PW-19-1816PermitNO.: PW- 8-1!
Miami Shores Village--, Permit Type: Public
10050 NE 2 Ave
Miami Shores FL 33138 Work Classification: Pub is
305-795-2204 1 Permit fttus: A0
Issue Date: 08/14/201W 1 Expiration: 02/03/2020
Location Address Parcel Number
431 NE 100TH ST, Miami Shores, FL 33138 1132060170500
Contacts
ERIN HALLORAN Owner ONE STOP PAVING Contractor
451 NE 91 ST, MIAMI SHORES, FL 33138 CARLOS M ACOSTA
Other: 3522623193 1463 NE 173 ST, N MIAMI BEACH, FL 33162
Business: 7862991354 carlosmarcia@yahoo.com
Description: REMOVE ASPHALT LINSTALL
ING CONCRETE Valuation: $ 4,000.00 Inspection Requests:
FRONT PATH AND PATIO . INSTALDRIVEWAY, 3fl5-762 4949
FRONT PATH, PATIO AND LANDINNCRETE STEP Total Sq Feet: 31.00
TO BACK PATIO.
Fees
Amount
Education Surcharge
$0.80
Public Works Permit Fee
$100.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$106.30
Payments
Date Paid Amt Paid
Total Fees
$106.30
Credit Card
08/14/2019 $106.30
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.
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-4-4 /7 /-7 r,
Authorized Signature: Owner
/ Applicant / Contractor / Agent
August 14, 2019 Page 2 of 2
pECEJVED
Miami Shores Village JA 06 2019
Public Works Department
(305)795-2210BY
Public works forms are available from the building department, 10050 NE 2nd Ave., Miami Shores, FL 138
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property
Permit#: pS yv�'�
(6
Name of Applicant (if utility see below): E1� t V1
Owner off the following described property:
Legal Description: Lot Block Subdivision
Folio #;
Address H 31 NE 100 i awl shcw'es 33 139
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
Citv:
Telephone:
State Certification or Registration #:
Email:
State:
ZIP:
Certificate of Competency #
CONTRACTOR NAME: Ov1 P YfoIP_ _ ec, \_Jti v^ 1 •F, C
Qualifier/Authorized Agent: p r \,0 S 5
Address: 14 0 � 1-13 s
City: "J . State: IP: 3 3 Z
Telephone: (Q '21�1 05-4 Email: o S sr-- G-z C d • "-,
State Certification or Registration #C_C (- L) I,_n I �1 Certificate of Competency #:
Requests permission to install describe work, attach separate page if necessary) in the adjoining right of
way: �`c Pau-¢ , �iiy P�nr �� reAW\J_e ('gyp kcx.l VA+ -DE I, )CAU
Type of Work: ❑ Paving ❑ Utility l] Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other: D '
DESIGNER: Architect/Engineer:
Address:
City:
Telephone. -
Registration #:
Value of Work for this Permit: -$
'State:
Email:
ZIP:
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 $ '�, .49:s
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 goodfaith 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 or Authorized Agent
The foregoing instrument was acknowledged before
me this day of 20, by
who
is personally known to me or who has produced
r\vivCA-& )icv-An _ as
identification.
Signature
Company/Utility Agent '
The foregoing instrument was acknowledged before
me this day of AIJ4JQ2O9� by
((,t.(r C2S , 4 C (.� who
is personally known to me or who has produced
OYi,1P,r1;� f r`r 0-,f'1 S.P as
identification.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign:
Print: "'!pu"BARBARO SOBRINQ Print: I BARBAROSOBRINO
° • ,:' :: MY COMMISSION # GG 296168
SEAL: ,: :, : MY COMMISSION # GG 296168 SEAL:
r �o= EXPIRES: February 3, 2023 I r;F_ o EXPIRES: February 3, 2023
'•,FOF F�2� GF F� ,. Bonded Thru Nota Public Underwriters
Bonded Thru Notary Public Underwriters L- ry
APPROVED BY: , Public Works Director, or Designee
2017-04-15
NOTARY PUB
Sign:
Print:
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 WAY
Whereas, (owner) EC i n I Inrar)
hereinafter referred to as the owner of the following described
property (address): L43 I N IW" S-�-
Legal Description: Lot Block . Subdivision
Folio #
OR BF.. 1546 Fs 564 (1R`3s )
G :,, r.,,
Y r.'t; `TN C L.Er;`K _. C.OUR.T
TATE OF FLORIDA. COUNTY OF MIAMI-DARE
•1EREBY CER iFY that this is a tree co P�'D COUA,ry
iginai f in COPYof the J�� CLERK 0
of i On_��__day of 0
THE Ai3 2G
y and and Officia; Seal.
i"!E `. RiJI•' rj, Cie f Circuit and County Courts:NG A 'ry, Colp Y._'RV6T
,r 7�27
Requests permission to install (describe work): R2aY�o��p c�So�j#y-iah�-n�'-way
Within the public right of Way of (address) 43' j UL l �O�''` . fyvmi S hbrest Pl-
�313R
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 authorized representative).
Signature (4
Owner or Agent
State of Florida
County of Miami Dade
The foregoing instrument was acknowledged
ll� who is
as identifn icatios V:\o�ryo2o
�� this -I day of , 20( by
rune or who has produceff
:off
R A`WS
SEAL:
it �nrnS F