PW-18-3191Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue Date:12/13/2018
Parcel Number
456 NE 102 ST, Miami Shores, FL 33138-2453 1132060170570
Contacts
Permit No... PW-10-18-3191
Permit Type: Public Works
work Classification: Public Works
Permit status: Approved
Expiration: 06/11/2019
KATHERINE CASTELLON Owner KATHERINE CASTELLON Applicant
456 NE 102 ST, MIAMI SHORES, FL 331382453 456 NE 102 ST, MIAMI SHORES, FL 331382453
CONINMAQ LLC Contractor
ANA GUTIERREZ
16741 ROYAL POINTCIANA DR
Business: 7862853073
Description: DRIVEWAY APPROACH Valuation: $ 3,000.00 Inspection Requests:
305-762-4949
Total Sq Feet: 130.00 —j I
Fees
Amount
Education Surcharge
$0.60
Public Works Permit Fee
$100.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$106.10
Building Department Copy
Payments Date Paid
Amt Paid
Total Fees
$106.10
Credit Card 12/13/2018
$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 ponstruction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
Authorized Signature: Owner / Applicant / Contractor / Agent Date
December 13, 2018 Page 2 of 2
i
RECEIVED
Miami Shores Village OCT 18 2018
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
\T t
(� Permit#:
Name of Applicant (if utility see below):
Owner off the following described property:
Legal Description: Lot Block Subdivision
Folio3n ` 0 �{ ,
Address: S � 1
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City: State: ZIP:
Telephone: Email:
State Certification or Registration #: Certificate of Competency #
CONTRACTOR NAME: CoL I
Qua lifier/A ho ized Agent: t
Address: i
City. State ZIP:
Telephon il:
State Certification or Registration #: c ISI Certific to of Compe ency #:
Requests ermi ion to install (describe work, a tach separate a e if necessary) in the adjoining right of
way: f) ri foAC4—
Type of Work: ❑ Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
City: State: ZIP:
Telephone: Email:
Registration,#: �.....ri. .
Value of Work for this Permit:: $:: Square/Lineal Footage of Work':
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
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
pp icant or Authorized Agent
The foregoing instrument was acknowledged before
me this � day of (CC-7 20 lE� , by
who
is ersonally known to as produced
as
identification.
PEDRO VILLEGAS
Commission # GO 108020
Explres May 24, 2021
9ond�ihro Troy Fsln Msunnce
APPROVED BY:
2017-04-15
Signature udkx. t
0"
Company/UtM Agent
The foregoing instrument. was acknowledge efore
me this � day of G� 20 �19, by
who
is ersonally know to me�orr whq has produced
- C ]i—FUF J4 �Oafi
identification.
NOTARY PUBLI
Sign:
Tu-t;& AS
L: .....
FEDRO ALLEGAS
Commission # GO 108020
j Expires May 24, 2021
Bonded Tw Troy Fain Inennnee SO-SM7019
****************************
Public Works Director, or Designee
nr
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
OR BK 31159 Ps 1966 (1P3s)
RECORDED i 19i 27/20123 13:45.27
HARVEY RUVIN, CLERK OF COURT
MIAMI--DADE COUNTY? FLORIDA
of fLCaak COJNTY OF DAI)F-
10 .AD20
Rk,�sl
�/ , Courts
COVENANT OF C NSTRUCTION WITHIN RIGHT OF AWAY 1.�� c D.
Whereas, (owner)�.�T m*,) � ` ( D: 588
hereinafter referred to as the owner of the following described. AKIERRA BRAZIL 162
property (address):
Legal Description: Lot Block Subdivision
Folio # C - - C��
Requests permission to install (describe work):
Within the public right of way of (address)
Im
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
State of Florida
Oounty of Miami Dade
T e foregoing instrument was acknowledged before me this o� day of `J , 20 1�, -by
){ who is personally known to me or who has produced
NOTE
Sign:
Tint:
(4o),80rAed
PEDRO VILLEGA8SEACommission # GG 108020
Expires May 24, 2021
Thru Troy Fak Inswanc•: Eo^•d!:
POWER OF ATTORNEY
The undersigned as,Katherine Castellon of
Gold Coast Investments of Florida _hereby
authorizes, appoints and designates Carlos Pena as attorney -in -fact for the Company and exercise in the
Company's name, place and stead all or any of the following powers:
GENERAL GRANT OF POWER. As it pertains to the Company's property located at
456 NE 102nd St, Miami Shores, FL 33138
may negotiate on behalf of the company with Miami -Dade County and any subdivisions and/or
departments of Miami -Dade County violations, fines, liens, building permits, structural defects or
other related matters. The Company grants to_ Carlos Pena full power and authority to do
everything, including, but not limited to, the execution of any documents necessary in exercising any
of the powers herein granted as fully as the Company might or could do if on its own, and the
Company hereby ratifies and confirms all that Carlos Pena shall lawfully do or cause to be
done by virtue of this power of attorney and the powers herein granted. Carlos Pena may exercise or
perform all acts, powers, duties, rights or obligations whatsoever authorized by this power of attorney
in the Company's own name to bind the Company. (Document not enforceable for any Sales or
Rentals).
IN WITNESS WHEREOF, the Company has executed and delivered this Power of Attorney as of the
date first written above.
(Company/Owner Name)
By.
NameXath re ine Castellon
Title: Managing Member
ACKNOWLEDGEMENT
STATE OF FLORIDA
COUNTY OF MIAMI-DADS
On the- day of , 2018, before me, the undersigned, a Notary Public in and for the
State of New York, personally appeared- , personally known to me or proved to me on the basis of
satisfactory evidence to be the individual whose name is subscribed to the within instrument and
acknowledged to me that he executed the same in his capacity and that by his signature on the
instrument, the individual, or the person upon behalf of which the individual acted, executed the
instrument.
NOTARY PUBLIC —
My Commission Expires: ,...,,
PEDROVILLEGAS
r Commission# GG 108020
Expires May 24, 2021
,tBonded Thru Troy Fain Insurance 800-3967019