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PW-19-2814Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Issue Date:12/03/2019 Parcel Number 1077 NE 98TH ST, Miami Shores, FL 33138 1132050180240 Contacts Permit NO.: PW-1 1 -19-2814 Permit Type: Public Works Work Classification: Public Works Permit Status: Approved Expiration: 06/01/2020 ONE POTATO TWO POTATO LLC Owner DECO CONCRETE INC Contractor 107798 JOSE MONNAR Business: 3058285158 10773 NW 58 St #161, MIAMI, FL 33178 Business:3058285158 m.aguilar@decoconcreteinc.com Other:3053454740 Description: BRICK PAVER DRIVEWAY Valuation: $ 1,000.00 Inspection Requests: 305-762-4949 Total Sq Feet: 0.00 Fees Amount Education Surcharge $0.20 Public Works Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $105.70 Payments Date Paid Amt Paid Total Fees $105.70 Credit Card 12/03/2019 $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 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.,Y,at all work will be done in compliance with all applicable laws regulating construction and zoning. Futhermore, I authorize the above named con or to do the work stated. Authorized Signature: Owner / Applicant / December 03, 2019 Agent Date Page 2 of 2 �r Miami Shores Village Public Works Department (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#: — I I^t 1 CIO 1 � 1�)S-- o',r- ICA=!�r1 Name of Applicant (if utility see below): Owner off the following described prope;t—� Legal Description: Lot_ Block �'R Subdivision Folio #; i 32 ' �/� • oa 7p Address I1lE I :�3f/nfie-'s �9 1; /�3t UTILITY NAME: Qualifier/Authorized Agent: Address: City: Telephone: State Certification or Registration #: Email: State: CONTRACTOR NAME: DECO CONCRETE, INC ZIP: Certificate of Competency # Qualifier/Authorized Agent: JOSE MONNAR Address: PO BOX 720067 City: MIAMI State: FLORIDA Zip: 33172 Telephone: 305-828-5158 Email: jgtorres(rDdecoconcreteinc.com _ State Certification or Registration #: CBC057725 Certificate of Competency #: Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of way: Type of Work: ❑ Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation ❑ Landscape ❑ Antenna ❑ Other: DESIGNER: Architect/Engineer: Address: City: Telephone: _ Registration #: Value of Work for this Permit: $ Permit Fee $100.00 Notary $ Bond $ State: Email: ZIP: Square/Lineal Footage of Work: ***** Fees***** Training/Education $ 0.20 Technology Fee $ 0.80 Scanni (if required) Total Fee Now Due $ u _ --d 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 uu ized Agent The foregoing instrumen was ackn wledged before me this � day of 20� by who is personal) wn to me or who has produced as identification. NOTARY PUQ_LS; :titer Pii MARIA M. AGUILAR Notary Public State Florida of Commission # GG 246536 �? of rti My Comm. Expires Aug 7. 2022 Bonded through National Notary Assn. APPROVED BY: 2017-04-15 ** Signature V-struoment mpany/Utility Agent The foregoin was acknowledged before me this ,day of uJv9tt/20 P_t , by ?Alyj a- dTf who Is p onally known to, or who has produced identification. ;,"P P� MARIA M. AGUILAR ;i°��`. Notary Public - State of Florida _�y"o: Commissior = GG 246536 �16F My Comm. Expires Aug 7, 2022 Bonded through National Notary Assn. ******* * * * * * Public Works Director, or Designee CFN: 20190534106 BOOK 31581 PAGE 3033 DATE:08/23/2019 1.0:02:39 AM HARVEY RUVIN, CLERK OF COURT, MIA-DADE CTY Miami Shores VIIIagP Building 13apar6ent 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner )/� JI r •! • D' hereinafter referred to as the owner of the following scribed Property (address): Legal Description o6/ % sHa ko��_ Block Subdivision Folio # // Requests permission to install (describe work): �/1P1GtM . Within the public right of way of 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. q?m 3. The Owner does hereby agree to remove or relocate their facliities'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 In affidavit filed in the Public Records of Dade County, Florida by the Village na er of Miami Shores Village (or his fully authorized representative). A V er or Agent 6 M' J�-- The foregoin instru e t was acknowledged before me this day of , 20�by who is personally known to me or who has produced Identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expi _ AAAfA M. AGUILAR ? : y� Y•? . Notary Publk - state of f lorida . � Commission 0 GG 246536 MYCanm.&PtMAug7,2022 Bonded through' Notary Assn.