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
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