PW-18-334 Perm#No.,PW-2-18-334
Miami Shores Village Permit Type:Public Works
10050 N.E.2nd Avenue NE
Pleamh, ' Work-Classification:Public Works
Miami Shores,FL 33138-0000 Permit Status:-APPROVED Phone: (305)795-2204
FLORIDA c
Issue Date:2122/201`8 Expiration: 05/23/2018
Project Address Parcel Number Applicant
842 NE 96 Street 1132060142900
Miami Shores, FL 33138- Block: Lot: PINNEAPLE AND OSITO LLC
Owner Information Address Phone Cell
PINNEAPLE AND OSITO LLC 842 NE 96 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 3,000.00
CHAMPION CONCRETE (305)252-8055 (786)402-4802
µm Total Sq Feet: 450
Scanning: 1 Available Inspections:
Inspection Type:
Excavation
Review Public Works
Final Public Works
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
CCF $0.00
DBPR Fee Invoice# PW-2-18-66395
$0.00 02/22/2018 Check#:2796 $54.00 $50.00
DCA Fee $0.00
Education Surcharge $0.20 02/08/2018 Check#:2800 $50.00 $0.00
Permit Fee $100.00
Scanning Fee $3.00
Technology Fee $0.80
Total: $104.00
IA consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformityith the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume respon ility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING ECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I cert tha al the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zonin Eli r I bove-named contractor to do the work stated.
February 22, 2018
Authorized Sig tura:Owner / Applicant / Contractor / Agent Date
Building Department Copy
February 22, 2018 1
Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-297024 Permit Number: PW-2-18-334
Scheduled Inspection Date: March 28, 2018 Permit Type: Public Works
Ins4 pector: Miranda, Chris Inspection Type: Final Public Works
Owner: Work Classification: Public Works
Job Address:842 NE 96 Street
Miami Shores, FL 33138-
Phone Number
Parcel Number 1132060142900
Project: <NONE>
f
Contractor: CHAMPION CONCRETE Phone: (305)252-8055
Building Department Comments
REPLACE STREET BROKEN SIDEWALK i
Inspector Comments
Passed IZI
Failed
Correction
Needed
Re-Inspection ❑
Fee '
J
No Additional Inspections can be scheduled until
re-inspection fee is paid.
9
March 27,2018 For Inspections please call: (305)762-4949 Page 10 of 19
_
l/
P Miami Shores Village RECEIVED� f�E� 0 8 Z��$
Public Works Department
(305)795-2210
Public works forms are available from the building department, 10050 NE 2nd Ave., Miami Shores,FL 33138 ' ?(2k
.
PUBLIC WORKS PERMIT APPLICATION
Permit Type:Work in the Right-of-Way on Miami Shores Village or Miami-Dade Propertyl Permit#:
Name of Applicant(if utility see below):. /ary LtL�'o
Owner off the following described property. v `
Legal Description: Lot Block Subdivision
Folio#; -3206 - 01 �- OOO
Address:— ''1Z AIL 1 CJI
UTILITY NAME:
Qualifier/Authorized Agent:.
Address:
City. State: ZIP:
Telephone: Email:
State Certification or Registration#: Certificate of Competency#
CONTRACTOR NAME: OW
Qualifier/Authorized Agent: .
Address:
City: State: ZIP:
Telephone: d° Email: 9 �,0-J��D®.Gf�
State Certification or Registration#: Certificate of Competency
Requests permission to install (describe work,attach separate page if n essary)in the adjoining right of
way: 40ke- w s�
Type of Work: ❑ Paving ❑ Utility; %Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER:Architect/Engineer:
Address:
City: State: ZIP:
Telephone: Email:
Registration_#: -u
Y
Value of Work for this'P.ermit:+^$ Square/Lineal Footage of 1No`rk: i
Fees ,u .
Permit Fee$ 100.00 --
Notary$ Training/Education$0.20 ,Technology Fee$0.80 Scanning$
Bond$ (if required) Total Fee Now Due$ CrD
F ,
t
t.
Bonding Company's Name(if applicable):
Bonding Company's Address:
City: State: ZIP:
r Application is herebj'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 understandthatseparate 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:Asa 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,recordedtnotice of commencement must be posted at the job
site for the first inspection which occurs seven (7)days after the public works permit is is ed. In the
absence of such posted notice,the inspection will not be approved and'a reinspection- I'kie charged.
-0
Signature Signature
Applican r Authorized Agent Com any/Utility A ent
The foregoing instru nt was acknowledged before The foregoing instrume t was acknowledged before
me this�day o d/[ i 20�by me this day of �P /(JOf' 20 by
who who
is personally known to me or who has produced "is personally known to me or who has produced
F O Z/ 3 0//Q as as
identification. identification:
NOTARY PUBLIC: NOTARY PUBLIC- t
Sign:
%Print: Q P v Print:
SEAL: SEAL: -'
GAILY LLAPUR
MA
MY'COMMISSION#FF21,776
_;:+.%..' IVIAGALY LLAPUR
EXPIRES March 25.2019 d 'k4Y COMMISSION#FF21:3776
Qp EXPIRES March 25.2019 1'r
FloridalloU•ygervice.:on'.
Zpb-0'53 1407 39bL'S3 F1MwaNma vServi e.car.
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APPROVED BY: '� Public Works Director,or Designee
2017-04-15
t
SKETCH OF BOUNDARY SURVEY
SCALE: 1"
LEGAL DESCRIPTION:
=20'
l LOTS 5 A 0
SUBDIVISION --- BLOCS 75
i M1Ald1 SHORES SECTION N0. 3
/ ACCORDING TO THE PLAT THEREOF AS RECORDED W PIAT 10
BOOR AT PAGE 37
OF THE PUBLIC RECORDS OF MIAMI-DADE
_COUNTY,FLORIDA.
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�yG{Q" ya.•SURYgYCCERTIFY / / TAPL£S AND KIM TAP ES
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ATTA HED SKETCI jOF"BOUNDARY SURVEY OF THE ABOVE DESCRIBED PROPERTY I3 A TRUE AND CORRECT
ENTATLON OF.A FIELD SURVEY MADE UNDER MY DIRECTION AND MEETS THE MINIMUM TECHNICAL
STANDARDS' _
I i /' C ^ 81C17 S� BY THE FLORIDA BOARD OF PROFESSIONAL SURVEYORS AND MAPPERS W CHAPTER
,I f 8 ♦ r v� �O\y /-CLINTON
CODE,PURSUANT TO SECTION 472.OY7,FLUMDA STATUTES.
i�i•'. . ?� .: cam" t:- LES AND-KIM STAPLES
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'NUMBER/ 0 3653
/g STAP
:•• �' y�_1 rle., g�I y_, • a ''�`Ta"U' g NIpw �/ (A{� 1O#B Nom _- — M DATE OF THE FIEIA SURVEY_ 5-?0-2003
•t.! fl?. t•'i�iI•II x. / I ,/ U� ��- D NN Y: ..Y. - -REVISION =-1.7_
DATE: 2007
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.[�• i rA,"v5 ,,«a ° /'/ `�� E.BELTRy�( T
•ti°• :• • �. ,• ��• d� $sMSOCIA ES INC.
4:' / 12533 S.11.'30th STREET '
NNy rci •kr�j• i. 7Y AAnAtrPAM:iltN7' .. MIAMI. FLORIDA 33175
••••• ^21+1 T • •'i T _ Y:ANCNgT _ / PHON
• - __ - __
} E: (305)552-7450
� •i• 1 •••.+•.,•, CLRTIPICATE OF AUTHORIZATION NUYB¢R LB 5293
• ' 1•i f• ' • .AP.s/B'.
�� ) 'M • SURVEYOR'S NOTES:
• • IEGAL DMRDTION WAS FURNISHED BY CUEN'r.
__-�_� • E1(AYWATION OF THC ABSI'HACT Or tTTld YDL HAVE TO BE
YADC N DETpt1@aE RLCORDCp WSTRUYEM,V ANY AFTECYWO
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.RESIRICT10Na.RG4CRVATION3 OR EASEMENTS OI RCCORpS. PROPLRIy.
NO UNDERGROUND WSTADATIONS 0R OFROYEYCNTS HAVE BEEN LOCATCp,IXCEf+T AS NOTED.
i• LOCA IE tiomi-�•CouAtst..NaN-800(Ela :s DETERI@iEa.B9HIP BY VISUAL YGN9 ONLY UT ANY).IBGAL OrNER9F10'NOT
ABBREVIATIONS (v ANY MPLILD)
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BEARINGS HEREON(IF ANY) ARE REFERRED TO AN ASSUMED VALUE OF roNYo mx�L Enx-wux�owP[uas � 8lUZ O 0 yq�.4 ERNESTO BE RAN
sa[.-a[T u-Lu B. 'rDUMD AL-LUt (7 (� U J PROFESSIONAL -RVEYOR k MAPPER No.4885
FOR THE c.A. -aa[o BrAAmc A/c .Aa DaYorte°Ilo+c uNrt s.Dn' mDa.YDIE
.SAID BEARING IS IDENTICAL WITH THE PLAT OF RECORD m� rea '." cA—A— STATE OF FLOR
ACCORDING TO THE N.F.I.P. THE SUBJECT PROPERTY °u M10'•auc. -Touxa wa•Dlac A' 0 L" DAM
-
co—.FLOOD ZONES_ g _ - •rouNn MAD. - .Milo cur Yu. [l'D- -uou� _ - - _8-17-2007
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03AI3338
NOTE:THIS L9 NOT A VALID SURVEY WITHOUT
SIG ORIGINAL O RAISED SEAL AND
SIGNATURE N A FLORIDAPERLICENSED
— SURVEYOR AND YAPPER