The URL can be used to link to this page

PW-19-2740Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Issue Date: 01/14/2020 Parcel Number 1201 NE 103RD ST, Miami Shores, FL 33138 1132050200060 Contacts Permit NO.: PW-1 1 -19-2740 Permit Type: Public Works Work Classification: Public Works Permit Status: Approved Expiration: 07/13/2020 Lorine McGee Owner 1201 103 CHAMPION CONCRETE Contractor JAIME BASILIO 10280 NW 63 TER 105, DORAL, FL 33178 Business: 3052528055 jaimechampion@yahoo.com Other:7864024802 Description: REPLACEMENT OF ASPHALT DRIVEWAY WITH Valuation: $ 2,500.00 Inspection Requests: CONCRETE. 305-762-4949 TotalSq Feet: 600.00 Fees Amount Education Surcharge $0.60 Public Works Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $106.10 Payments Date Paid Amt Paid Total Fees $106.10 Credit Card 01/14/2020 $106.10 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 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 Signature: Owner / Applicant / — -M-i r / Agent Date January 14, 2020 Page 2 of 2 4p _ NS 15 .i31 Miami Shores Village " Public Works Department BY: (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#. S -i 1-I 273 �1 a1 I I I '► 2`1 0 Name of Applicant (if utility see below): L- (JY 1n(! rNr c e-e Owner off the following described property: Legal Description: Lot Block Subdivision Folio #; -- 0';10 - W(o0 Address: I'A 1 NF 10,_�v-A 54- (Ylmmt SVvwC.S UTILITY NAME: Qualifier/Authorized Agent: '— Address: -- City: State: ZIP: -- Telephone: Email: State Certification or Registration #: Certificate of Competency # -- CONTRACTOR NAME: CTt w4i Lpwl`P-i Qualifier/Authorized Agent:-J&&;(- Address: 7YO /V 'rrR,`lL City: State: ZIP: 3 17 Telephone: Z f Email: State Certification or Registration #: Certificate of Competency #: GC 0 543 00 F) Requests permission to install (describe work, att9ch separate page if necessary) in the adjoining right of way: 41041V CJN C ,6 -e— 6 Type of Work: ❑ Paving ❑ Utility ❑ Landscape ❑ Antenna DESIGNER: Architect/Engineer: _ Address: Citv: Telephone: Registration #: ❑ Sidewalk ❑ Electric ❑ Irrigation 211*0'ther: C.Orcr&e InyP State: ZIP: Email: Value of Work for this Permit: $ 4ES� 6 Square/Lineal Footage of Work: ***** Fees***** Permit Fee $ 100.00 Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scannin $ Bond $ (if required) Total Fee Now Due $ _ 11 � , (� If 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 s bject to the attachment. Also, a certified copy of the recorded notice of commencement must be osted at the job site for the first inspection which occurs seven (7) days after the public works permit issued. In the absence of such posted notice, the inspection will not be approved and a_reinspecti will be charged. Signaturx:�e4o— Po a Applicant or Authorized Agent The foregoi instrument was acknowledged before me this'M day of li/OJ-N� 20L by _, -Gotta= le&ee who is personally known t e or who has produced A— / as identification. Sign: Print: _ ..%A��i� 4044 APPROVED BY: JAIME ARMAN00 BASkio -- MY LION / GG 2VM EXPIRES: June 1Z 2022 Bwded n,ru � Pubk W4WW M Signature The fore oing instrument was acknowledged before me this S 'day of IVOV 20 (1 , by a1,ftl`C' who i persopallv.known to me or who has produced �J as 1111111111//// identi c10— n. ��yPODY pR, V, Sig Z Z • Z Nuu287268 iO :% Print: 1 0 i 9 '.j ed tbO ��0.' 47; SEAL: /� A ., /IC Under;'�. pQ'�� GBli� STATE�F,��` Public Works Director, or Designee 2017-04-15 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF W Whereas, (owner) 1_ x\r,o 'P'1C Gree- hereinafter referred to as the owner of the following descril property (address): 13,0 i N v_- O 3 -u sT. V IlCkI -J�L331-3 Legal Description: Lot Block Subdivision ae -4 yac: kP -------- Requests permission to install (describe work)_ Within the public right of way of (address) I'd) O 1 N►= 1 O .�j-d Sfi fy) N a,w. % Y,\o-, C 5 r L \ 3 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 aut -, rized representative). Signature POA Owner or Agent State of Florida County of Miami Dade [ The foregoing instrument was acknow edged before me this � ' day ofVz,4Cl�� , 20 , by Y -- /yC(P who iVpersonally known to me or who has produced as me ilrlca n. NOTARY PUBLIC:7 JAIME ARMANDO BASIUO Sign: - I MY COMMISSION # GG 227M r ., EXPIRES: J 12, Print: ^/ /�J�L' 10As/ "A8._. �