PW-19-1498Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Issue Date: 09/09/2019
Parcel Number
9632 NE 5TH AVENUE RD, Miami Shores, FL 33138 1132060170140
Contacts
Permit No.: PW-06-19-1498
Perm Type: Publ : Works
Work Classification: Public Works
Permit Status: Appmsred
Expiration: 02/05/2020
DAVID ELIAS HALABU Owner STAR ISLAND CONCRETE DESIGN CORP Contractor
9632 NE 5 AVE, MIAMI SHORES, FL 33138 MIGUEL CORPAS
Other: 3052137625 dhalabu@hotmail.com 1018 nw 47 street, Miami, FL 33127
Business: 3057767916 miguelcorpas22@gmail.com
Description: STAMP CONCRETE DRIVEWAY AND PATIO Valuation: $ 1,600.00 Inspection Requests:
305 7`62-4949
Total Sq Feet: 1,600.00
Fees
Amount
Education Surcharge
$0.40
Public Works Permit Fee
$100.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$105.90
Payments
Date Paid Amt Paid
Total Fees
$105.90
Credit Card
08/09/2019 $105.90
Amount Due:
$0.00
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 AFFIDAVIlh I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulgtingionstructi andAzoning. Futher_more, I authorize the above named contractor to do the work stated.
Authorized SicYnature: gwWr/ Applicant / Contractor / Agent
August 09, 2019
Date
Page 2 of 2
504A RECEE ED
_
Miami Shores Village
Public Works Department ��N
(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#: T " " � -ig -)` 016
Name of Applicant (if utility see below):
Owner off the following described property:
Legal Descri tion: Lot Block Subdivision
Folio#;
Address: G7(o3Z ILA .4,ir ?_D
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City: State:
Telephone: Email-
State Certification or Registration #: _
CONTRACTOR NAME: ECG✓
Qualifier/Authorize Agent:
Address:
City: Ct-tact'
Telephone: a // Z
State Certific tion or Registration #:
Requests pe
way:
ZIP:
Certificate of Competency #
0
State: ZIP.
Email: 4.yt
Certificate of Competency #:
n to install (describe work attach sep�
-mac 't,6 GB c� Z �
/Z
if necessary) in the adjoining right of
Type of Work: Paving ❑ Utility ❑ Sidewalk ❑ Electric
❑ Landscape ❑ Antenna ❑ Other:.,. ,
❑ Irrigation
DESIGNER• Architect/Engineer: ;x � ' ' 0...�,
Address: `.
Cit' r State: y�._.< ZIP:
Telephone:....; _ :,; Email:
Registration ,#-,.,.
Value of Work for this Permit: $ tl4 o Square/Lineal Footage of Work:
Permit Fee $ 100.00
Notary $
Bond $
***** Fees*****
_Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
(if required) Total Fee Now Due $
Ip'�:i ."(0
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 approvecj end a reinspection will be charged.
Signature ,!
LAppl or uthorizMdAgent
The forego* instrument was a`cknowledged'before
me this day of 26_& by
who
is personally known to me or who has produced
as
identification.
Sign:
Pri
Sign
(f—� g pang Utility Agent
The fore of instr ent as acknowle ed efore
me this 2 day of 20 , by
v
is personallx known to me or who has produced
l�► lCi CUB I' as
identification.
Sign:
uoptcpwuwoo IOW J
Print: i� pewy auuaieA
SEAL: vpv%ji10°M —
** **** ***********************************
APPROVED BY: '1 i Public Works Director, or Designee
2017-04-15
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 796.2204
Fax: (305) 756.8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WA`
Whereas, (owner) D kyl :H k U�
hereinafter referred to 16IJ
t owner of the following describe
property (address): f�C S'+" Ave- W 1A tA*'V\ 15-k
Legal Description: Lot J1i Block 17G Subdivision SHci(eS ser i li/►�D
Folio # 11-3 jn 6 - 01-4 --oltio
Requests permission to install (describe work):��T
Within the public right of way of (address)
ec PL 33 0
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 authorLzed representative).
Signature
State of Florida
County of Miami Dade 1,, ' �y, b
The fore oing instrument was acknowled are-t��t ' day of Y �r \ , 20 ",I y
Vl� I who is g r onally known to e or who has produced
as identification.
NOTA IC:
;�roMAHARAIK.GON�tLEZ
Sign' MY COMMISSION # GG 044602
EXPIRES: November 2, 2020
Print: Np COUNT ;s `'
Y 'eoF1F 1u, Bonded Thru Notary Public Underwriters
on inal riled in this office on day of 0p
AD20 ul N
WITNESS my hand a icial Seal,.
H RVEnOL
a k c�079
ounty Courts ��- ""i°" o�
13 F
AVIS 943_
1��t A,_ t,- TCA OLIA t, C \��o tt'�� '- � I U) '\
14 /q
(L
Y
STATE OF FLORIDA
MIAMI DADE COUNTY
The foregoing was acknowledged before me this 1(0— day of
cX r�Ea� , 20 1 �i
By �iG�� ,who is personally known to me or who
has produced F - k A=N S - as identification.
Notary Signature: Seal::. SINDIAALVAREZ
'.; MY COMMISSION # GG 238273
." EXPIRES. September 3, 2022
Bon "! ;° ded Tbru Notary Pubk WW"Wrbr;