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PW-17-2907 { Permit NO. PW-12-17-2907 Miami Shores Village Permit Type:Pudic Works 10050 N.E.2nd Avenue NE Work Classification.Public Works Miami Shores, FL 33138-0000 Per I Phone: (305)795-2204 Permit Status:APPROVED ��ORIDA Issue Cate: 12/1912017 Expiration: 03/19/2018 Project Address Parcel Number Applicant 9879 NE 13 Avenue 1132050090490 Miami Shores, FL Block: Lot: JACQUELINE BARRANTES Owner Information Address Phone Cell JACQUELINE BARRANTES 9879 NE 13 Avenue (917)698-2863 MIAMI SHORES FL 33138- 9879 NE 13 Avenue MIAMI SHORES FL 33138- Contractor(s) Phone Cell Phone Valuation: $ 10,000.00 ARTISTIC CONCRETE GROUP INC (305)888-9095 Total Sq Feet: 429 Scanning: 1 Available Inspections: Inspection Type: Excavation Review Building Review Building Review Public Works Final Public Works r I I Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $0.00 DBPR,Fee Invoice# PW-12-17-65869 $0.00 12/12/2017 Credit Card $50.00 $59.00 DCA Fee $0.00 Education Surcharge $0.20 12/14/2017 Check#:287 $59.00 $0.00 Notary Fee $5.00 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $109.00 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 AFFIDAVITcert; that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zon' g. re, I authorize the above-named contractor to do the work stated. -- December 19, 2017 Authorized ignatur :Owner / Applicant / Contractor / Agent Date Building Department Copy December 19,2017 1 r1E1111 mEl gel t 19 I r; Miami Shores-Village -i- BuildingOR F3 2010 (IF'9q)- ' 'Peliartment isr, �ry 4- Fj. 10b50 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 STA rE OF FLORIDA,COUNTY OF DADE, co I HE�EBY CERTIFY that this IS a true Copy Of the k CL trig i r7 a/filed in this o ofi e-onday of, r A.D.20_1,� COVENANT OF CONSTRUCTION WITHIN RIGHT-OF WAYM;7S Jny 1-*eal j n 0" N GOD M I" HAR J 111.CLE Courts Whereas, (owner). k r� kkly a1 (1 D.C. co hereinafter referred to as the owner of.th'p following d_escribed4_ 4 "INji- , property(address):, q A)F 4,q 47;74 qyu V�'/ rr-G Legal Description: Lot Block Subdivision A v CIT-A, 'Etur\,Q q Folio # A5 Requests permission to install (describe work):. _A4 Within-the public right of way of (address) 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. 2The owner does hereby agree to indemnify and hold Miami Shores Vi.Ilage 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 iteni(s) to be removed and 6 lien being placed on the ,property, and/or assessed against the Owner for 61i costs incurred in the removal and disposal of the iterh(s). 4,1 The undersigned further agrees that these conditions shall be deemed a covenant running with the land and shall1emain 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, Flbrida'by the Village Manager of Mia'mi Shores Village (or his fully autKo-r-Bed reprbsentative). Signature cc- Owne oo r Agent A Vy a/c�j State of Florida Couhty-of Miami Dade The foregoing instrument wa . cknowledged before me this day-of 20 by J a ccue f r& 6 Mrrm -who is personally known'lo me or who has produced as identification' NOT 'R UJBLI�. L . ........... YANADYR n:Sig IETO MY G0MMjSSj0J!4#FF 2114031 Print L-P�a, SEA EXPRESi March 25,2019 U,\13iEtry Pubic LJnd6Wd,'--[S RECEIVED * Miami Shores Village ' C 12 20 R Public Works Department (305)795-2210 Public works forms are available from the building department, 10050 NE 2"d Ave., Miami Shores,FL 33138 PUBLIC,WORKS PERMIT APPLICATION Permit Type:Work in the Right-of-Way on Miami Shores Village or Miami-Dade Property � tt { Permit#: (::j 0 ` Name of Applicant(if utility see below): ct CD( tIj2,t^4 dAAP Owner off the following described property: Legal Description: Lot 4- Block_ _Subdivision _ (6 zt.✓ �YYI 1 Folio#; 205 —pp c1 =(jy Address: UTILITY NAME: Qualifier/Authorized Agent: Address: City: State: ZIP: Telephone: Email: State Certification or Registration#: Certificate of Competency# CONTRACTOR NAME: 's l rC l Qualifier/Authorized Age`t: c c "i tvc,% Address: r City: M 101 �' T State: 71-� ZIP: Teleph ne: Email: State Certification or Registration#: LCRC0061 Certificate of Competency#: .i ,,Requests permission to install (describe work,attach separate page if necessary) in the adjoining right of way: LnlffiA go �Yf D ~ �- Type of Work: E3-111-aving ElUtility E] Sidewalk ElElectric ❑ Irrigation, ❑ Landscape ❑ Antenna ❑ Other: DESIGNER:Arch itect/Enginee r: �` • . •:,aia`';�� . Address: t :;c �� arF -''.'rr � .► City: " . State: .ZIP: Telephone: ',,.i -Email:' Registration#: ., n. x; �..,. ., t �'= qF 1 Value of Work`for this Permit: _•�'�Wi, ODb Square'/Lineal Footage of Work: Fees Permit Fee$ 100.00 Notary$ Training/Education$0.20 Technology Fee$0.80 Scanning$ Bond $ (if required) Total Fee Now Due$ 4 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. } ti +� "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 tb 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 anclYreinspection wih,'be charged. 4 r. Signature Signature VPorulment an or Authorzed Agent Compan /Utility Agent The foregoing was acknowledged before The foregoing instrument was acknowledged before me this 4 day of 20L,by me this day o r-tb 5 20�by �IIV�-lam- fLC2?�.Jt1 who 19e awho is p1to me or who has produced is personally known to me or who has produced as as identification. identification. NOTARY PUBLIC: ii NOTARY PUBLIC: ��•'�XPIR '•. p��i bi Sign: >% Sign: _u,•!��` =a:2 z � goo= ` Print: •0 :ti= Print: .30k,^- f'7 SEAL: SEAL: t y John Roque '�� ••'• .••••;; '��'��`� �' NOTARY PUBLIC sii'� NOTAgy e STATE OF FLORIDA ,��'Ir414111:1ttot�� Comm#FF946106 '%c ti Expires 4/17/2020 APPROVED BY: (11* - Public Works Director, or Designee 2017-04-15