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PW-18-1374 Permit NO. PW-5-18-1374 Miami Shores Village Permit Type:Public Works 10050 N.E.2nd Avenue NE r mi t Work Classification.,Public Warks Miami Shores,FL 33138- e r0000 Permit Status:APPROVED �Fio ioA` Phone: (305)7952204 Issue Date:5/29/2018 Expiration: 08/2712018 a a s. i Project Address Parcel Number Applicant 58 NE 92 Street 1132060130030 MIGUEL AMOR Miami Shores, FL 33138- Block: Lot: Owner Information Address Phone Cell MIGUEL AMOR 58 NE 92 Street MIAMI SHORES FL 33138-2812 58 NE 92 Street MIAMI SHORES FL 33138-2812 Contractor(s) Phone Cell Phone Valuation$ 150.00 SOFLO SPRINKLERS LLC (786)295-9148 Total Sq Feet: 0 i Scanning: 1 Available Inspections: i } Inspection Type: Excavation Review Public Works Final Public Works i i i i Fees Due Amount Pay Date Pay Type Amt Paid Amt Due CCF $oso Invoice# PW-5-18-67625 DBPR Fee $0.00 05/29/2018 Check#: 1450 $ 104.60 $0.00 DCA Fee $0.00 Education Surcharge $0.20 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $0.80 Total: $104.60 � I i 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 AFFIDA IT: I fy that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction d ing. u ermore uthorize the above-named cont;Z4L�.fe to do the work stated. `jb l May 29, 2018 u riz ig a re:Owner / Applicant / Cont c / Agent Date Building Department Copy May 29, 2018 1 Miami Shores Village AY 2.• 2018 �✓ Public Works Department ' (305)795-2210 BY: Public works forms are available from the building department, 10050 NE 2na Ave.,Miami Shores,FL 3313 t t PUBLIC WORKS PERMIT APPLICATION r s Permit Type:Work in the Right-of-Way on Miami Shores Village or Miami-Dade Property I 116 i 4 Permit#: l�--C - I d 1 b r Name of Applicant(if utility see below): M 1 WJ L- Iq^0(L Owner off the following described property: Legal Description: Lot Block Subdivision + Folio#; (�-3'�06 -013 •-003p , Address: G,d UTILITY NAME: , Qualifier/Authorized Agent: 1 Address: l City: State: ZIP: Telephone: Email: t State Certification or Registration#: Certificate of Competency# ,1 7 CONTRACTOR NAME:—cS6FL_0 S ItiIky&LCk-S LL.0 Qualifier/Authorized Agent: GO,-'6'6y Whyrut FL• Address: MOO 0(10 GU'Tcf'2 V-0 ! City: C.Q l LEQ 13 w Y State: VL ZIP: —5,13 12 9 Telephone: Email:. TO Fw 5log IMlc4-rE Cry;-'1o+/L , Cc) State Certification or Registration#: I 0000 Certificate of Competency#�'a.(�100 L535 Requests permission to install (describe work,attach separate page if necessary)in the adjoining right of way: e, n k I�✓ h ea d5 t Type of Work: ❑ Paving ❑ Utility ❑ Sidewalk ❑ Electric 'IPA Irrigation 1 c E ❑ Landscape ❑ Antenna ❑ Other: DESIGNER:Architect/Engineer: Address: City: State: ZIP: Telephone: Email: Registrtican�. .tx...�rs�« .�s.�.�..,sa+..wb. . •� a �3r.'��'if�1t33:►�a ,��.,;„,t, Ya2Rkt3Q N3'{lN41?;. �;'_'1�::, �►•I'�,+'a+�sl�s� .a rtila�S�,r»l:•l;• ::ilG'uR�ttfi'9}! °'� �;', '., � Value AWN orate s r , °. ' W tf �� 1, I ?�rp1jV0 $ . F Square/Lineal Footageiof,; ork: •c!- ' t0s F i ygm milgN.3 rz+, s ;ht ' � +� `c?S �! Vf-M+3,igx3 m5r r Ft .�1M'N 9 1fi+ f,N4.I ji7.�+ ***** Fees***** *** Fees***** -t t! * 1, `d r• � r ,� c..b�ilt:a sinal l'.�ltflkl4 C.r ..+F# .'�c"'?mac"'v�4e�+!!'awK'.�"{ w4;tsr+ ✓u�..»."� Permit Fee$ 100.00 e ' Notary$ Training/Education$0.20 Technology Fee$0.80 Scanning$ s i Bond$ (if required) Total Fee Now Due$ + s ! 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$2,500,the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to the attachment.Also,a certified copy of the recorded'notice`of commencement must be posted at the job site for the first inspection which occurs seven (7)days after the public works permit is issued. In the absence of such posted notice,the inspection will not be approved and a reinspection will be-charged. t a Signature Signature Applicant or Authorized AgentE Company/U ' y Agent The foregoing instrument was acknowledge before The foregoing instrument was acknowledged before me this �u day of 20_ by me this J day of 20_4,by who who is personaily known to me or who has produced is p rsonally own'to me or who has produced UZ CI-4--C as as identification. identification. NOTARY PUBLIC: Sign: p Sign: Print: Print: <� Print: SEAL: SEAL JENNIFER DEMPSEV :" m dE1pNPE11 BEMPSEY No"PoWle-Stati•ot Florida Ain, t>oirimisslon N'FF 928767 -SMt of Fb'ridaCom mission,0 FF 926767FV My t)oen.Expires May 14,2019 . MyComm.Expires May 14,2019�0% fto!*Nallonal ary Assn. Bolldid N fond tlraugl Notary Assn. APPROVED BY: Public Works Director, or Designee 2017-04-15 Soso StAINNI S U,( f ad 6LD CUTWO,R&-, dR ,,,5 CUTUA bAy; ORE'T 8 s V 1 5,NC.1931 Ll` ' C F N 201 2'F'.1 1:3 1 4 6$d Miami Shores Village OR BK. 34992 Ps 1709 UF'ss i Building Department,, ,I _1 ...�... IAR4EY ii.l�.i.�lr _1..i--Ri.. OF 0,,J 1_1 10050 N.E.2nd Avenue �oRmpy Miami Shores, Florida 33138 ST FIARfi?A,ooUtid r ofp�q� Tel: (305) 795.2204 1FlER F1'tirsttIskabveoopyoiNua ► ° Fax: (305) 756.8972 orpnel In ft 0069 of A.D.20--_,_ N + WIM m end 1. COVENANT OF CONSTRUCTION WITHIN RIGHT OF"DI�' tEt�<, c+rcuaa aant�CGs Whereas, (owner) PA 16JFi. AYIA Q fL UC ' hereinafter referred to as the owner of the following desc k e property (address): - 5� 'NE �(�. 5 7 , Legal Description: Lot Block Subdivision Folio # 1) 3)06-c9T7- ©b*3o Requests permission to install (describe work): '�In�Q� 5fr1 N ILI c FL )4-fWS © tS 1 14� S W 1�itF Within the public right of way of (address) _5$ PC q) ST , IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follows: i 1. To maintain and repair., when necessary, the above-mentioned item(s) installed within the dedicated right of waft'.' 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 i 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 Dade County,.Florida 'by the Village Manager of Miami Shores Village (or his fully authorized representative). Y Signatures ' r Owner or 1 a■ �oar State of Florida NN�ry►MMo•qua of County of,Miami Dade # ftielw'hio The foregoing instrument,was ac a May of _,, 20 � � , by AMD( wh has produced Or rJ I (-rar k�as identification. - NOTARY PUBLIC: Sign: J+NMFN DEMPSEY Print: I !' - SEAL: ': NOW% "U111111-.6tMeofFlorlda Cur, siloAa.FF 926767 +� tea;' My Comm Explres`M>ty 14,2^ •,,� � Bonded+', 1j0 Na 11onW N00r': j .. 1 {