PW-18-2292Miami Shores Village
10050 N.E. 2nd Avenue NE
Miami Shores, FL 33138-0000
Phone: (305)795-2204
Project Address
mit
Permit NO. PW-8-18-2292
Permit:Type: Public Works
WorkClasslfcatkrra: Public Works
Permit Status: APPROVED
issue Date: 9/10/2018
Expiration: 12/09/2018
Parcel Number
Applicant
158 NE 110 Street
Miami Shores, FL 33138-
1121360040450
Block: Lot:
WILFREDO ACOSTA
Owner Information
Address
Phone
CeII
WILFREDO ACOSTA
158 N. E. 110 ST.
MIAMI SHORES FL
Contractor(s)
ONE STOP PAVING
Phone CeII Phone
(786)299-1354
Valuation:
Total Sq Feet:
$ 5,000.00
900
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-8-18-68699
09/10/2018 Check #: 2137
Amt Paid Amt Due
$ 104.00 $ 0.00
Available Inspections:
Inspection Type:
Excavation
Review Public Works
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
construction and zonin
Authorized Sig
rtify that .I the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
thermore I authorize the above -named contractor to do the work stated.
ture:Ow -r
/ Applicant / Contractor / Agent
September 10, 2018
Date
Building Department Copy
September 10, 2018
1
Owner off the following described property:
Legal Description: Lot t4 Block 2-
Folio #; t l 21 3 (o Oo 4 04
Address: tSv iJ f Ito a1-
UTILITY NAME:
REC
Miami Shores Village
Public Works Department
(305)795-2210 BY--
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#:
PW 18-2Z' Z
Name of Applicant (if utility see below): . 1 ` e Ld A e o a+,
018
tit
Subdivision Co 11p. .g 41 8 i L1 s t.i3 11-8
Qualifier/Authorized Agent:
Address:
City: State: ZIP:
Telephone: Email:
State Certification or Registration #: Certificate of Competency #
CONTRACTOR NAME: (Ovi,e C'(-ab 17Ct v ; '-,l ,a ,�.s,
Qualifier/Authorized Agent: e,G,ka t 1a4-49 s 44 t
Address: L46') iJk t-l7i s }-
City: w - i•-t - tOiex-� i^ State: '2FC-- ZIP: 3 3 l 6 2
Telephone:—i9(d Zctzt 1354 Email:. car -Ls a. c,'a p cfc LID 0_ co„,,t,
State Certification or Registration #: C C. tS (3 Z tit Certificate of Competency #: - 2-31 613 O
Requests permission to install (de tribe work, attach separate page if necessary) in the adjoining right of
way: "C.7 lai h Co �cr�'e a Le s .
yige-00-c
Type of Work: Paving ❑ Utility ❑ Sidewalk
❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
City: State: ZIP:
Telephone: Email:
Registration #:
Value of Work for this Permit: $ Stv
Squar3/Lineal Footage of Work: ' d 0
***** Fees *****
Permit Fee $ 100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
Bond $ (if required) Total Fee Now Due $
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
APPLICANTS 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
Applicant or Authorized Agent
The foregoing instrument as acknoedged before
me this' —7 day of ' v'lc).� us--// ,20 1 , by
-
W.I J-. 4. wrwho
is personally known to me or who has produced
identification.
NOTARY PUBLIC:
Sign:
Print:
SEAL:
APPROVED BY:
'BARBARO SOBRINO
MY COMMISSION # FFF195634
EXPIRES: February 3, 2019
ti coded Thru Notary Public Underwriters
as
_ ..411Voaa
(Signature -�
Z P
pang Utility Agent
The foregoing instrumen was acknowledged before
me this -7day of A c s-I , 20 (2) by
a- b S. CA- w who
is personally known to me or who has produced
as
identification.
Sign:
Print:
SEAL:
CC.
BARI;1�iiiSOBRINO
+fie?'. �a�c
+: MY COMMISSION # FF 195634
EXPIRES: February 3, 2019
Bonded Thru Notary Public Underwriters
t+xit
* n **. `*************************************
6:1`b`lb , Public Works Director, or Designee
2017-04-15
Infliiiiii111111,111111111111
111111111111
D OCIJMENT COVER PAGE
For those clomments not providing the rea-od±bd 3 x 3
s'paff, on the Ent page, this Dover page must be attached.
A-D„ arldifimaj recording fee fiSr this page mast be remitted.
L.
IA 213 8 P. 0 4 3 -4- '71
OR BK..31094 f9.q.:2,623-7,629 (2Psrs)
RECOR5FD 03/H9/201S 12::11:12
HARVEY RUVTN, CLERKOF COURT
' A I-DADE COUNTY 7 Fl..01;!ID A
(0p2=2_1Drive. Eis tint: rr_scrycd far TrtMrean'g DE"an r_rsc)
Do Eminent. Tiflp:
(Ni.l.orEgag, Dna., FAD.) •
Return:b. o criment To / Pr epared By:.
Cd) On all documents prepared ..„7,thign are to be recoided intisepli i-1-ords of may county „ a 3:42
-5Drasp top rigirE-hsaid non-n_elontbeficstpage end al -.;Mcb_b13 - Ole sp ace aith.e. tap rigb±-102.4.
o.enala s-ab-segLenigag-asiaailbeleftbIa-Icnclres-erifici use by tl,r- I:1=k rjf acratt
1
CLPCT 155 Rev, C8/-16
Web aidres-s.: www..mtaml-dadacle_-_Ficcmtn •
'fr\icti4_
• „
OR "•K 31094 PG :3629
LAST PAGE
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)
hereinafter referred to as the
owner of the following described property (address): /GS iv 6 I/O r f- Al_ h S.
Legal Description Lot I el Block 2 Subdivision s de,-4'/_r
Folio # 1/ 2/-G 004 04-5-0
Requests permission to install (dscribe work):
p(ei / ki ce.-C.rtip ,e 0 G'c G, er S
i/f/( //rtin
Within the public right of way of (addres1 106 if s1
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
Gv/LF,e.E20 Qcosti�
The f re oing instrument was acknowledged before me this '-- day of 4,2
!4 � � , 20 � � , by
tv,/ re cos who is personally known to me or who has produced
as 'dentification and who did take an oath.
GTATE OF FLORIDA, COUNTY Of D
1 HreilirgY CERTFv 11)4 thu: is a true c w ;d t*
NOTARY PU
Sign:
Print:
My Commissio
Expires:
ortj.inai fitedAir�'t�1s ; fficiL„
oS'
F;lI1J `j .D. 20
HAR-VEY R :r '( '> Court Cou.
o . BARB/Via SOORINO
MY COMMISSION # FF 1 .,634
EXPIRES: Fshruary 3, 2019
Bcinded Tbru hlolary Public Undemiler;
Mission:
To protect, promote & inprore the health
of all people in Florida through integrated
state, coudy & comnurrty efforts.
Vision: To be the Healthiest State in the Nation
Rick Scott
Governor
Celeste Philip, MD, MPH
State Suyeu l Geier and Secretary
August 15, 2018
One Stop Paving INC
1463 NE 173 Street
Miami, FL 33162
RE: Modification to a Single Family Residence - No Bedroom Addition
Application Document Number: API358918
Centrax Permit Number: 13-SC-1868943
158 NE 110 Street
Miami, FL 33161
Lot: 14 Block: 2 Subdivision:
Dear Applicant,
This will acknowledge receipt of a floor plan and site plan on 08/08/2018 for the use of the existing
onsite sewage treatment and disposal system located on the above referenced property. NO
OBJECTION
For concrete driveway and Concrete driveway approach.
A.E.
This office has reviewed and verified the floor plan and site plan you submitted, for the proposed
remodeling addition or modification to your single-family home. Based on the information you provided,
the Health'Department concludes that the proposed remodeling addition or modification is not adding a
bedroom and that it does not appear to cover any part of the existing system or encroach on the
required setback or unobstructed area. No existing system inspection or evaluation and assessment,
or modification, replacement, or upgrade authorization is required.
Because an inspection or evaluation of the existing septic system was not conducted, the Department
cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use.
You may request a voluntary inspection and assessment of your system from a licensed septic tank
contractor or plumber, or a person certified under section 381.0101, Florida Statutes.
If you have any questions, please call our office at (305) 623-3500.
Sincer ly,
strid Edwards
Engineering Supervisor III
Department of Health in Dade County
Florida D.O.rb.o.t of xwa
in Dade County • • , Florida
PHONE: (305) 623-3500
www.11orw.h.we.yov
TWITTER:HealthyFLA
FAC EBOOK: F LDepartmentofHealth
YOUTUBE: fldoh