PW-18-644Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Permit
Issue D.
: 3/19/2018
Permit NO. PW-3-18-644
Permit Type: Public Works
Work Classification: Public Works
Permit Status: APPROVED
Expiration: 06/17/2018
Parcel Number
Applicant
955 NE 98 Street
Miami Shores, FL 33138-
1132060143360
Block: Lot:
INVESTQUEST PARTNERS HOLI
Owner Information
Address
Phone
Cell
INVESTQUEST PARTNERS HOLDINGS 175 SW 7 Street
- MIAMI FL 33130-
(305)746-8282
175 SW 7 Street
MIAMI FL 33130-
Contractor(s)
E.G IMPROVEMENT LLC
Phone
(786)295-0559
Cell Phone
Valuation:
Total Sq Feet:
$ 4,000.00
1660
Scanning: 3
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
Invoice #
03/13/2018
03/19/2018
Pay Type
PW-3-18-66762
Cash $ 50.00 $ 54.00
Credit Card $ 54.00 $ 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 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 AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction and zoning. Futhermore, I authorize the a. -d contractor to do the work stated.
Authorized Signature: Owner / Applica
Building Department Copy
March 19, 2018
r.. or / Agent
Date
March 19, 2018 1
MARRE
1 3 18
Miami Shores Village
BY:
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
,Permit#-• DS 18 400
vw is- tm.14
Name of Applicant (if utility see below): c\C),)e, ttr tab
Owner off the following described property:
Legal Description: Lot Block /C) Subdivision
Folio 11 -32EXD - 014
Address: Gis5 QE_ c755 ICE
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City: State: ZIP:
Telephone: Email:
State Certification or Registration #: Certificate of Competency #
CONTRACTOR NAME: E. G Ity-tpcoSetnerri-
Qualifier/Authorized Agent: i-le,c-for MfiSto`tn
Address: R031 SW 10 "rec.('
City: Rica vv.: State: ZIP: 331.14
Telephone: left,. 2oiS . sq Email: heciot e. hhriAe. ek.,,2101-wrIeud-.
State Certification or Registration #:C(bC 1250(201 Certificate of Competency #:
Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of
way: VIASIOACA;c04 of pauctiN FOi Owoath"
Type of Work: El Paving El Utility D Sidewalk El Electric El lerigation
Landscape fl Antenna Ei Other:
DESIGNER: Architect/Engineer:
Address:
City: State: ZIP:
Telephone: Email: ,
Registration #:.., „ ,....,...".."......."..,,,,........,:,...."-,x.,,,,-
b.... Ek ,-,0- k... slr'g ,.1 1 r..t..ilf
Value of Work:for thislPerrfirt:;11;$
-.} -,,--• ft , "a Ne'V't,"•,""",",",,,,,...„, „.,.. ,....sse,-;
.,,o'4`.1hi ")P:i:'AA1
A0A,,4" t ,0 • '"
Square/Lineal Footage divvcif-k:")1,(40) ...,
..,,,,,...."."..N,1Fees *****
Permit Fee $ 100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning
Bond $ (if required) Total Fee Now Due $ 5 ch,
t, 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 to the person_whose property is subject to the
attachment. Also, a certified copy of the recorded notice of corrimericement 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.
a
Signature
t.:
pplicant or Authorized Agent
The foregoing instrument was acknowledged before
me this 'Z4 day of R13 , 20 t( , by.
who
is personally known to me or who has produced
*CAL as
identification.
NOTARY PUBLIC:
Sign: 1 ►�
Print:
S
040, Notary Public State of Florida
WAQAAS MERCHANT
My Commission GG 151486
oi c•' Expires 10/15/2021
APPROVED BY:
Signature
Co ' pany/Utility Agent
The foregoing instr' rhent was acknowledgedbefo're
me this.: 2-1 day of T 5 , , 20 t , by
H ecue barteketvl who
is personally known to me or who has produced
• Ft. Di. as
identification.
NOTARY- RUfBLIC:
Sign:
Print:
SEAL.
�d! " Notary Public State of Florida
yo
WAQAAS MERCHANT
'' My Commission GG 151486
ofExpires 10/15/2021
********,********************************** ?'_..)
.
{
, Public Works Director, or Designee
2017-04-15
STATE OF FLOPIDA, COUNTY OF DADE
I HEREBY CERTIFY that the forego
ing is a true and correct copy of the
kI
original on file in this office. ,bI 0 o 24160
HARVEY RUVIN, Clerk of
Deputy
GIRL ' IE,RRRE-THEOC #201673
Miami hores Village MAR 0. 8 2018
Building Department
10050 N.E.2nd.Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
COVENANT OF -CONSTRUCTION WITHIN RIGHT OF WAY
Whereas, (owner) cl Qt kiz%
hereinafter referred to as the owner of the following described
,property (address): cf55 14z Tfi")i
Legal Description: Lot 4 . Block ? Subdivision
Folio # 11 ?)20� - c L - 33G
Requests permission to install (describe work): 'boers
1111111 I1II 11111 111111111 (111111111 iiimu
C.FN- 2O18RO1 3-677
OR BY. 3i:ij ? Pu 3861 (1Pus)
RECORDED 03 08i200 O9 i5t0
HARVEY RLIV+IN, CLERK OF, COURT
EMIAMI-DADE COUNTYp FLORIDA
Po(' appfoctQi„
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.Dede 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 of' '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
Villagecausing 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 condition's 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 ale Count f lorida by the Village Manager of Miami Sho"r`es Village
(or his fully autf ized reprseyriat
Signature
L./Owner or Agent
State of Florida
County of Miami Dade
..The foregoing instrument was acknowledged before me this Z day of Fell , 20 t6 by
hSl �u who is personally known to me or who has produced
,pL as identificati ij n.
NOTARY PUBLIC:
Sign: _
Print: WA SEAL:
Notary Public State of Fiorida
WACIAAS MERCHANT
My Commission GG 151486
Expires,1011512021