PW-18-3172Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date:11/06/2018
Location Address Parcel Number
9475 NE 2 AVE, Miami Shores, FL 33138 1132060133760
Contacts
Permit NO.: PW-10-18-3172
Permit Type: Public Works
work Classification: Public Works
Permit Status: Approved
Expiration: 04/15/2019
BANK OF AMERICA NA Owner BANK OF AMERICA NA Applicant
101 N TRYON ST, CHARLOTTE, NC 28277 101 N TRYON ST, CHARLOTTE, NC 28277
CAL DEVELOPMENT INC Contractor
EITHNE CATHERINE KEANE
98 se 7th st, deerfield beach, FL 33441
Business: 5944421188
inspection Requests:
Description: MILL/OVERLAY in the alley between Valuation: $ 17,949.75 nspe tion Rg'
11-3206-013-3740 and 11-3206-013-3810. The alley to the
west of parcel 11-3206-013-3760 for the entire lenght of the Total Sq Feet: 5,700.00
Fees
Amount
Education Surcharge
$3.60
Public Works Permit Fee
$100.00
Technology Fee
$2.50
Total:
$106.10
Building Department Copy
Payments Date Paid
Amt Paid
Total Fees
$106.10
Check # 34077 11/06/2018
$106.10
Amount Due:
$0.00
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: Owner / Applicant / Contractor / Agent
November 06, 2018 Page 2 of 2
r, 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#: CCLY '
Name of Applicant (if utility see below): Bank of America NA
Owner off the following described property:
Legal Description: Lot Block Subdivision
Folio #; 11-3206-013-3760, 11-3206-013-3740; 11-3206-013-3810
Address: 9475 NE 2nd Ave., Miami Shores, FL 33138; 236 NE 95 St., Miami Shores, FL 33138; 231 NE 94th St., Miami Shores, FL 33138
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
Citv:
Telephone:
State Certification or Registration #:
Email:
CONTRACTOR NAME: CAL Development
Qualifier/Authorized Agent: Eithne Catherine Keane
Address: 6850 Lyons Technology Circle
CitV: Coconut Creek
Telephone: 954-564-0655 Email:
State Certification or Registration #: CGC1512095
State:
State: FL
ZIP:
Certificate of Competency #
ZIP: 33073
Certificate of Competency #:
Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of
way: Asphalt will be milled and overlayed in the alley between parcels 11-3206-013-3740 and 11-3206-013-3810. The alley to the west
of parcel 11-3206-013-3760 for the entire length of the parcel will also be milled and overlayed.
Type of Work: ❑■ Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer: Nisit Sapparkhao, PE -Infinity Engineering Group, LLC
Address: 1208 E. Kennedy Blvd., Suite 230
City: Tampa State: FL ZIP: 33602
Telephone: 813-434-4770 Email: nisit@iegroup.net
Registration #: 64085
Value of Work for this Permit: $ Square/Lineal Footage of Work: J/ w
*�***Fees
*****
Permit Fee $ 100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
Bond $ (if required) Total Fee Now Due $ ( - &--.)
d .r A .
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
_ &7
11�plicant or Authorized Agent
The foregoing instrument was a nowledged�2efore
me this day of �, 20 �b , by
lk
Q * 11 � Vt.." 77E k who
is personally known to me or who has produced
as
Signature
Company/Utility Agent
The foregoin .nstru pt as a�,k,n^owledged before
me thisday o, by
who
is personally known to me or who has produced
tb9
identification. identification.
NOTARY PUBLIC: NOTARY PU IC:
Sign: 4 Sign:
Print: �`c�'t+�'�-� Print:
SE L:
u' ., I,UCY GUTIERREDNotaryAssn.
TARYN L REIS
5-0
,• "`: Notary Public Sta.``.►AY °�ei%, Notary Public State o1 FlOtida
;��,°� Commission N G°'s
`'l`oF��•' My Comm. Expires Commission M FF 997689
Bonded through Nationa•- My Comm. Expires Jut► �, 2�20
f t� °��` Bonded through National Notary Assn.
APPROVED BY: , Public Works Director, or Designee
2017-04-15