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PW-18-1143Miami Shores Village 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 Phone: (305)795-2204 Project Address Parcel Number Issue Date Permit NO. PW-5-1$-1143 Permit Type: Public Works Work Classification: Public Works Permit Status: APPROVED 2018 Expiration: 07/31/2018 Applicant 22 NW 105 Street Miami Shores, FL 33150-1242 1121360131170 Block: Lot: WHALEN GROUP, LLC Owner Information Address Phone Cell WHALEN GROUP, LLC 22 NW 105 Street MIAMI SHORES FL 33150- (305)710-6801 22 NW 105 Street MIAMI SHORES FL 33150- Contractor(s) BRUNO CONTRUCTIUON CORP Phone (305)766-8984 Cell Phone cAllictL Valuation: $ 2,400.00 Total Sq Feet: 800 Scanning: 1 CA Fees Due CCF DBPR Fee DCA Fee Education Surcharge Permit Fee Scanning Fee Technology Fee Total: Amount $o.00 $o.00 $o.00 $0.20 $100.00 $3.00 $0.80 $104.00 Pay Date Pay Type Amt Paid Amt Due Invoice # PW-5-18-67356 05/02/2018 Credit Card $ 104.00 $ 0.00 Available Inspections: ran 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. 0 - - 'AVIT: 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 z. ing.Futhermore, I a thoriz= the a•t•ve-n - -d co (tractor to do the work stated. u orized Signe ure: Owner " / pplicant / Contractor / Agent May 02, 2018 Date Building Department Copy May 02, 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 FL 33138 PUBLIC WORKS PERMIT APPLICATION Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property /�� Permit#: ?IA.)t a —1\43 Name of Applicant (if utility see below): Vj c.iAit1 Owner off the followin Jescri ed property: Legal Descrjption: Lot 3 (/ Block Folio#; /-' 2/3 — O/S f�� Address: 77 4A) (Q, S! ' Subdivision ( //CELLED UTILITY NAME: Qualifier/Authorized Agent: Address: City: State: Telephone: Email: State Certification or Registration #: Certificate of Competency # ZIP: CONTRACTOR NAME: .vttf\ t . - J Vim- (.. Qualifier/Authorized Agent: U 1 t.. A-, -C_ rViA-C., Address: ^ 2 Q. v City: I v Telephone: State Certification or Registration #: C&C is i T}01 Certificate of Compe Req is p rmission to` n�stall (describe work, attach s paste page if necessary way: V l&LL y k�fi� ?...A.A.,t. •( IN ( P&L) a S y in the d oirSingri�g'h f Type of Work: A Paving ❑ Landscape DESIGNER: Architect/Engineer: Address: ❑ Utility Antenna ❑ Sidewalk ❑ Electric ❑ Irrigation ❑ Other: City: - State: ZIP: Telephone: . Email: Value of Wirk'for this�Perr�it 8to . fit gut, 23R"Tr:! Permit Fee 100.00 Notary $ Bond $ (if required) Registration.#:, ,ta 5. )1Utioi ilk $ 210U Email: W31 .: ,,n <_' ***** Fees ***** Square/Lineal Fgotage,of;Work .-<..v�,.x Training/Education $ 0.20 Technology,Fee $ 0.80 Scannin $ 3 Total Fee Now Due $ 104 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 a`s`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 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. Signatufe The foregoi �this 1G Applicant or Authorized'Agent instrumenAwas acknowledged before daypf (/-�, 20 1 41( , by -( lil who finally Mown tom ho has produced D/t 7G at 1 as identification. NOTARY PUBLIC: Sign: Print: Chlwl-6.( (0Gt2 SEAL: CH� 1TAL GLOOR COMPASSION FF142540 EXPIRES: July 16, 201d www.A*ROMNoriwr rol APPROVED BY: Print: SEAL: Signature Company/Utility Agent The foregoing instrument was aCknowledgeg before me this 2-6" day of /4pr I \ , 20 it , by V ►^ c Er\7t? tg'01--"7 who is personally known to me or who has produced as identification. NOTARY PUBLIC Sign: CA/tank( (i(©c CHANTAL GLOOR COMMISSION r FF142510 EXPIRE& Jut/ 16, 2018 www.AARUMNOTMY.coa **** **************************** S \ ke( , Public Works Director, or Designee i 2017-04-15 1 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 1111111111111111111111111111M11111111111111 C F FE 201 �RO2567 11 OR BK_. 3O953 Pi_ .1 q COVENANT OF CO ST UCTI HIN R GHT OF WAY Whereas, (owner) UU c �;-ei,f hereinafter referred to as the owner of the following described property (address): ZE 'L l,J \uc,-;'-` 61-- f/ Legal Description: Lot �o Block /ZS'Subdivision //,;ri i/ J of t Folio # //- 2/3-673 - l/7j Requests permission to install (describe work): Within the public right of way of (address). Z2 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 fully authorized representative)_. Signature Owrief & Agent State of Florida County of Miami Dade ^\ regoing inst um nt was acknowledged before me this Z day of s \ , Wig IS -personally known to me or who has produced qn1 NOTARY PU LIC as identification. Sign: C� J�- Print: SEAL: CHANTAL GLOOR COMMISSION / FF14250 www/ANtouNotutWIRES: July 16, 2001