PW-19-2318Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
Parcel Number
1225 NE 93 ST, Miami Shores, FL 33138 1132050270030
Contacts
MARK & DARLENE HUTCHINSON Owner MARK & DARLENE HUTCHINSON Applicant
1225 NE 93 ST, MIAMI SHORES, FL 33138 1225 NE 93 ST, MIAMI SHORES, FL 33138
Other:9544459705 Other:9544459705
KMR CONSTRUCTION MANAGEMENT INC Contractor
KEVIN MICHAELRAFFERTY
2042 MADISON ST, HOLLYWOOD, FL 33020
Business: 9543423400 kyle@kmr.construction
Other:7862993840
.._. _ _ _ — _---- ......... __' .
Ins ection Requests:
Description: 1600 SQ DRIVEWAY AND POOL DECK PAVERS 1400 Valuation: $ 10,000.00
SO FT 305-762-4949
Total Scl Feet: 3,000.00
HRS APPROVED IN Al PAGE OF ORIGINAL PLANS
Fees
Education Surcharge
.00Public
Works Permit Fee
.00
Scanning Fee
LAunt
.00
Technology Fee
.50
Total:
.50
Payments
Date Paid Amt Paid
Total Fees
$113.50
Credit Card
10/21/2019 $113.50
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:ELEWCTAL—,PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNE�S FFI IT:hat II h fpregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating ns r� tion uthorize the above named contractor to do the work stated.
Signature:
Contractor / Agent
Date
October 21, 2019 Page 2 of 2
�..,, Miami Shores Village
Public Works Department
(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#:
F►� - 10 -1 c1- 316
Name of Applicant (if utility see below):
Owner off the following described property:
Legal Description: Lot 3 '� Ll Block - Subdivision J j --v c:_
Folio #; //-3:'?®5 - 6 4'7 - 6C_-Y
Address: /a�5 /V c G%�, S"T i (�I �r>, `�i10`PS , 1; 1'3
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City: State: ZIP:
Telephone: Email:
State Certification or Registration #: Certificate of Competency #
CONTRACTOR NAME: k1VUL
Qualifier/Authorized Agent: , l
Address: /V y�?L/ C_ /
City: A u State: 16 A 6.4 IP: 3 02
Telephone: '7_V6 , 0 9-13$1/c�mail: A F-dit 1 V .Sd
State Certification or Registration #: L' G- C, Gu24__,7y7_ertificate of Competency #:
-* j_�V_s
Type of Work:
�cpQ,-v %-,'2tl i i I
Paving ❑ Utility
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
City:
Telephone:
Registration #:
State:
Email:
ZIP:
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 $
1t ti,
Bonding Company's Name (if applicable): 4//A
Bonding Company's Address:
Cite:
State:
MIS
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
pplicant or Authorized Agent
The foregoing instrumen w acknowledged before
e this `� sr da f G 20 1 `1 , by
4t1, �1 v C ; -o" who
is personally known to me or who has produced
k�� — as
identification.
Sign;
Print:
*' �'• ��k
2 : Z OGG 287268
°0ded the,%,0,� • 4�:
�� 'py ublic d N ,
�. STAI���
APPROV?l9�6uu►ut���� ,
f
Signatu4-
�_o;�Of y, utiIity Agent
The foregoing instrument was acknowledged before
me this_day of 51�iat 20 1 `r , by
who
i personally kn n to me or who has produced
as
identification.
SEA
SUE M OBRIEN
•B` Notary Public - State of Florida
_�•
• ^ '' Commission d GG 132903
My Comm. Expires Aug 9, 2021
Bonded through National Notary Assn.
tom, Public Works Director, or Designee
2017-04-15
r
Y
"
Miami Shores Village
r
Building Department
10050 N.E.2nd Avenue
" Iva
LORivp'
Miami Shores, Florida 33135
Tel: (305) 795.2204
Fax: (305) 756.8972
COVENANT OF CO,bI RUCTION WITHIN RIGHT OF W.
Whereas, (owner) 4±L)t(' h r'n4y1 // �
hereinafter referred to as the owner of the following described
property (address): Jaaf /
Legal Description: Lot Block_ Subdivision
-Fo l l o-#_-- -3
Requests permission to install (describe workwLp4
Within the public right of way of (address)
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 Pu cords of Dade County, Florida by the Village Manager of Miami Shores Village
(or s fully aut orized repres ntative).
Signature f7.
LINDAM.NI
Owner orA ent MY COMMISSION#GG018141
g '�= EXPIRES: December 2, 2020
.o_
State of Florida ":FodF°P' Bonded ThruNdary Public Undewiters
County of Miami Dade
The foregoing instrument was acknowledged before me this lU day of �� 20 by
� G,f C-�r) z Ho,, �s t, who is personally known tome or who has produc d
(=L identification.
NOTARY PUBLI J�
Sign
print: _ C M I L 1-I c:,. 1 SEAL: