PW-17-1217 ,Per s Pll>f- =-7-1 17
Miami Shores Village et}!it P �:`PW , W2�'s
10050 N.E.2nd Avenue NE *fit/*m. 5'�5dailba PlUbk WbA
...,
Miami Shores,FL 33138-0000 � ,�;_
APPROVED
Phone: (305)795-2204
F0
�� 3f12f117 Expiration: /2017
Project Address Parcel Number Applicant
17 NE 106 Street 1121360060260
Miami Shores, FL Block: Lot: JUAN&MARIA SANCHEZ
Owner Information Address Phone Cell
JUAN&MARIA SANCHEZ (305)345-0202
Contractor(s) Phone Cell Phone Valuation: $ 2,985.00
COASTAL GROUP CONSULTANTS LL (305)477-9030
Total Sq Feet: 480
Scanning:1 Available Inspections:
Inspection Type:
Excavation
Review Planning
Review Planning
Review Planning
Review Public Works
Review Public Works
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.00
Invoice# PW-5-17-63895
DBPR Fee $0.00 05/30/2017 Check#:1814 $56.00 $50.00
DCA Fee $0.00
Education Surcharge $0.60 05/03/2017 Check#: 1784 $50.00 $0.00
Permit Fee $100.00
Scanning Fee $3.00
Technology Fee $2.40
Total: $106.00
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 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. Futhermore,I authorize the above- amed contractor to do the work stated.
May 30,2017
Authorized Signature:Owner / Applicant / Contractor / Agent Date
Building Department Copy
May 30,2017 1
tee• Miami Shores Village "Ck-,
Public Works 05)795D-2210ment �QY o8
Public works forms are available from the building department,10050 NE 2nd Ave.,Miami Shores,FL 33138 C
PUBLIC WORKS PERMIT APPLICATION
Permit Type:Work in the Right-of-Way on Miami Shores Village or Miami-Dade Property
Permit#:IF>V-j
1 -2-1 S-1
Name of Applicant(if utility see below): JAA a n �a I'1 LI 19
Owner off the following described property:
Legal Description: Lot 10 Block Subdivision h4ffininas 9(71'4V Orf qk+ 2
Folio#; J
Address: _ (1 IJP, Ou cotrlui i G onj b-(f..r, h . � �3
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City: State: ZIP:
Telephone: Email:
State Certification or Registration#: Certificate of Competency#
CONTRACTOR NAME: Cm d'd 67YA 1 [ate,
Qualifier/Authorized Agent: W 1 0 Cb--e'110
Address: a.-Ian 1 fh C1
City: State: Ft ZIP:
M()
Telephone. RSQ Email: D'
State Certification or Registration Mncz4c , �` ^l I 'Certificate of Competency#:
Requests permission to install (describe work,attach separate page if necessary)in the adjoining right of
way: [IC. _d44VI I"
Type of Work.• ,Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER:Arch itect/Engi nee
Address:
City: State. ZIP:
Telephone: Email:
Registration#:
Value of Work for this Permit: $ !'T'arJ Square/Lineal Footage of Work: ^f
Fees *+***
Permit Fee$ 100.00
Notary$ Training/Education$0.20 Technology Fee$0.80 Scanning$-]�'
Bond$ —(if required) Total Fee Now Due$ �� ,
Bonding Company's Name(if app 1 le):
Bonding Company's Address:
City: State: ZIP:
Application is hereby made to obtain a public works permit to do the work in the right of way 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,regulation construction in
this jurisdiction. I understand that separate permits must be secured for
APPLICANT'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be
done in compliance with applicable laws regulating construction and specifically construction in the
right-of-way.
"WARNING TO APPLICANT:YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN
YOUR PAYING TWICE FOR IMPROVEMENTS TO THE RIGHT-OF-WAY. 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 public works permit with an estimated value
exceeding$2,500,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 the
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 public works permit is issued. In the
absence of such posted notice,the inspection will not be approved and a reinspection ' be charged.
Signature Signature 2 A&-
Applicant or Authori Agent mpany/Utility Agen
The fore oing instrument was acknowledged before The foregoing instrumen, ;acknowledged before
me this�_day of 1 20�,by me this�_day of Aad 20�,by
Jocin �C 47 who f-�IIY�I (�I who
is personally known to me or who has produced is personally known to me or who has produced
FL J)t as FI IN as
identification. identification.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: A Sign: �1
Print:b n'o M-1 a:z Print: m)r
SEAL: SEAL:
r
Not PuWlc Stato of Fields jDlana
l�Diana Ramirez .�+" ,Ntic State of FbNde
� mlo�023221 ;� amhez' wIsslon 00 023221
er 8123/2020
APPROVED BY: S l8 Public Works Director,or Designee
2017-04-1S
1 I11 1 11111 111111MR 11 111111111
•' ""'"m OR BK 30551 Pg 3016 QF'9a}
RECORDED 05/30/2017 13 e 2U e 0 j
Tft HARVEY RUQ,INY CLERK OF COURT
[qR 411-AMI—DADE COUNTYP FLt7fiID
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
Whereas, (owner) JU ,1►-, n�7, hereinafter referred to as the
owner of the following described property (address);
Legal Description_ �� '-�1-'�� Lot -_ i(I Block.-20-7__ Subdivision M=rl
Folio # i i— 2 a -�C -� Z
Requests permission to Install (describe work): , @3�t, °Pay1tY "-, I mm
Within the public right of way of(address) ! 1
I i L
IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows:
1. To maintain and repair, when necessary, the above-mentioned item(s) Installed within the
dedicated right of way. If it becomes necessary for Miami Shores Village or Dade County
to make repairs or maintain said items within public right of way including restoration of
street by reason of the Owner's failure to do so, such expense shall be paid by the Owner
or shall constitute a lien against the above described property until paid,
2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade
County harmless from any and all liability, which may rise by virtue of permitting the
installation of these items within the public right of way.
3. The Owner does hereby agree to remove or relocate their facilities at their own expense,
within 60 days notice by the Village to do so. Failure to comply with this notice will result
In the Village causing the Item(s) to be removed and a lien being placed on the property
and/or assessed against the Owner for all costs incurred in the removal and disposal of
the itern(s).
4. The undersigned further agrees that these conditions shall be deemed a covenant
running with the land and shall remain in full force and effect and be binding on the
undersigned, their heirs and assigns, until such time as this obligations has been
canceled by an affidavit filed in the Public Records of Dade County, Florida by the
Village Manager of Miami Shores Village (or his fully authorized representative).
Signature
Owner or Agent
.The In instrument was acknowledged before me this day of . 20 M by
LJay-) nc who Is personally known to me or who has produced
as identification-and who did take an oath.
N OT R etp�►'DJ Notary PuNc$mta of F tda
Sign: mane Remmez
Print: CLCOUNro, ,U , oz ,
My Commission Expires; r�
DC -
R STRINGER#17220