PW-18-1990Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Parcel Number
Permit NO. PW-7-18-1990
Permit Type: Public Works
Work Classification: Public Works
Permit Status: APPROVED
Expiration: 10/28/2018
Applicant
384 NE 94 Street
Miami Shores, FL
1132060136140
Block: Lot:
PENN DAVIS
Owner Information
Address
Phone
Cell
MICHELLE CANERO
384 NE 94 Street
MIAMI SHORES FL 33138-
384 NE 94 Street
MIAMI SHORES FL 33138-
Contractor(s)
AT FIRST IRRIGATION INC
Valuation:
Total Sq Feet:
$ 2,000.00
45
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 Amt Paid Amt Due
Invoice # PW-7-18-68333
07/30/2018 Credit Card $ 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 one by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLUMBING, MECHANICAL, V4rJDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing inf mation is .ccurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the abo a named c tractor to do the work stated.
Authorized Signature: Owner / Applicant / Contr!!f“ r / Agent
July 30, 2018
Date
Building Department Copy
July 30, 2018
1
way:
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
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property p,p�
Permit#: ?Lie ` E U c/ 1
Name of Applicant (if utility see below): .e.41,1)40S
Owner off the following described property:
Legal Description: Lot Block
Folio #;
Address: 7 yes` 5
UTILITY NAME:
Subdivision
33i3�
AJ(9- tc9 o
Qualifier/Authorized Agent:
Address:
City: State: ZIP:
Telephone:
State Certification or Registration #:
Email:
CONTRACTOR NAME: A.\'
Certificate of Competency #
ram:
Qualifier/Authorized Agent: —N 03
Address: \\A.3 . . '\
City: \*-044-,
Telephone144.,-',)- — Email:
State Certification or Registration #:
•
State:�KL_ ZIP:
•
Certificate of Competency #: \3-r'"S•k(,.•
Requests permission to install (de$cribe work, Mach separate Cge if necessary) in the adjoining right of
Type of Work: ❑ Paving , %a ❑ Utility ❑ Sidewalk ❑ Electric Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
City: State: ZIP:
Telephone: Email: a LL ,_' . ;.
Registration #:
•
Value of Worklfo -"ibis Permit:?'`$ 1/--•
:C2.4114X.J '14 , 14
iti-•,.'t:Yi;: `: sli.f '::lli �{)•? ..
Permit Fee $100 00 "°
Notary $
Bond $ (if required)
Square/Lineal. Footage of,Work:
*****Fees*****
ryy� ,�1�'h+lrFviA't-i ��+i"a nt�(^nt .'i(N•k
Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $:
Total Fee Now D e $ \'(S`-('' . (-IC)
40 40
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 approve p and a reinspection will be charged.
Signature
Applicant or Authorized Agent
The foregoing instrument was l acknowledged�efore
me this / day of 45 Q , 20 / by
�C-NN WW2-1) -- At who
is personally known to me or who has produced
u`r t,siSe as
identification.
Print:
SEAL:
MINAA ALVAREZ
.
MY COMMISSION # GG 238273
off: EXPIRES: September 3, 2022
rFOF . Bonded Thai Notary Public Underwriters
APPROVED BY: r
Signature
ompany/U ilitr Agent
The forego'ng inst ment vas acknowledged before
me this .ayif✓ ,201 by
�P��g RAJ 7'Abk. who
is personally known to me or who has produced
L -4-1 02_ (..0ENS as
identification.
NOTARY PUBLI
Sign:
Print: gINCII.Q
SEAL:
7
`r!":!! ,- SINDIA ALVAREZ
• ... t MY COMMISSION # GG 238273
• '`` EXPIRES: September 3, 2022
°
'' F`o Bonded Thru Notary Public Underwriters
**********************************(IL k
, Public Works Director, or Designee
2017-04-15
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
I IIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIII IIIIIIII
CFN `?off 18R04-43243
OR BK 31070 Pg 4406 (1P3s )
RECORDED 07/24/2018 i 9 53:13
HARVEY RUVINs CLERK. OF COURT
IlIAMI-DADE COUNTY? FLORIDA
STATE FLORIDA, COUNTY OF DADS
1 HER CERTNFY Met this Is a hue cairn( env
COVENANT OF CONS3RUpITION WITHIN RIGHT OF Way Mated sea
Whereas, (owner) J �hn A ` "�E
hereinafter referred to as the owner of the following descri
property (address): `�% q !N� S7 1
Legal Description: Lot '-y Block 'To Subdivision
Folio# 1 l-"320G- a13-�tLi0
Requests permission to install (describe work): S(�r,r(k f crs opt
or llted In I once on. 'y of
�2 4 2012 .AD.2O
hand end
IN, CLERK -` and County Cowls
I I'Y2
Within the public right of way of (address) 9 0.1 g- 9 y'v- ST
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 Dade County, Florida by the Village Manager of Miami Shores Village
(or his fully au orized representative).
Signature
Owner or Agent
State of Florida
County of Miami Dade
The foregoing instrument was acknowledged before me this k 7 day of 31A-Li
7NN EDIAJA.121, 17AvIS who is personally known to me or who has produced)
ncx cu as identification.
NOTARY UBLIC:
Sign:
Print: to PLUA'Q,E�
SEAL:
,20)8 ,by
i
SINDIA ALVAREZ
.; • MY COMMISSION # GG 238273
EXPIRES: September 3, 2022
:. R F °! Bonded Thai Notary Public Underwriters