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PW-17-2099Project Address Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Permit Parcel Number Issue Date: 8/2 Permit NO. PW -8-17-2099 Permit Type: Public Works Work Classification: Public Works Permit Status: APPROVED 2017 Expiration: 11/23/2017 Applicant 10626 NE 10 Court Miami Shores, FL 33138-2102 1122320280960 Block: Lot: FRANK HERNANDEZ Owner Information Address Phone Cell FRANK HERNANDEZ 10626 NE 10 Court MIAMI SHORES FL 33138-2102 Contractor(s) HOME OWNER Phone CeII Phone Valuation: $ 1,000.00 Total Sq Feet: 185 Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $0.00 $0.00 $0.00 $0.20 $100.00 $3.00 $0.80 $104.00 Pay Date Pay Type Invoice # PW -8-17-64928 08/25/2017 Credit Card Amt Paid Amt Due $ 104.00 $ 0.00 Available Inspections: Inspection Type: Excavation Review Public Works Final Public Works 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 AFFIDAVI 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 zor. uthermore, I authorize the above-named contractor to do the work stated. Authorize gnature: Owner / Applicant / Contractor / Agent Building Department Copy August 25, 2017 Date August 25, 2017 1 NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. -5 1JCI5 TAX FOLIO NO. 11 J 22-7' -DL -(01('0 STATE OF FLORIDA: COUNTY OF MIAMI-DADE: CFN 2017R0496437 OR BK 30668 Ps 4950 (1F'ss) RECORDED 01/25/2017 12+16:01 HARVEY RIJVIH, CLERK OF COURT MIAMI-DADE COUNTY, FLORIDA STATE OF FLORID COUNT OF DADE THE UNDERSIGNED hereby gives notice that improvements will be madgfig ct: with !this,:: opyotthe property, and in accordance with Chapter 713, Florida Statutes, the follovr3�f in 1n . e ° , isprovided in this Notice of Commencement. A,L `A Mit N!TNLS; R P it '11 it " 1. Legal description of property and street/address: iAR , AD 20 Official Seal. 4r1 Space above reserved for use of recording office iu 1,1 c --o- tt ; ; 72)-.)i),5 tts .c. 2. Description of improvement: 11 -e -PLA 'T J p L f 4 ?a7 U a.tc 4f-1 A-4017 3. Owner(s) name and address: fl`kNIC. �L5''-t3A"tJb C., CO1'Interest in property: tiZ' r1� tati^ GI • ('tit 6t1 -011-c'5 Ft- '72", g Name and address of fee simple titleholder: 4. Contractor's name, address and phone number: fltd'4- I A t) I, t^2g-- �z 5. Surety: (Payment bond required by owner from contractor, if any) Name, address and phone number: Amount of bond $ 6. Lender's name and address: 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name, address and phone number: 8. In addition to himself, Owners designates the following person(s) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name, address and phone number: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13. FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF COMMENCEMENT. Signature(s) of Owner(s) or Owner(s)' Authorized Officer/Director/Partner/Manager Prepared By LNe-1L Prepared By Print Name F.1—t—hl- I481.4JortA Print Name Title/Office Title/Office STATE OF FLORIDA COUNTY OF MIAMI-DADE � The foregoing instrument wa acknowledged before me this �,7— day of By ` r�v� V, i�cr�,✓A5---kecYtkin P 7 ❑ Individually, or ❑ as for ❑ Personally known, or ❑ produced the following type of identification: Signature of Notary Public: Print Name: (SEAL) VERIFICATION PURSUANT TO SECTION 92.525, FLORIDA STATUTES Under penalties of perjury, I declare that I have read the foregoing and that the facts sta • o'in it are true, to the best of my knowledge and belief. Signature(s) of • ner s) or Owner(s)'s Authorized Officer/Director/Partner/Manager who signed above: By f By 123_01-52 PAGES 6/12 „ON., BeIkis Conde COMMISSION # FF185 • -� • ,� EXPIRES: December 28, 2i /°'i`r��P`° WWW.AARONNOTARY.0 D3\ 1-- 2-0t,?s Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 ,TATE OF 'HEREBY LOR TIF 111111111111111111111111111111111111111111111 CFN 2017Ro4964-36 OR BK 30668 Ps 4949 (1Pss) RECORDED 03/25/2017 1:1601 HARVEY RIJVIN1 CLERK OF COURT h1IA11I-DADE COUNTY, FLORIDA DA, COUNT OF DADE i that t i .tilt: COVENANT OF CONSTRUCTION WITHIN RIGHTNI : ES t" III '1 ' an 20 ' ictal Seal. Whereas, (owner) rf'-Pci<<- Weft-tJA yEy r . •�� �. ��•f nrycouris hereinafter referred to as the owner of the followinglilesjib- - D.C. property (address): (0v1.4, 1J.2 141 c -r - is is Iriginal til copy of the y of Legal Description: Lot (. Block G Subdivision Folio# ,-o' Requests permission to install (describe work): RzPvri, CotsW15 17740.5) Within the public right of way of (address) 10b2t, pts. Lo -hi cX Ptiewvi 4itur- t Pt. `P.'(36 iriAl 4110' 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 item(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 . de County, Florida by the Village Manager of Miami Shores Village (or his fully authorize representative). Signature Own or Agent rk State of Florida County of Miami Dade The foregoing ins rrument was acknowledged before me this Z `f day of UGv jT , 20 (9 , by "V�rk � s - nh ivho is personally known to me or who has pro uced TtbELlz._ L as identification. NOTARUBLIC: Sign: sm Print: S'c i' (rte-F..UJpe . SEAL: 1st r% Notary public State of Florida Sindia Alvarez FAQ My Commission FF 156750 mor Fvo Expires 09/03/2018 Miami Shores Village Public Works Department (305)795-2210 Public works forms are available from the building department, 10050 NE 2"d Ave., Miami Shores, FL 33138 RE -CT -El \TEL AU G -4\S 2017 Oat; PUBLIC WORKS PERMIT APPLICATION Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property (�� Permit#: \Th ZOc18 Name of Applicant (if utility see below): uti 01.00/ Jr) Owner off the following described property: Legal Description: Lot 6. Block Ci Subdivision o,.M 414%125 Folio #; (t- 22 - tab- (ALA Address: I OUL.(. P2 (04h CoJR.T t r4i4. S}IoQti, 'It 33138 UTILITY NAME: Qualifier/Authorized Agent: F11414- RerWAIJ,E1 Address: tc'-2i, ,J. loth (,0t)2T City: 10141.1t 402e5 State: FLOR-tn4 ZIP: 33('t Telephone: ;c2I'.I; Zd- 2.4Email: F L c- NI -f N41 5 i4jJ 6 • C414 - State Certification or Registration #: Certificate of Competency If CONTRACTOR NAME: }ko'e OWrvCr- Qualifier/Authorized Agent: Address: City: State: ZIP: Telephone: Email: State Certification or Registration #: Certificate of Competency #: Requests permissio to install (describe work, attach separate page if necessary) in the adjoining right of way: (LeP4iw6 (Pgvitg, i'rriN6 PPrwacN Type of Work: ® Paving ❑ Utility ❑ Sidewalk ❑ Electric 0 Irrigation ❑ Landscape ❑ Antenna ❑ Other: DESIGNER: Architect/Engineer: Address: City: State: ZIP: Telephone: Email: Registration It Value of Work for this Permit: $ )( OOD,-1—/ Square/Lineal Footage of Work: I8S . 2. 1-123 *****Fees***** Permit Fee $ 100.00 Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scannin $ Bond $ (if required) Total Fee Now Due $ \ Q Bonding Company's Name (if applicable): 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 will be charged. 1 Signature �ISignature Applicant Y Puthorized Agent Company/Utility Agent The foregoing instrument was acknowledged before The foregoing instrument was acknowledged before me this 18 day of AtuS-l- , 20 n , by me this day of , 20 , by who Tiny)V, Q NA°s' {-ter►la is personally known to me or who has produced DrN` .1 iNv\C't as identification. NOTARY P Sign: Print: SEAL: s� () 1111 .tee - YANADY PRIETO I ; _ MY COMMISSION li FF 2i4O31 EXPIRES: March 28 2019 s%?