PW-19-1132Location Address
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 05/24/2019
Parcel Number
1316 NE 105TH ST, Miami Shores, FL 33138 1122320270150
Contacts
Permit NO.: PW -055-19-1132
Permit Type: Public Works
Work Classification: Public Werks
Permit stotus: Approved
Expiration: 11/13/2019
Flus LLC Owner R2 BUILDERS INC Contractor
PO BOX 402306, Miami Beach, FL 33140 RODOLFO RODRIGUEZ
Business: 3052313113
Description: SIDEWALK FLAGS REPLACEMENT, TO CORRECT Valuation: $ 6,500.00 Inspection Requests:
CASE #003691-2019 & CASE #003690-2019 305-762-4949
Total Sq Feet: 0.00
Fees
Amount
Education Surcharge
$1.40
Public Works Permit Fee
$100.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$106.90
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$106.90
Credit Card
05/24/2019 $106.90
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 AFFID IT: certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating constr ion oning. Futhermore, I authorize the above named contractor to do the work stated.
4
Authorized
/ Applicant / Contractor / Agent
Date
May 24, 2019 Page 2 of 2
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(305)795-2210
Public works forms are available from the building department, 10050 NE 2"d 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#:Tvj-6s_0-1132,
Name of Applicant (if utility see below): 5111S LL
Owner off the following described property:
Legal Description: Lot Block Subdivision
Folio #; //---0150,
1 J
Address: Z3/6 A/& _ /US /7C/ • gla4,0/ S7aye '
UTILITY NAME: N A-
Qualifier/Authorized Agent:
Address:
City: State: ZIP:
Telephone: Email:
State Certification or Registration #: qq Certificate of Competency #
CONTRACTOR NAME: Q'Z 6v1IU2tS 1 w
Qualifier/Authorized Agent: I?CJ.16 Qod?itca�.tp�
Address: )0950 IJ LU 11> 'VA sT`creT Ui14Ta
City: %A%ft\IP0A 6W'.-4 A's State: FL ZIP: 3301!^[
Telephone: 3oS-231-3113 Email: lw�& R216/1 1"If- Calk
State Certification or Registration #: C(nL 1613M(09 Certificate of Competency #:
Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of
way: Sidewt-W T-kay- U-P10u,t4wi . To CoRWcT CASE ---#00301 -2419
x
Type of Work: ❑ Paving ❑ Utility
❑ ' Landscape ❑ Antenna
1.1
DESIGNER: Architect/Engineer:
Address:
City: State:
Telephone: Email:
Registration #:
r
Value of Work for this Permit: f$ �'r � 00
® Sidewalk ❑ Electric ❑ Irrigation
❑ Other:
ZIP:
Square/Lineal Footage of Work:
Fees
N..'rtis!°Ae"q,PpnuA 99-".ybar^'A...bX"yWa::.
Permit Fee $ 100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
Bond $ (if required) Total Fee Now Due $ 1 06 �1 V
-r I
w
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.
Signatu a Signature
Applicant or Authorized Agent C any/Utility Agent
The foregoing insfrument'was acknowleded efgore The•foregoing insinlment was'acknowledged before
me this ��ay of 177.4k; 20� by me this k /.� day of /�'� 20 �9 , by
whowho
is personally known to me or who has produced is personally known to me or has produced
1:1L •0•L• as I t) L-- as
identification. identification.
Sign:
r 1P -
SEAL: Y o .. GEORGE A. DEKKI
Notary Public - State of Florida
Commission # GG 227444
? ov n My Comm. Expires Jun 11, 2022
Bonded through National Notary Assn.
APPROVED BY:
2017-04-15
Sign:
Print: _ t¢� f�pQ�aA
SEAL:
�uv'i�;• JULISSARODRIGUEZ
Notary Public - State of Florida
Commission M GG 182910
My Comm. Expires Mar 5, 2022
Bonded through National Notary Assn.
********************************
V '3� Public Works Director, or Designee
May 15th, 2019
Miami Shores Village E,IVED
Attn. Public Works Department M Y 1 7 2019
10050 NE 2nd Ave. Miami Shores FL 33138.
BY:_
To whom it may concern:
This letter will authorize R2 Builders INC to take out a permit to replace concrete sidewalks at
1316 NE 105th Street Miami Shores, FL 33138.
For any other questions and clarifications, please contact me through the number provided
below.
Sincerely yours,
`/o YMARIS ALEMAN
954-8125789