE:
REVIEW DATE:
INVOICED DATE:
PAID DATE:
SCHEDULE IMPACT:
EXECUTED:
No
CONTRACT FOR: 1:Redevelopment of Bernstein Park
TOTAL AMOUNT:
$ 5,533.00
DESCRIPTION:
Cut asphalt and excavate a 12 "x12 "x30' section in front of Maintenance building. Install dowels and
pour 4,000 psi concrete to provide sealed surface
for flood panels.
ATTACHMENTS:
Qongp . dpo ,I�d ,
POTENTIAL CHANGE ORDERS IN THIS CHANGE ORDER:
PCO #
Title
Schedule Impact
Amount
037
1 Concrete for Flood Panels
5,533.00
TOTAL:
$ 5,533.00
CHANGE ORDER LINE ITEMS:
Burke Construction Group, Inc. page 1 of 2 Printed On: 3/19/ 2018 09:50 AM
Change
Order
Request
AIA Document G710
PCO # 037 : Concrete for Fl Pa nels
#
Cost Code
Description
Type
Amount
1
03 -100 - CONCRETE / MASONRY
Concrete Pump
Subcontractor
$ 450.00
2
03 -100 - CONCRETE / MASONRY
Demo (4 men B hrs @ $32.50)
Subcontractor
$ 1,040.00
3
03 -100 - CONCRETE / MASONRY
Compact, vapor barrier, and install rebar ( men 6 hrs @ $32.50)
Subcontractor
$1.040.00
4
03 -100 - CONCRETE / MASONRY
Mac materials ( rebar, epoxy, drill bits, vapor barrier
Subcontractor
$ 250.00
5
03 -100 - CONCRETE / MASONRY
Small tools ( hammer drill, plate compactor)
Subcontractor
$ 150.00
6
03 -100 - CONCRETE / MASONRY
Concrete material 12 yards (Short Load at Monroe Concrete)
Subcontractor
$1,200.00
7
03 -100 - CONCRETE / MASONRY
Finisher ( minimum cost)
Subcontractor
$ 250.00
6
03 -100 - CONCRETE / MASONRY
Dumpster (concrete debris)
Subcontractor
$ 650.00
Subtotal: $5,030.00
Overhead: 5.00% Applies to all line item types 251.50
Profit: 5.00% Applies to all line item types 251.50
Grand Total: $5,533.00
The original (Contract Sum) $ 7,921,975.00
Net change by previously authorized Change Orders ($86,614.84)
The contract sum prior to this Change Order was $ 7,835,360.16
The contract sum would be changed by this Change Order in the amount of $ 5,533.00
The new contract sum including this Change Order will be $ 7,840,893.16
The Contract Time will be (increased) (decreased) (unchanged) by
The date of Substabtial Compl as of the date of this Change Order therefore is
Master Permit Issue Date 8/18/2016 Contract Base Days: Added Time Above:
OWNER X
ARCHITECT
CONTRACTOR X
FIELD
SUBCONTRACTOR
r ♦ • r
Reservations: This proposal is based solely on the usual cost elements such as labor material and normal markups, and does not include any amount
for additional changes in the sequence of work, delays, disruptions, rescheduling, lost productivity, extended or unabsorbed overhead, overtime,
acceleration and or impact costs, unless speciffically stated. The right is expressly reseved to amend and make claim for any and all of these related
items prior to final settlement of this contract.
Bill Horn (Architect)
915 Eaton Street
Key West Florida 33040
Monroe County Engineering
1100 Simonton Street
Key West Florida 33040
Burke Construction Group, Inc.
10145 NW 19th Street
Miami Florida 33172
SIGNATURE DATE
SIGNATURE DATE SIGNATURE DATE
Burke Construction Group, Inc. page 2 of 2 Printed On: 3/19/ 2018 09:50 AM
Change
Order
Request
AIA Document G710
OWNER
ARCHITECT
CONTRACTOR
FIELD
SUBCONTRACTOR
PROJECT: Bernstein Park
6751 5th Street
Stock Island< Florida 33040
x
X BU KE
Construction Group Inc.
CHANGE ORDER NUMBER: 038
DATE: 2/12/2018
CONTRRACTOR PROJECT #: 1611
CONTRACTOR: Burke Construction Group, Inc.
10145 N.W. 19th Street
Doral, Florida 33172
Prime Contract Change Order #038: Landscape Changes by Owner
TO: Monroe County Engineering FROM: Burke Construction Group, Inc.
1100 Simonton Street 10145 NW 19th Street
Key West, Florida 33040 Miami Florida 33172
DATE CREATED: 2/12/2018 CREATED BY: Armando Silveira (Burke Construction Group,
Inc.)
CONTRACT STATUS: Pending - In Review REVISION: 2
DESIGNATED REVIEWER: Armando Silveira (Burke Construction REVIEWED BY:
Group, Inc.)
DUE DATE:
REVIEW DATE:
INVOICED DATE:
PAID DATE:
SCHEDULE IMPACT:
EXECUTED: No
CONTRACT FOR: 1:Redevelopment of Bernstein Park
TOTAL AMOUNT: $ 2,714.25
DESCRIPTION:
$ 2,714.25
Remove and replace 4 Gumbo Limbo with Sable Palm. remove and dispose of 9 bougainvilleas.
ATTACHMENTS:
R -evi d.,E t 84,5 — f r�na Ate ti,� Earl s ABrag_I?��rg Irt� ® 17.348.[00
POTENTIAL CHANGE ORDERS IN THIS CHANGE ORDER:
PCO #
Title
Schedule Impact
Amount
038
1 Landscape Changes by Owner
2,714.25
TOTAL:
$ 2,714.25
CHANGE ORDER LINE ITEMS:
Burke Construction Group, Inc. page 1 of 2 Printed On: 3/14/ 2018 02:49 PM
Change OWNER
Order
Request ARCHITECT
CONTRACTOR
FIELD
AIA Document G710
SUBCONTRACTOR
X
Description
X
Type
Amount
rw * us0 : Lanascape %,nanges ray owner
#
Cost Code
Description
Type
Amount
1
02 -901 - LANDSCAPE & SOD OUTSIDE THE
SPORTS FIELDS
Remove 4 Gumbo Limbo and replace with Sable Palm
Subcontractor
$ 2,000,00
2
02 -901 - LANDSCAPE & SOD OUTSIDE THE
SPORTS FIELDS
Remove 9 bouganvileas
Subcontractor
$ 350.00
3
02 -901 - LANDSCAPE & SOD OUTSIDE THE
SPORTS FIELDS
Overhead and profit 10%
Subcontractor
$ 235.00
Subtotal:
$2,585.00
OH & P: 5.00% Applies to all line item types
129.25
Grand Total:
$2,714.26
The original (Contract Sum) $ 7,921,975.00
Net change by previously authorized Change Orders ($86,614.84)
The contract sum prior to this Change Order was $ 7,835,360.16
The contract sum would be changed by this Change Order in the amount of $ 2,714.25
The new contract sum including this Change Order will be $ 7,838,074.41
The Contract Time will be (increased) (decreased) (unchanged) by
The date of Substabtial Completion as of the date of this Change Order therefore is
Master Permit Issue Date: 8/16/2016 Contract Base Days: Added Time Above:
Reservations: This proposal is based solely on the usual cost elements such as labor material and normal markups, and does not include any amount
for additional changes in the sequence of work, delays, disruptions, rescheduling, lost productivity, extended or unabsorbed overhead, overtime,
acceleration and or impact costs, unless speciffically stated. The right is expressly reseved to amend and make claim for any and all of these related
items prior to final settlement of this contract.
Bill Horn (Architect)
915 Eaton Street
Key West Florida 33040
SIGNATURE DATE
Burke Construction Group, Inc.
Monroe County Engineering
1100 Simonton Street
Key West Florida 33040
SIGNATURE DATE
page 2 of 2
Burke Construction Group, Inc.
10145 NW 19th Street
Miami Florida 33172
SIGNATURE DATE
Printed On: 3/14/ 2018 02:49 PM
A quatic Landscaping Design, Inc.
25405 SW 107th Av,
Princeton, FL 33032
Phone # 305.257.2220
Fax # 305.258.1584
Name /Address
Burke Construction Group, Inc.
1355 NW 97th Ave., #200
Doral, FL 33172
P: 305.468.6604 x241
F: 305.468.6654
Bernstein Park
Qty Descript Rto Total
4 Remove 4 Gumbo Limbo and replace with Sabal Palm 14 -16' 500.00 2,000.00
ht.
1 Remove and dispose (9) Bougainvilleas 350.00 350.00
Gfed` - a46 - 40 - 34Z - 00
1 Irrigation: 1 Quick Coupler and 2 heads at soccer field. 660 615�
1 .. - 47260-40
1 Overhead and profit of 10% $"
Sod was
installed
Burke w ill
pay the .
Total
Total price includes tax. Some plant material and /or sizes may not be available as per specifications at time of planting.
Finish grade to within +/- 2" by others. Unless otherwise specified, all permits, removals, relocates, tree protection,
manual continued watering, maintenance, MOT, soils, berms, swales, excavation, backfilling, cutting /patching of
asphalt/concrete, coring, boring, compacting, hardscapes, pots, planters, tree grates, root barriers, weed fabrics,
furnishings, lighting, irrigation, water meters, backfllow & certification, wells, pumps, design /plans, Davis
Beacon /Prevailing wage are excluded from this proposal. Proposal good for 30 days. By signing this proposal /contract, Signature
you accept the prices and specifications as set forth herein, and you are authorizing us to do the work as specified.
Warranty does not cover loss due to sustained winds of 75 mph or more, floods, frost, lightning, vandalism or theft.
Plr •
U ntract
Estimate NO.
III � _ III
www.aquaticlandscape.com
Change
Order
Request
AIA Document G710
OWNER
ARCHITECT
CONTRACTOR
FIELD
SUBCONTRACTOR
PROJECT: Bernstein Park
6751 5th Street
Stock Island< Florida 33040
CONTRACTOR: Burke Construction Group, Inc.
10145 N.W. 19th Street
Doral, Florida 33172
x
x
BURKE
Construction Group Inc.
CHANGE ORDER NUMBER: 039
DATE: 3/16/2018
CONTRRACTOR PROJECT #: 1611
POTENTIAL CHANGE ORDERS IN THIS CHANGE ORDER:
PCO #
Prime Contract Change Order #039:
Crash Chains
TO:
Monroe County Engineering FROM:
Burke Construction Group, Inc.
1
1100 Simonton Street
10145 NW 19th Street
$ 974.09
Key West, Florida 33040
Miami Florida 33172
DATE CREATED:
3/16/2018 CREATED BY:
Armando Silveira (Burke Construction Group,
Labor
Inc.)
CONTRACT STATUS:
Pending - In Review REVISION:
0
DESIGNATED REVIEWER: REVIEWED BY:
DUE DATE:
REVIEW DATE:
INVOICED DATE:
PAID DATE:
SCHEDULE IMPACT:
EXECUTED:
No
CONTRACT FOR:
1:Redevelopment of Bernstein Park TOTAL AMOUNT:
$ 974.09
DESCRIPTION:
Supply and install crash
chains and kick down stops in closet doors 27, 28, 34, 35, & 36.
ATTACHMENTS:
NCO Optspn,A,-R1, 040f,
POTENTIAL CHANGE ORDERS IN THIS CHANGE ORDER:
PCO #
I Title
Schedule Impact
Amount
039
1 Crash Chains
1
974.09
TOTAL:
$ 974.09
CHANGE ORDER LINE ITEMS:
PCO # 039: Crash Chains
#
I Cost Code
Description
46.39'
Type
Amount
1
08521 -DOORS/FRAMES/HARDWARE
Supply and install crash chains and kick down door stops.
Labor
$ 1,127.70
2
08521 - DOORS /FRAMES /HARDWARE
Burke credit to Monroe County
Labor
1 ($200.00)
Subtotal:
$92730
OH & P: 5.00% Applies to all line item types
46.39'
Grand Total:
$974.09
Burke Construction Group, Inc. page 1 of 2 Printed On: 3/27/ 2018 03:35 PM
Change
Order
Request
AIA Document G710
OWNER
ARCHITECT
CONTRACTOR
FIELD
SUBCONTRACTOR
The original (Contract Sum)
Net change by previously authorized Change Orders
The contract sum prior to this Change Order was
The contract sum would be changed by this Change Order in the amount of
The new contract sum including this Change Order will be
The Contract Time will be (increased) (decreased) (unchanged) by
The date of Substabtial Completion as of the date of this Change Order therefore is
Master Permit Issue Date: Contract Base Days:
rl
• s r e
$ 7, 921, 975.00
($86,614.84)
$ 7,835,360.16
$ 974.09
$ 7,836,334.25
Added Time Above:
Reservations: This proposal is based solely on the usual cost elements such as labor material and normal markups, and does not include any amount
for additional changes in the sequence of work, delays, disruptions, rescheduling, lost productivity, extended or unabsorbed overhead, overtime,
acceleration and or impact costs, unless speciffically stated. The right is expressly reseved to amend and make claim for any and all of these related
items prior to final settlement of this contract.
Bill Horn (Architect)
915 Eaton Street
Key West Florida 33040
SIGNATURE DATE
Monroe County Engineering
1100 Simonton Street
Key West Florida 33040
SIGNATURE DATE
Burke Construction Group, Inc.
10145 NW 19th Street
Miami Florida 33172
SIGNATURE DATE
Burke Construction Group, Inc. page 2 of 2 Printed On: 3/27/ 2018 03:35 PM
Doors, d - W ♦•
Request for Change Order
Project Name: BERNSTEIN PARK
Project Location: 6751 5th Street
Stock Island, A. 33040
2000 NW 16th St, Suite B, Pompano Beach FI. 33069
Ph. 954 - 821 -9139 • Fax 954 - 491 -9833
Date: 1/25/2018
RCO #: 05 -A
Contact: Armando Silvera
Burke Construction
Phone: 305 - 322 -7862
COST I TOTAL
Below materials requested by Daniel 1- 17 -18; Add Chains & Stops to Closet Doors
27, 28, 34, 35, 36
10 CCS -1 Heavy Crash Chain Stop - Silver Zinc $52.99 $529.89
10 KDS - B Kick Down Stop (Brass Base) - 26D $15.34 $153.40
Material Cost $ 683.29
Tax $ 44.41
Installation $ 400.00
Total Change Order Amount $ 1,127.70
Please proceed with the above changes to this project - formal change order for this amount to follow
Signaturej I Print Name:
Date: Title:
Change OWNER x
Order
Request ARCHITECT
CONTRACTOR X
FIELD
AIA Document G710 UKK
SUBCONTRACTOR Construction Group Inc.
PROJECT: Bernstein Park CHANGE ORDER NUMBER: 040
6751 5th Street DATE: 4/6/2018
Stock Island< Florida 33040 CONTRRACTOR PROJECT #: 1611
CONTRACTOR: Burke Construction Group, Inc.
10145 N.W. 19th Street
Doral, Florida 33172
Prime Contract Change Order #040: 1 inch Irrigation Meter
TO: Monroe County Engineering FROM: Burke Construction Group, Inc.
1100 Simonton Street 10145 NW 19th Street
Key West, Florida 33040 Miami Florida 33172
DATE CREATED: 4/06/2018 CREATED BY: Armando Silveira (Burke Construction Group,
Inc,:)
CONTRACT STATUS: Pending - In Review REVISION: 0
DESIGNATED REVIEWER: REVIEWED BY:
DUE DATE: REVIEW DATE:
INVOICED DATE: PAID DATE:
SCHEDULE IMPACT: EXECUTED: No
CONTRACT FOR: 1:Redevelopment of Bernstein Park TOTAL AMOUNT: $ 5,90625
DESCRIPTION:
Cost difference between 5/8" meter to 1" meter thru FKAA. The site contractor will not charge to change the meter box and RPZ.
ATTACHMENTS:
Beru(c nPaTK_'rigatic 00121 Op0000 0,pdt
POTENTIAL CHANGE ORDERS IN THIS CHANGE ORDER:
PCO #
Title
Schedule Impact
Amount
040
11 inch Irrigation Meter
5,906.25
TOTAL:
$ 5,906.25
CHANGE ORDER LINE ITEMS:
PCO # 040 : 1 inch Irrigation Meter
# Cost Code Description Type Amount
1 02 -665 -WATER & SEWER 5 /6" irrigation meter from FKAA Subcontractor ($3,750.00)
2 02 -665 - WATER & SEWER 1" irrigation Meter from FKAA Subcontractor $ 9,375.00
Subtotal: $5,625,00
Overhead & Profit: 5.00% Applies to all line item types 261.25
Grand Total: $5,906.25
Burke Construction Group, Inc. page 1 of 2 Printed On: 4/6/ 2018 04:04 PM
Change
Order
Request
AIA Document G710
The original (Contract Sum)
Net change by previously authorized Change Orders
The contract sum prior to this Change Order was
The contract sum would be changed by this Change Order in the amount of
The new contract sum including this Change Order will be
The Contract Time will be (increased) (decreased) (unchanged) by
The date of Substabtial Completion as of the date of this Change Order therefore is
Master Permit Issue Date: Contract Base Days:
$ 7,921,975.00
($86,614.84)
$ 7,835,360.16
$ 5,906.25
$ 7,841,266.41
Added Time Above:
Reservations: This proposal is based solely on the usual cost elements such as labor material and normal markups, and does not include any amount
for additional changes in the sequence of work, delays, disruptions, rescheduling, lost productivity, extended or unabsorbed overhead, overtime,
acceleration and or impact costs, unless speciffically stated. The right is expressly reseved to amend and make claim for any and all of these related
items prior to final settlement of this contract.
Bill Horn (Architect)
915 Eaton Street
Key West Florida 33040
SIGNATURE DATE
Burke Construction Group, Inc.
OWNER
ARCHITECT
CONTRACTOR
FIELD
SUBCONTRACTOR
� s a ■
Monroe County Engineering
1100 Simonton Street
Key West Florida 33040
SIGNATURE DATE
page 2 of 2
Burke Construction Group, Inc.
10145 NW 19th Street
Miami Florida 33172
SIGNATURE DATE
Printed On: 4/6/ 2018 04:04 PM
Florida Keys Aqueduct Authority Service Worksheet
Estimate Orly -Fees Subject to Change
µ!"iris shoot is applicable on date of preparation only.
Owner's flame and Mailing Address: Agent's Name and Mailing Address.:.
Monroe Coun Johnnie Yost ue
1100 S6monton Street Ste 2 -216 _
Kev Went. FL 33040 vonoue- atann etMrnonroecountyfi.00v
Date: 3123/201$ Reviaed 4/4, S Map No. I -045 & 1.046 Key: Stock Island
Name: 'Bernstein Park Lot: Pt 1.2.3,4,& Pt5 Block: 57
Subdivision: Maloney Address or Other: 6751 5th Street
Real Estate #: 00127300 000000
Water Fixture Value Charge
0
X
$75.00
-
$0.00
Sewer Fixture Value Charge
0
X
$0.00
$0.00
Size
Drop -in or Tap
No.
Meters:
1.0"
Drop -In Fee
1
X
$580.00
=
$580.00
0
X
$0.00
$0.00
0
x
$0.00
-
$0.00
Deposit
-
$150.00
Service Charge
1
X
$20.00
$20.00
Front Footage
0
X
$0.00
-
$0.00
Water S.D.C. Credit Grandfather Fixtures
0
X
$75.00
=
$0.00
Water S.D.C. Unit Credit
0
X
$5,000.00
-
$0.00
Sewer S.D.C. Credit Grandfather Fixtures
0
X
$0.00
$0.00
Sewer S.D.C. Unit Credit
0
X
$2,700.00
_
$0.00
Plan Review Fee
0
X
$50.00
-
$0.00
Water S.D.C. Single Family
0
X
$9,375.00
$0.00
Water S.D.C. Single Family (3 or Less)
0
X
$3,188.00
-
$0.00
Water S.D.C. Single Family (4 or More)
0
X
$2,813.00
-
$0.00
Irrigation Fee
1
X
$9,375.00
g
$9,375.00
Sewer S.D.C. Single Family Unit
0
X
$0.00
$0.00
Fees Waived Due to Government Service
-
- $150.00
TOTAL[
$9,975.00
lfater_Only)
Front Footage Due: No - Existing Account on Property
of the Line: 8 & V
Installed:
*FIXTURE WORKSHEET*
I Description: Number of Units: 1 11
Date: 3/23/2018, Revised 4/4/2018
Map No.:
1 -045 & 1 -046 Key:
Stock Island
Name: Bernstein Park
Lot:
Pt 1,2,34,& Pt5 Block: 57
Subdivision: Maloney
Address or Other:
6751 5th Street
Weight of
Sub -Total
Description of Fixtures
Numberof
X
Fixture Units
Fixture Value
Fixtures
Water
Sewer
Water
Sewer
Bathtub /Spa
X
8
mm
Shower Head (Shower Only)
X
1.5
Water Closet: Tank Type
X
1.6
=
Lavatory: 1/2"
X
4
Water Closet: Flush Valve
X
1.6
3 Compartment Sink
X
1.5
Wash Sink
X
1.5
Washing Machine: 1/2"
X
6
Janitors Sink
X
1.5
=
Hose Bib 3/4"
X
12
Drinking Fountain (public)
X
2
Urinal: Pedestal Flush Valve
X
35
Irrigation System with 16 zones
80 gpm of highest zone
TOTAL FIXTURE VALUES:
0
Backflow Prevention f r Comm r i T e pev810 mOnt;
AGKFLOW Backlow Assembly:
Conditions On canal or waterfront with normal fixtures
Hazard: high
BackflowAssembl: RPX
Additional Notes: Contractor to Instali new 1" meter box and RPZ to serve Irrigation systern as part of eAst'ing utility peww t. FKAA to drop In 1 °"
ureter once permit is closed by Engineering. No sewer us6ng fixtures allowed. Hold work order until notified by Engineering,
RPZ reaur red.
*GRANDFATHERED FIXTURES WORKSHEET*
Description: Number of Units: 1
Date: 3123)2018, Revised 41412018
Map No.:
1 -045 & 1 -046 Key:
Stock Island
Name: Bernstein Park
Lot:
Pt 1,2,3,4,& Pt5 Block: 57
Amount:
Subdivision: Maloney
Address or Other: 6751 5th Street
Number of
Weight of
Sub -Total
Description of Fixtures
X
Fixture Units
Fixture Value
Fixtures
Water
Sewer
Water
Sewer
Bathtub /Spa
X
8
Shower Head (Shower Only)
X
2.5
Water Closet: Tank Type
X
3
m
Lavatory: 318"
X
2
Water Closet: Flush Valve
X
35
Kitchen Sink: 1/2"
X
3
Ice Machine (Commercial)
-
X
2
Washing Machine: 1/2"
X
6
Service /Bar Sink 1/2"
X
3
=—
Hose Bib 1/2"
X
6
Urinal: Wall or Stand
X
12
TOTAL FIXTURE
VALUES:
0
Additional Notes: Contractor to Install new I" meter box and RPZ to serve irrigation system as part of existing utility permit. FKAA to drop M I"
meter once permit is c0osed by Engineering. No sewer using fixtures a&lowed. Fold work order until notified by Engineering.
RPZ required.
Prepared by: Kim Judge
Date: 3/23/2018
Pre- TreatmentRev:
Reviewed by: Marnie Walterson
Date: 4/4/2018
Date: Date Paid: