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PW-18-112Miami Shores Village 10050 N.E. 2nd Avenue NE Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Pe ■ Issue Date. 212/2018 Permit NO. PW-1-18-112 Permit Type: Public Works Work Classification: Public Works Permit Status: APPROVED Expiration: 05/03/2018 Parcel Number Applicant 922 NE 91 Terrace Miami Shores, FL 1132060000030 Block: Lot: BBJJB LLC Owner Information Address Phone Cell BBJJB LLC 922 NE 91 Terrace MIAMI SHORES FL 33138- (954)558-3959 922 NE 91 Terrace MIAMI SHORES FL 33138- Contractor(s) Phone AG & GENERAL CONSTRUCTION INC (954)203-9219 Cell Phone Valuation: $ 2,550.00 Total Sq Feet: 255 Scanning: 1 Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Amount $0.00 $0.00 $0.00 $0.20 $100.00 $3.00 $0.80 Total: $104.00 Pay Date Pay Type Amt Paid Amt Due Invoice # PW-1-18-66131 02/02/2018 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 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 above -named contractor to do the work stated. Authorized Signature: 0 . / Applicant / Contractor / Agent February 02, 2018 Date Building Department Copy February 02, 2018 1 1-13 Miami Shores Village f JAN 1,$ 2018 Public Works Department (305)795-2210 //,,LL Public works forms are available from the building department, 10050 NE 2' Ave., Miami Shores, FL 33138 - [ (,1- PUBLIC WORKS PERMIT APPLICATION Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property Permit#: 1 J J8 Qw 1(6_U2 Name of Applicant (if utility see below): Nice-0 ins 8er/,'o .- Owner off the following described property: Legal Description: Lot Block Folio #; Address: cM)., IV-C.. (41 Terra( Subdivision r` U,I I Shoo,i UTILITY NAME: Qualifier/Authorized Agent: Address: City: State: ZIP: Telephone: Email: State Certification or Registration #: Certificate of Competency # CONTRACTOR NAME: 4 &er✓e c (GOA/5 i-rvc4;OW Qualifier/Authorized Agent: (s..istcAvo /9-(c0, -}t„yt,. Address: IelG,( 6. (,, il6 ierlac+2 City: O[tks,)}}a►N F1erick- State: FlcYiclL ZIP: I3'3 l Telephone: 5l1r-13S-- 131/S Email: M44-e4ocaccorkiteacv 7I i Q 9 rji€)( ,cervi State Certification or Registration #: CCG I04/if f f Certificate of Competency #: Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of way: CoriiGre7(C r,'-e v&U) Type of Work: ❑ Paving ❑ Utility .D Sidewalk ❑ Electric ❑ Irrigation ❑ Landscape ❑ Antenna ❑ Other: DESIGNER: Architect/Engineer: Address: City: State: ZIP: Telephone: Email: Registration #: _ , • vogAv j, ., 4'.1::t4 r ... ; g n'•ItI' are.) $�P' Value of Work.for this Permit o $x' =�,C0 . 00 Square/Lineal Footage of'Work 9( oiJ5' j is h, t ;a Fid"Oii i0 f P'4, rr. ,. ***** Fees ***** ;iiva',F.\St Afi++:ig7E t-e,. ' ' 9 Permit Fee $ 100.00 C.,Sai 119 .014 nr;; ,, -T0.» Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $ Bond $ (if required) Total Fee Now Due $ i .t 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. Signature % Signature /f coS7et- Applicant or Authorized Agent Co pany/Utility Agent The foregoing instrument was acknowledged before The fore oing instrum cknowledge efore cme this J, day of���. i , 20b_, by m his ay of 20 , by v‘ L L©Z N (CpC tt> J �� who who is personally known to rip or who has produced as identification. NOTARY PUBLIC: Sign: Print: SEAL: Jude Deronceray -� Notary Public- j • State of Florida, My Commission Expires 12101/2018 ,. Arbive �� n Commission No. APPROVED BY: is peen la ly known to me or who has produced as identification. NOTARY PUBLIC: Sign: Print: SEAL. >elkQUA) &-''C'a o"�;;,�y'- MELIZA ALVAREZ "• ''•`= MY COMMISSION # FF974952 Na, EXPIRES April 05, 2020 (407) 398-0t53 - mo idaplota,,Service.com 1 / /t ' % , 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 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) c- LOB f4QMt\ INVEST 013F LL1 hereinafter referred to as the owner of the following described property (address): S22- Mc_ °S l s r TEKiNC-V- Legal Description: Lot Block Subdivision I 111111 11111 11111 Bill IIIII 11111 ililililt IDI CFN N 2018R0030 } 81 OR E.K. 30829 Ps 2723 ((1Pss RECORDED 01r'1/ `01= 1159. - `1kth:VE'' y:U4'l.Hr CLERK OF COURT MIA I--r [:E COUH ' .; FLORIDA Folio # (l - 3 Z o C - QoG co '3 o STATE OF FLORIDA, COWNTY OF Requests permission to install (describe work): 114Ylh81t1° Within the public right of way of (address) IN CONSIDERATION of the approval of this permit by the Village, the owner aifFSMAGESIT#310229 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 authorized representative). Signature Owner or Agent t,;,'colas a,Y/ ') State of Florida County of Miami Dade The foregoing iklstrument was acknowledged before me this I WI' day of ICO (CAS • C • berli o Z who is personally known to me or who has pro Drier 1 iCMS-e as identification. NOTARY ; LIC• Sign: Print: SEAL: An a r , 20 IS , by uced