PW-18-1938Miami Shores Village
10050 N.E. 2nd Avenue NW
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
Pe
•mit
Permit NO. PW-7-1$-1938
Permit Type: Public Works
Wont Classification: Public Works
Permit Status: APPROVED
Issue Date: 7119/2018
Expiration: 10/17/2018
Parcel Number
Applicant
300 NW 112 Terrace
Miami Shores, FL 33168-3300
1121360010260
Block: Lot:
ROMINA MAGORNO
Owner Information
Address
Phone
Cell
ROMINA MAGORNO
300 NW 112 Terrace
MIAMI SHORES FL 33168-3300
(786)306-2665
300 NW 112 Terrace
MIAMI SHORES'FL 33168-3300
Contractor(s) Phone
ALL DESIGN CONCRETE CORP (305)320-8484
Cell Phone
Valuation:
Total Sq Feet:
$ 800.00
100
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-7-18-68273
07/19/2018 Credit Card
Amt Paid Amt Due
$ 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 tha all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
constrtion and zoning. Futhermor, authdri�e the above -named contractor to do the work stated.
July 19, 2018
Authorized Signature: Owner pplicant / Contractor / Agent
Date
Building Department Copy
July 19, 2018 1
Block
Folio#; \k"'1(— c) 6,'V
Address: 30b 11•Njk.._ Cy
RECEIVED
JU 19 2018
Miami Shores Village
Public Works Department BY:
(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
Name of Applicant (if utility see below): py�,� , hq
Owner off the following described property:
Legal Description: Lot
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City: l r•c
Telephone:i t/C.460C, fiS Email:
State Certification or Registration #• Certificate of Competency #
CONTRACTOR NAME: eO&wed%
Qualifier/Authorized Agent: • e a-S
Addres •
City:
Telephone:? g6-3Email:.
State Certification or Registration #:
Subdivision
Permit#: (9 Iq 3
K0.060
t ,cL„ Shj-s £s"
State: TL
City: h State:
Telephone: Email:
Registration #:
Value of Work for this Permit: $800.Oo
State:
ZIP:
ZIP:
Certificate of Competency #:
Requests mission to install describe work, ttach separate pageif necessary) in the adjoining right of
way: �QCX5 fhnock
•
Type of Work: Paving ❑ Utility
❑ Sidewalk
❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address: „ .
ZIP:
ZOD,s'0=.3c,ryf¢,r
Square/Lineal Footage of,Work:, .'►.00
•
11^5ul!'..
***** Fees *****
Permit Fee:$ 100:00 '
Notary $ �'� "' °t�'' Trainmg/Education $ 0.20 Technology Fee $ 0.80 Scanning $
Bond $ (if required) Total Fee Now Due $ I c 4. dp
<�1p et r ,
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•withhapplicable 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 recoi`ded 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
,ApW'ant or Authorized Agent
The forego' : nstruthen- waf acknowledge efore
pgt rh is I f; . ay of TV, _ , 20 , by
141 d► 100 O. Of -WE) who
is personally known to me or wh as produced
as
identification.
NOTARY PUBLIC:
Sign:
Print:
SEAL:
c r ;Ani. e N-1-ti-05
MARIA DE BRUZOS
MY COMMISSION # Y11136575
EXPIRES;August 21, 2021
Bond:.; fin NO : PublicUndOIWtltt*t
APPROVED BY:
Signature
Company/Utility Agent 1
The foregoing ins4
trumerViswqs acknowled a efore
me is d y of V , 20 t , by
In e. �e who
is personallJcnownS to me orlwho has produced
as
identification.
Sign:
Print:
SEAL:
******* *************
kov
;.IARIADE BRUZOS
i COMMISSION # GO 136575
> * * Ili August ::1, 2021
Thru ; : ;taryPu' : :;_Under
u. IC Works Director, or Designee'
201.7-04-15
111111111111111111111111111111111111111111111
C F14 2018R0426943
OR BY, 31061 F's 4 (1P9s)
RECORDED 0 /17/201 _, 10:0i3:37
HARVEY RUVIN? CLERK OF COURT
MIAMI-DALE COUNTY? FLORIDA
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
Whereas, (owner) i...0v....-% ,exq geA910(nD her ' after referred to as the
owner of the following described property (ad ess): 306 ((a ` -r r-
Legal Description Lot 10 Block 2 Subdivision 1
Folio # U (— a 134 a —001 — 0-�,c desM
Requests permission to install (describe work):
Within the public right of way of (address) lA (( a Ten'oo,e
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 authorized representative).
Signature
Owner or Agent
he foregoing trument was acknowledged before me this 1Say of Vi , 20 l r by
AA • - , .who is personally known to itRAT2byr3 0, 45
as identification an, ho did takaan oath: - 'HEREBY, 'T/FY
mgmal (.
NOT
Sign:
Print:
My Commission Expires:
RY PUBLIC:.
y
D.C.
STR!N,OFR
MAR ,, MS
'' ' I MY COMMISSION # CO iMiiffi
EXPIRES:MO.4M Mil
.4. fit; Bonded rnrU