PW-18-371Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
�mit
Permit NO. PW-2-1 8-371
Permit Type: Public Works
Work Classification: Public Works
Permit Vitus: APPROVED
Issue Date: 2/13/2018,
Expiration: 05/14/2018
Parcel Number
Applicant
138 NE 107 Street
Miami Shores, FL 33161-7032
1121360070210
Block: Lot:
WALKER & ELIZABETH SAINVIL
Owner Information
Address
Phone
Cell
WALKER & ELIZABETH SAINVIL
138 NE 107 Street
MIAMI SHORES FL 33161-7032
Contractor(s)
DRIVEWAYS BY DESIGN INC
Phone
(305)776-7916
Cell Phone
Valuation:
Total Sq Feet:
$ 100.00
0
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-2-18-66437
02/13/2018 Check #: 3026 $ 54.00 $ 50.00
02/13/2018 Check #: 3025 $ 50.00 $ 0.00
Amt Paid Amt Due
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 alLwork.done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL, PLU ANIC ' , COWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFI. ' J _I a foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constructio - may' • e, I authorize the above -named contractor to do the work stated.
February 13, 2018
orized Signature: Owner / Applicant / Contractor / Agent
uilding Department Copy
Date
February 13, 2018 1
Miami Shores Village
Public Works Department
(305)795-2210
Public works forms are available from the building department, 10050 NE 2nd Ave., Miami Shores, F 33138
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property
Permit#: PA/
Name of Applicant (if utility see below): AJAa<Et2 SA-Altr,GC
Owner off the following described property: I
Legal Description: Lot S Block 2cam Subdivision nuh.k. s "-r%Am.'scbzr=5 Exi me 3
Folio #; // - 2/36.- 007 - a 2 to
Address: /36 /VE /07 S✓ M4,'i SNo'2E‹
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City: State: ZIP:
Telephone: Email:
State Certification or Registration #: Certificate of Competency #
CONTRACTOR NAME: Dn..v/=w 5 ay,
Qualifier/Authorized Agent: 12ENF A,4r
'1Address: S/3 NE 73 s/
-City:-M/ar-r. Fe 33/38 State: . ZIP:
Telephone: =7%9'Email: PE e Prl v¢ S/3cyOa- .y^• ��!'�
State Certification or Registration #: Certificate of Competency #:,/ 7ci733C
♦Y
Requests permission to install (describe work; attach separate page if necessary) iri the adjoining right of
way: A rem/ l'r2 7—F D/2,'v�= �✓cc�
Type of Work: 1[� Paving ❑ Utility
I41►1GM(1))1 ..L/andscape�� Antenna
ins dug '{`f10V11t:-.❑1 4..Ari..:..( Q }
I tEQR3' i)Q1+Pcig. rrirrIcj )r'lt
DESIGNERaArchitect/Engine'e0 t
Address:` 3" .a� Yiut. _....._., ___ ,....rs
City: ... State:
Telephone: Email:
Registration #:
Value of Work for this Permit: $ S 0019
Icv.-ee}
[x]-. Sidewalk ❑ Electric ❑ Irrigation
❑ Other:01anr,A1 iy MI AM r"-,,. 11
1iilUu4) y'i61011-R`litut4 to Rife!,: +~ tip', iI
1I rEOR5r))'+c.o1::&iirmo> O*=ts
V �N
S7C .ec viol ° 1i
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 $
.1
74
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
. in'stallations 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 issue
absence of such posted notice, the inspection will not be approved and a reinspec
Signature
Applicaft or utorized-gent
The foregoing instrume was acknowledgedbefore
me this day of (E6%� , 20 /C9 , by
(Z) SeciG• (../, L who
is personally known to me or who has produced
/ 1/e---i5 (<C-J2--5
identification
as
1" MAXIME KOMORNIK
NOTARY PUB ?; .�0
z,
Sign:
Print:
SEAL:
APPROVED BY:
;r:; State of Florida -Notary Public
ion # GG 128031
ission Expires
25,2021
Company/Utility Agent
f. g g instrument was acknowledged before
me this 3 day o ¢ , 20 a, by
is personal own to me or who has produced
_ as
who
identification.
NOTARY PUBLIC:
Sign:
MAXIME KOMORNIK
\`A State of Florida- tary Public
Co ission # G 128031
, y Co io Expires
'onaw��,,� 021
Print:
SEAL:
\\`) q , Public Works Director, or Designee
2017-04-15
JE
STAR ISLAND CONCRETE
DESIGN, CORP.
www.drivewayom.com
Cell: (786) 294-7284 - Oscar Canales
Cell: (786) 367-4712 - Miguel Corpas
PROPOSAL SUBMITTED TO:
2EET
2-2 NE 6s-s
Vrop.oliat-QC.ontratt
Lic. & Ins.
Lic. # E201903
CITY
DESIGN
COLOR
3°5--72(7 '(6
JOB NAME,
SZLIv,Z(
JOB LOCATION
f.34f9 iVE rot si
DATE
' !/jam
1
i i
F{
1
/ /
•�•
- �_
i
-'
�(—
, t
i
i i
L
t�
-�
j
...
1
I
I
(
! I
i
i
{
t
i
I
_ _.
i I
!
t
1
i
t
i
{
I
!
j
j
f�_
i
L t--
_ —__
i
,
I" 4-
' t
T
i
ij
1
}
t
1
I
t
j
i !
i
t
I
I
L
=
j
i
{
i
{
i
_
{- i-
I
I
}
t
i
I
I
I-
y
-j
{ '
i,-
I
i- I
,
i
!
,
,
!
t
t
{
•
1
I
1
I I
i
s
!
i
i
I
;
,
;
I-
Ii
I I
€ I
f
i
i
i
i
I
I
It.
;
{
i
I
,
i
i
I
I
i
I
'
i
i.
—..s
I
I
!
t
-
l i i
i
E
( i
i
I
r
i
4
i
!-
i
i!
4.i
TOTAL PRICE $ (. ? 5`17
DEPOSIT $
We have read the foregoing proposed contract and accept the same BALANCE $ / 2 S
on the terms and conditions stated.
Purchaser
* SEE REVERSE FOR TERMS & CONDITIONS Approved by
MO
OM
VA