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PW-20-385Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Issue Date: 02/28/2020 Parcel Number 940 NE 99 ST, Miami Shores, FL, 33138 1132060143380 Contacts Permit NO.: PW-02-20-385 Permit Type: Public Works Work Classification: Public Works Permit Status: Applied Expiration: 08/26/2020 VICTOR MAYORGA Owner VICTOR MAYORGA Applicant 940 NE 99 ST, MIAMI SHORES, FL 33138 940 NE 99 ST, MIAMI SHORES, FL 33138 CAIBAI CONSTRUCTION LLC Contractor 10SE LOSA Business: 7862292770 caibaiconstruction@gmail.com Inspection Requests: Description: DRIVEWAY AS PER APPROVED MASTER PERMIT Valuation: $ 900.00 Inspe tion Re Total 5q Feet: 461.00 Fees Amount Education Surcharge $0.20 Public Works Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $105.70 Building Department Copy Payments Date Paid Amt Paid Total Fees $105.70 Cash 02/28/2020 $105.70 Amount Due: $0.00 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating constructin and zoning. Futhermore, I authorize the above named contractor to do the work stated. re: Owner / Applicant / Contractor / Agent Date February 28, 2020 Page 2 of 2 RECEIVED FE 2 1 2 20 Miami Shores Village BY: Public Works Department (305)795-2210 Public works forms are available from the building department, 10050 NE 2"d Ave., Miami Shores, FL 33138 PUBLIC WORKS PERMIT APPLICATION Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property Permit#. 1;7:>(N - Oz Name of Applicant (if utility see below): VIC'✓T01L MAIYa12G►A- k C LAVplk COUA4 Owner off the following described property: Legal Description: Lot 6 J, Block YO Subdivision wli0ti1A1i �6k4 �ci'iov. 3 Folio #; 11- 320(o -0Ag- Is ro Address: J4J0 Ne 9VW 'S'f"¢ Cr, MMAmt 54(,o(b% VLr 3313$ UTILITY NAME: Qualifier/Authorized Agent: Address: City: Telephone: State Certification or Registration #: Email: State: ZIP: Certificate of Competency # CONTRACTOR NAME: C404i C0N5TP_VCTiDt-J LLC- Qualifier/Authorized Agent: ,10SC A• t o5A, Ye Address: )0 3(c, 5W 9_417c- -t-&t_ ry tState: L ZIP: 3 3 f 6 S Telephone: ... r ,1_ ._ Email: t= C' ii3fia,`L' Nsi%1 c.7r`o�1 r�,ait. , State Certification or Registration #: C05 R"o65 Certificate of Competency #: Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of er%4A,�`.s.-1-t.w-ti.-t Type of Work: ❑ Paving ❑ Utility (R Sidewalk ❑ Electric ❑ Irrigation ❑ Landscape ❑ Antenna ❑ Other:_ DESIGNER: Architect/Engineer: 'P(5iNW'D0 AL-feTO Address: 2•T2__T_ 101- &Vr•i 5tli1� 200 City: LA►i� woft.'r" State: L_ ZIP: 33riEa1 Telephone: 1 (5(ol) 2 rf l�-$$"0g Email: ___ AC©t of l Q TEA 42[Hri'�cruR .VS Registration #: ,4Q qo _ Value of Work for this Permit: $ Square/LineaIl Footage of Work: ***** Fees***** Permit Fee $ 100.00 Notary $ Training/Education $ 0.20 Bond $ (if required) Technology Fee $ 0.80 Scanning $ Total Fee Now Due $ Bonding Company's Name (if applicable): Banding Companyrs Address; City State: ZIP: to' 'IN Application is hereby made to obtain a public works permit to do the work in the right of wary 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 I:n compliance with applicable lags regulating ounstruction and specifically construction In the right -of -wary, 'VAtRNING 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, CON5UIJ WTN YOUR LEW)ER 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 estimatedvalue exceeding $2,5W the applicant must promise In good faith that a copy of the notice of commencement and construction lien law bwhu're 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 jab site for the first Inspection which occurs seven (7) days after the public works permit Is issued. in the absence of sruch pasted notice, the inspection will not be approved and a r+einsptection will be charged. - Stgnatur Signature Applicant or orixed Aunt Convany/Utility Agent The foregoing irtwvrnent was acknowledged before The foctlMng instrument was acknowlieCiged before \me this 2I day^ o ( 20-2,D,, by me this clay, of 20 by who who Is ersonally known to me or who has Ixod'oced is` ally known to me or who has produced " �a tIZ lv� (`1Ecvsas Identification. Identification. Arirrr Print: hti1�I IINVAiC %hWLeS SEAL: StAL: STEPHAW POWAIS SINDIA ALVAREZftW1A*k • � W Fbri�o !T`� : • COMMSOM * FF "7U7 MY COMMISSION # GG 238273 myCplllwl (love S" 26if'I?0 EXPIRES: September 3, 2022 Im�M10Nteor�l�eio�ulMONryAtpu: forFCo.. Bonded Thru Notary Public Underwriters 4�Y+ltrtki•#i*iM+i �'�aearss'e�7 r+rrrs*s, APPROVED BY: — `�- 4=4aLzje , Public Works Director, or Designee -F42�) a1,d �LA412 IIIII IIIII IIIII IIIII IIIII IIIII ill�l IIII IIII Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 CFN 2� i20R010972 5 OR BK 31820 Ps 20?9 (Pss) RECORDED 02/13/2020 15:11:1710 HARVEY RUVIN: CLERK OF COURT MIAMI-DADE COUNTYr FLORIDA STATE OF FLORIDA, COUNTY OF MIANIt=DADS t,o couy7 1 HEREBY CEI2TlFY tdaa this is a true copy of the ��° CLERK origiigal Muted in this ofi�c n day of a AD Zv" Z; rA W14; can Wffic'N Seal. 3� COVENANT OF CONSTRUCTION WITH I N_R1GldLQQW Whereas, (owner) Vic4o/L A • MA y 0 <; A hereinafter referred to as the owner of the following described property (address) `)4o NE 139 V- 5TP46t Pl, 3313 Legal Description: Lot 6k1- Block $J Subdivision hfiaflMi Folio # 11 • 3 ZoG - o 14f - 33Wo Requests permission to install (described work)IF I 7h Within the public right of way of (address) Q40 N E ad' Circus nd Count)yCouft D.C. CIE MERRIIT #310M Pica 3 CKfo&L^t `r✓ 9 WAMi S4ot%4S , FL 33M5 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 Shore 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 places 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 have been cance#ed by an affidavit filed in the Public Records of Dade County, Florida bar the Vil ge Manager f Miami Shores Village (or his fully authorized represpntative). Signature: State of Florida County of Miami Da Thq foregoing instru NOTARY P Sign: Print: My Commig add. IS,zO-ZD Owner ofAg-g—nt V CT02 A • MP yoYZ was acknowledged before me this 11 day of iebfutV( , 2020, by , who is personally known to me or who has produced as identification. to A Gil res: of • 3 • Z022 0 " JAIRO A. GIL ='em Notary Public, State of Florida Commission# GG 254733 M� ly,mn: expires Sept. 3, 2022 SEAL: