PW-19-1737Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 04/16/2020
Location Address Parcel Number
1310 NE 105TH ST, Miami Shores, FL 33138 1122320810001
Contacts
Permit No.: PW-07-19-1737
Permit Type: Public Works
Work Classification: Public Works
Permit Status: Approved
Expiration: 01/27/2020
SHORES WATERSIDE VILLAS CONDO Owner
SHORES WATERSIDE VILLAS CONDO
1292-1314 NE 105 ST, MIAMI SHORES, FL 33138
Mobile:3059920550 yhernandez@exclusivepmg.com
AMARAN GROUP LLC Contractor
AIDELINE AMARAN
Business:7868605969 amadulcel4@yahoo.com
Description: PARKING ASPHALT OVERLAY Valuation: $2,400.00 Inspection Requests:
Total Scl Feet: 15,000.00
Fees
Amount
Education Surcharge
$0.60
Public Works Permit Fee
$100.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$112.10
Payments
Date Paid Amt Paid
Total Fees
$112.10
Credit Card
04/16/2020 $112.10
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.
covidl 9
Authorized Signature: Owner / Applicant / Contractor / Agent Date
May 13, 2020 Page 2 of 2
'P
Miami Shores Village ✓�i ��
Public Works Department
(305)795-2210
Public works forms are available from the building department, 10050 NE 2nd Ave., Miami Shores, FL 33138 �cr%
�
91 —
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property
Permit#:
Name of Applicant (if utility see below):
Owner off the following described prope
Legal Description: Lot Block
Folio #, // 2232/
Address: I
TILITY NAME'.r"l
Qualifier/Authorized Agent:
Address:
City:
Telephone:
tate Certification or Registration
CONTRACTOR NAME:
Qua lifier/Au_t orize Agent:
Address: G
City:
Telephone:
State Certification or Registration
Subdivision
10
N
Requests ermission ins�tall/�descri e work, attach separate page i esary) in he adjoining right o
way: Xamovkw e`(GC .3 5%
Type of Work: ❑ Paving ❑ Utility Sidewalk Electric ❑ Irrigation
❑ Landscape ❑ Antenna J ❑ Other:
DESIGNER: Architect/Engineer:
Address:
Citv:
Telephone:
Registration #:
Value of Work for this Permit: $ Square/LinealFootage of Work: i4'
***** Fees***** i
ZIP:
State:
Email:
Permit Fee $ 100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
Bond $ (if required) Total Fee Now Due $ 1 12 .10
Bonding Company's Name (if
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 !S"o,"v_-
Applicant oV Authorized Agent
The foregoing instrument Was acknowledged before
me is 23 day oft 2011�J by
who
is personally now to r who has produced
V-V?-���U�/`ti� as
identificatio6.
Sign:
Print:
Ry-V \
Signature
mpany/Utility Agent
The foregoing instrument was acknowledged before
me this ` day of J14A 20� by
1Ji cXd1__A)1 e_ who
is personally known to me or ho has produced
D `ets
idefitification.
NOTARY PUBLIC:
Sign:
Print:
SEAL: V ► SEAL:
Notary Public state at Flofida Notary Public Stetete of
Fionaa
Yariana Pavoni ,1 Grace Pedron Pine
My Commission GG 194M M commission GG 352426
Expires D3111/2022 Hxaros 0710712023
a
APPROVED BY: Public Works Director, or Designee
2017-04-15