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PW-19-1046Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 issue Date: 07/19/2019 Location Address Parcel Number 1329 NE 105TH ST, Miami Shores, FL 33138 1122320270060 Contacts Permit NO.: PW-05-19-1046 Permit Type: Public Works Work Classification: Public Works Permit Status: Approved Expiration: 01/15/2020 CHARANCE LLC Owner RELIABLE CONSTRUCTION GROUP. Contractor 1070 NE 119 ST CAMILO MEJIA 1101 SW 18 CT, FORT LAUDERDALE , FL 33315 Business: 3052294945 Other:7893264041 Inspection Requests: Description: 80LF OF NEW SIDEWALK AND RESEALING SIDE Valuation: Lj 305-762-4949 AREA OF ASPHALT TotalSq Feet: Fees Education Surcharge Public Works Permit FeeL]Amnt Scanning Fee Technology Fee Total: Building Department Copy Payments Date Paid Amt Paid Total Fees $106.30 Credit Card 07/19/2019 $106.30 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 Suture: Owner / Applicant / Contractor / Agent Date July 19, 2019 Page 2 of 2 V 1 J Miami Shores Village Public Works Department AY 9 019 (305)795-2210 Public works forms are available from the building department, 10050 NE 2"d Ave., Miami Shores, FL 3331138' 7i PUBLIC WORKS PERMIT APPLICATION Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property.., Permit#T-6_g-m' M � 0� Name of Applicant (if utility see below): Owner off the following described property: Legal Description: Lot Block Subdivision Folio #; O ") �NG%" S W_S Address: (3 � � UTILITY NAME: Qualifier/Authorized Agent: Address: Citv: Telephone: Email: State Certification or Registration #: CONTRACTOR NAME: ' Qualifier/Authorized Agent: Address: City: Telephone:- _3 — Email: State Certifi ation or Registration #: Requests permission t install (describe work, way: ► m %4: Type of Work: )( Paving ❑ Utility ❑ Landscape ❑ Antenna State: ZIP: Certificate of Competency # N T State: %-,T— V.-I f ZIP d" 1!'r Certificate rate pa it e( � �1GNw Sidewalk ❑ Electric 11K1. 4k`xS.'.t1'i:/ ❑ Othd:r _'71' r" 1 wi Jtt ..• `f./ DESIGNER: Architect/Engineer: Address: City: State: ZIP: y Telephone: Email: Registration #: N. .fit I Value of Work for this Permit: $ Squa e/Linea Footag Permit Fee $ 100.00 Notary $ Bond $ ***** Fees***** . WL)")\X v • w r- jetency #: k ary) in the adjoining right of �_ aS f5 eL ICT• ❑ Irrigation of Work: � J_� (41n s� • _ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $ (if required) Total Fee Now Due $ f1b . �3 LJ 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%nd 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 ermit is issued. In the absence of such pos d notice, the inspection will not be approved and rei spection will be charged. Signature Si natur Applicant or Authorized Agent Compan /U lity Agent The foregoing instrument was acknowledged before The foregoing instrument a cknowledged l4fore thi��° , day f f� 4 20 r by ' me this•�Q day of 20�1—C�—j" by who 1 '1 who i ersonallyI�nown to me or who has produced is personally known me or w o has produced -DY"U y l I(gnS`-Q as lIC (2 as identif1catiA. identification. N TAR• PUB I ; Heft;•. y NOTARY LIC: 01 Sign: o = g = AIGG 2d121i Print: Y� Yl`'� s �' Print: ,,,;;►� �., MAHARAIK.GONZALEZ myuumml SEAL: �i .�WNcU�. f.\A SEAL: r * EXPIRES Nwember2,2o20 'B • • • • \\� :';,c Thru Notary Public Underwriters ��/b..uc.SIR�.��\\\ ••fori�o, Bonded r , APPROVED BY: I& 1 , Public Works Director, or Designee 2017-04-15 Miami Shores Village Building Department 10050 N.E.2nd Avenue STATE of I Miami Shores, Florida 33138 'Nt:REBYCE original filed Tel: (305) 796.2204 Fax: (305) 756.8972 WITNESSm COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAS( Whereas, (owner) C l-t A A A tv c c LL L hereinafter referred to as the owner of the following described property (address): 13 2� a E a S fl S+ t1 t 1 j S P3RES, 3313 Legal Description: Lot j =A Block Subdivision r� rJc o C-FM 2019RO242450 OR BK 31410 P9 64 (11`9s) RECORDED 04/19/2019 11:22: 1 Y RUVINI CLERK OF COURT NIANI--DARE COUNTYr FLORIDA DRIDA. COUNTY of DADE r1FY that this is a true co- ofthe this o oday o/ f A 2 and a 0 ial Sc el. ��ur tY Ccutts Requests permission to install (describe work): S i N w A L k 1y c1-i J� Within the public right of way of (address) 13 2 q nit✓ I (3 S ST 2Et"r ti t` A m S i4o P,:�-._, 3 313 6' 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 CZ c iqA R H wc-E L L C County of Miami Dade nn The fore oing instrumen was ack o le gee fo me this 1 "1 day of r , 20 �, by (�c� C�W G (hV � � �� 1 9 i 111 '41 �C�own to me or who has produced s identification. ,yP� NOT P BLIC: Po,'.• Bi-,: MAHARAI K. GONZALEZ # g MY COMMISSION # GG 044602 Sig L;;P EXPIRES: November 2, 2020 a ;?• BondedThruNotar y Public Underwriters Pri G SEAL:...-: