PW-19-1331Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date': 07/25/2019
Location Address Parcel Number
1116 NE 92ND ST, Miami Shores, FL 33138 1132050270420
Contacts
Permit NO.: PW-06-19-1331
Permit Type: Public Works
Work Classification: Public Works
Permit Status: Approved
Expiration: 01/21/2020
SYLVAIN FABER Owner DECO CONCRETE INC Contractor
1116 NE 92 ST, MIAMI SHORES, FL 33138 JOSE MONNAR
10773 NW 58 St #161, MIAMI, FL 33178
Business: 3058285158
Other:3053454740
Description: PLAIN CONCRETE CUSTOM PADS APPROACH Valuation: $ 100.00 Inspection Requests:
TotalSq Feet: 0.00
Fees
Amount
Education Surcharge
$0.20
Public Works Permit Fee
$100.00
Scanning Fee
$3.00
Technology Fee
$2.50
Tota I :
$105.70
v
Payments
Date Paid Amt Paid
Total Fees
$105.70
Credit Card
07/25/2019 $105.70
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 per ,' assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for EL RICAL, 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 construclA nd zoning. Futhermore, I authorize the above named contractor to do the work stated.
mi
re: Owner / Applicant / Contractor / Agent
Date
Page 2 of 2
-+.► Miami Shores Village u 1 19
Public Works Department l�Z,
(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- ade Property
Permit#: I — 6 j� 2'7
Name of Applicant (if utility see below):
Owner off the following described property: � '�• ' l
l
Legal Description: Lot,_ t Block_ _Subdivision I�OLA Ade.
Folio #; 3
Address: _ Ll_t_to_ t1_E _ C1 'I C, C1n&A"_ CC 1631 12,91
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City: State: ZIP:
Telephone: Email:
State Certification or Registration #: Certificate of Competency #
CONTRACTOR NAME: _.W
Qualifier/Authorized Agent:
Address: t 1
City: State: ZIP: 0'1
Telephone:( Email: jgtorres@decoconc
State Certification or Registration #: Certificate of Competency #:
Requests permission to i stall (describe work, a ach sparate page if necessa ) in the adjoining right of
way: WV) C-1-C+e W SI-V w s -Pad S A'_ a ro cc CV
Type of Work: ❑ Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
City:
Telephone: _
Registration M
Value of Work for this Permit:
Permit Fee $ 100.00
Notary $
Bond $
State: ZIP:
Email:
Square/Lineal Footage of Work:
***** Fees*****
Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
(if required) Total Fee Now Due $ 1 n L - O
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
Applicant o horized Agent
The foregoing Instrument wa cknowledged before
me this day of 20,�, by
OS ) urym i who
Is personally known to me or who has produced
as
identification.
NOTARY PUBLIC:
Print:
SEAL:
ssf- s pN
M� GC a PSS
APPROVED
2017-04-15
Signature
Company/ itl7i�l' y Agent
The foregoing instrument was acknowledged efore
me this ` 11 day f A.4 20 4 by
who
is pe on���� X' O'V� roduced
����( • as
identification.
NOTARY PUBLIC:
.Q
Sign:61
/ - .
Print: `g /?�.
SEAL:
;: �'yr r� •.,
MARIA M. AGUILAR
Notary Public � State of Florida
a SIC
Commission s GG 24653b
My Comm. Expires Aug 7, 2022
Bonded through National Notary Assn.
Public Works Director, or Designee
CFN: 20190351251 BOOK 31472 PAGE 2901
DATE:06/05/2019 0,3:38:36 PM
HARVEY RUVIN, CLERK OF COURT, MIA-DADE CTY
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 758.8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
Whereas, (owner) ._` Il(�gYAJ i iC._ . hereinafter referred to as the
owner of the folloyAng d Ibed property (address): III Lj N E A a._
Lego} Descr_, Lot Block—.!@ZSubdivision
Fo}lo # K., call OUC90
Requests permission to Install (describe work): y�n�lallabt,�Q�'�(1,1��
Within 1PNOU'blic rjgh � f addre�
12-
IN CONSIDERATION of the approval of this permit by the Village, the owner agrees as follo
1. To maintain and repair, when necessary, the above -mentioned Rem(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 Rem(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 Agent
yiL!'.tinAk�l'
T e foregoingLinstrument was acknowledged before me this 21 day of , 20 idf, by
who Is personally known tome or who has produced U '—
a identification and who did JAe an oath.
NOTARY PUBLIC:
Sign:
Print: oftd&AM. A
My Commission Ex
,—oi ""'.. MARIA AL AGUILAR
`ti Notary public
- State of Florida
ConKnistlon a GG 246530
v or �' My Comm. Expires Aug 7. 2022
Bonded through National Notary Assn,