PW-18-2468Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
452 GRAND CONC, Miami Shores , FL 33138-2463
Contacts
Permit NO.: PW-9-18-2468 Permit !VR Number: 631578
Permit Type: Public Works
Work Classification: Public Works
Permit Status: Approved
issue Date: 10/05/2018
Expiration: 03/18/2019
Parcel Number
1132060170020
Project
JOSEPH RAIA
452 GRAND CONCOURSE, MIAMI SHORES, FL 331382463
Owner
CHAMPION CONCRETE
JAIME BASILIO
10280 NW 63 TER 105, DORAL, FL 33178
Business: 3052528055
Other: 7864024802
Contractor
JOSEPH RAIA
452 GRAND CONCOURSE, MIAMI SHORES, FL 331382463
Applicant
Description: ( REPLACE BROKEN STREET SIDEWALK )
Fees
Amount
Education Surcharge
Notary Fee
Permit Fee
Scanning Fee
Technology Fee
Work Without Permit 1st Offense
Work Without Permit 1st Offense
$0.20
$5.00
$100.00
$3.00
$0.80
$100.00
$100.00
Total: $309.00
Valuation: $ 1,200.00
Total Sq Feet: 1,620.00
Payments
Total Fees
Credit Card
Amount Due:
Amt Paid
$309.00
$309.00
$0.00
Inspection Requests:
305-762-4949
Building Department Copy
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDA IT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating c',nstru j on and zoning. Futhermore, I authorize the above named contractor to do the work stated.
1,4
Authori -d Signature: Owner / Applicant / Contractor / Agent Date
October 05, 2018
Page 2 of 4
Miami Shores Village
Public Works Department
(305)795-2210
Public works forms are available from the building department, 10050 NE 2nd Ave., Miami Shores, FL 33138
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property
Name of Applicant (if utility see below): _Ja.S(//f I . /2, -I/3
Owner off the following described property:
Legal Description: Lot Block
Folio#; // 32ob— a/7/ OG -o
Address: (/ CZ_G0Ge),VCD41Y9
Subdivision
Permit#:.Jv « -2 ` v1
13'uNl$-743
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City: State: ZIP:
Telephone: Email:
State Certification or Registration #: Certificate of Competency #
CONTRACTOR NAME: li/f/h'T/ 104. (gP7'e
Qualifier/Authorized Agent: `Mime A4S/y t)
Address: /L71-0 P/ 123 7 .qL A. -...-
City: 0/ 0/ - State: ii... - - - ZIP: 3307 ?-
Telephone: 3 $ 2-SZ a'b5S Email: V�
State Certification 'or,Registration #: Certificate of Competency #•L12 _61r .. '/Y
•
Requests permission to install (describe w rk, attach separate page if necessary) in the adjoining right of
way: fA-v 5 W'��
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•P,ermit:,
Iw•lvx : ka:W�;.w.�.�1 r
4 l.'; ie J 1 1i
Square/Lineal Footage
***** Fees*****
Permit Fee $ 100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $ ",�'
Bond $ (if required) Total Fee Now Due $ 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 Orior,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 andithat 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 subjec to the
attachment. Also, a certified copy of the recorded notice of commencement must be post at the job
site for the first inspection which occurs seven (7) days after the public works permit is is d. In the
absent c pos e. . '_ the inspection will not'be approved and a reinspection w I be charged.
ed Agent
The for .' g instrum nt was ack owledge before
me thi daX of 0_�� '�.. 20 1 , by
who
is personal known to me or who has produced
identification.
NOTARY P. BLIC:
Sign:
Signature
Co ahy/Utilityy Agent
The foregoing instru eiit was acknowledged before
w
e this 13 day o .(91 , 20 , by
-PI( ►'n fk-. t-' }3 0 who
is persckallyrknown j�rne or who has produced
as
• MY COMMISSION F FF 909724
EXPIRES: September 30, 2019
Bonded Thrn Notary Pubic Underwriters
APPROVED 'BY:
•
identification.
NOTARY PUBLIC:
Sign: •`:>'`\Q�1
Print:
SEAL:
Il101io
CV
a 'aich 6' 2p,;O. 9
• N,* .
%y •• #FF 954760 ' oT
�99'./464�, sondes �tm te. 04•
* £,******* **A*********************
, 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) _J cOS-ern —If (I1
hereinafter referred to as the owner of tD e following described
property (address): LicL MN CoA/COv/iiSe
Legal Description: of Block Subdivision
Folio # t1-3L®�- of %- t020
Requests permission to install (describe work): pieS
11111111111111111111111111111111111111111111
CFN 201SRC5551 5
OR EK. 31137 Fs 1627 (1Pgs)
RECORDED 0i9/12/2018 i.4:4 g0
HARVEY RIUVIN? CLERK Of COURT
MIA iI--DADE f:OUN..1Y, FLORIDA
Within the public right of way of (address) t137 qato taivC .i-C
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 Publi ' _ _ e e of Dade County, Florida by the Village Manager of Miami Shores Village
(or
,./...)9nature
State of Florida
Couritrof Miami Dade
The foreg ing in ument was acknowledged before me this'' day of mil
��.who is personally known to me or who has produ
as identification.
Owner or Agent
taA1E OP P'.ORIOA, OOVN r Y OF DARE
'HEREBY CERTIFY tatt this is a true copy of the
onoinal filed in this ofrcchhE P 1 2 2018 day of
,AD20
WITNESS my hand and Official Seal.
`-&ARVEY RUVIN, CLERK, I ,;wit ounty Courts
NOT
Sign:
Print: V l\i
44,
D.('
SFP� . -
+" VIVIAN YON
. 4 MY COMMISSION i FF 909724
EXPIRES: September 30, 2019
tie TS Bonded Tluu Notary Pubic Urdermiters
20 16 , by