PW-02-20-329 CanceledRECEIVED
Miami Shores Village 12 2020
Public Works Department F
(305)795-2210
Public works forms are available from the building department, 10050 NE 2nd Ave., Miami Shores, FL�i
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property
Permit#: 2-bf
Name of Applicant (if utility see below): C /4,1z- /-yo jp�FMA ►y
Owner off the following described property: q�
Legal Description: Lot Block Subdivision � I PMA 5/!f/��S S � J AtV
Folio #; 06 - 01 , 12' yo
Address: sr'
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City: State: ZIP:
Telephone: Email:
State Certification or Registration #: Certificate of Competency # GC 665
CONTRACTOR NAME: C /(4-V iiE� l U OL`L
Qualifier/Authorized Agent: "L
Address: 102ed A)w 6 yt'e
City: O state: ZIP:
+ _,3 3f7'_
Telephone3Djr 25;? YD Email: Ar
State Certification or Re istr tion #: Certificate of Competency
Requests permission to install (describ work, attach separate page if necessary) in the adjoining right of
way: 7� A-'( 2— b4.V,r*L) �i/ LI✓/�-/�S
Type of Work: ❑ Paving ❑ Utility Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
City:
Telephone: _
Registration #:
Value of Work for this Permit:
State:
Email:
ZIP:
S w7o 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 $ 1 - i
Bonding Company's Name (if applicable):
Bonding Company's Address:
City:
State:
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 #iII be charged.
by
who
is personally known to me or who has produced
as
identification.
NOTARY PUBLIC:
Sign: �
Print: nl�lft`{ �y4SINV
SEAL: JAIMEARMANDOBASIUO
•"g.
e :-f MY COMMISSION Yp6227924
:x; �q• EXPIRES: Juret2,2022
BW-d T n' NotM Putic UMentl M
Signature
Com ny/Utility Agent
The foregoing instrum nt was acknowledged before
_methis_�dayJof� PIWP 20�,by
j�LF �tUU who
is personally known toter who has produced
as
identification.
NOTARY UBLI
Sign:
Print:
SEAL: ✓;+?'^••, SINDIA ALVAREZ
" � MY COMMISSION M GG 23A273
;_'e' EXPIRES: September 3, 2022
APPROVED BY: Public Works Director, or Designee
2017-04-15
Property Search Application - Miami -Dade County Page 1 of 1
@ OFFICE OF THE PROPERTY APPRAISER
Summary Report
Property Information
Folio:
11-3206.013-1840
Property Address:
171 NE 102 ST
Miami Shores, FL 33138-2324
Owner
ROBERTO GUZMAN
CAROL HOFFMAN
Mailing Address
171 NE 102 ST
MIAMI SHORES, FL 33138 USA
PA Primary Zone
1000 SGL FAMILY - 2101-2300 SO
Primary Land Use
0101 RESIDENTIAL - SINGLE
FAMILY: 1 UNIT
Beds I Baths / Half
3 / 2 / 0
Floors
1
Living Units
1
Actual Area
2,307 Sq.Ft
Living Area
1,719 Sq.Ft
Adjusted Area
2,013 Sq.Ft
Lot Size
11,300 Sq.Ft
Year Built
1951
Assessment Information
Year
2019
2018
2017
Land Value
$338.884
$282,093
$282,093
Building Value
$182,136
$184,230
$186,323
XF Value
$12,330
$12,405
$12,480
Market Value
$533,350
$478,728
$480,896
Assessed Value
$487,823
$478,728
$480,896
Benefits Information
Benefit
Type
2019
2018
2017
Save Our Homes
Cap
Assessment
Reduction
$45,527
Homestead
Exemption
$25,000
$25,000
$250000
Second Homestead
Exemption
$25,000
$25,000
$25,000
Note: Not all benefits are applicable to all Taxable Values (i.e. County,
School Board, City, Regional).
Short Legal Description
MIAMI SHORES SEC 1 AMD PB 10-70
LOTS 22 & 23 BLK 13
LOT SIZE 100.000 X 113
OR 155734786 0692 1
Generated On : 2/12/2020
Taxable Value Information
20191 2018 2017
County
Exemption Value
$50.000
$50,000
$50,000
Taxable Value
1 $437,8231
$428,7281
$430,896
School Board
Exemption Value
$25,000
$25,000
$25,000
Taxable Value
1 $462,8231
$453,728
$455,896
City
Exemption Value
1 $50,000
$50,000
$50,000
Taxable Value
1 $437,8231
$428,7281
$430,896
Regional
Exemption Value
1 $50,0001
$50,0001
$50,000
Taxable Value
$437,823
$428,728
$430,896
Sales Information
Previous
OR Book-
Price
Qualification Description
Sale
Page
0511812016
$611,700
30084-3301
Qua[ by exam of deed
04/1512014
$560,000
29134-4686
Qual by exam of deed
07/26/2013
$325,000
28752-1358
Qual by exam of deed
Corrective, tax or QCD; min
04/13/2012
$0
28425-0785
consideration
The Office of the Property Appraiser is continually editing and updating the tax roll. This website may not reflect the most current information on record. The Property Appraiser
and Miami -Dade County assumes no liability, see full disclaimer and User Agreement at http:/Avww.miamidade.govrinfoldisclaimer.asp
Version:
https://www.miamidade.gov/Apps/PA/propertysearch/ 2/12/2020
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 beenin
the Public Recoro of Dade County, Florida by the Village ManacgftzfM ,Village
(or his fylly autho ed r,,��((.,��resentative . a`k"°" as >' k/\_befoma'ni5�
�/h' ) _ day of L . 20 T by, .
Signature
er
State of Florida Comm.AGG924911 =* ' " riee:OCbW2Z2023
EVires: October 22, 2023 nm ,� Bonded In Aemn Wtary
County of Miami DacY�,},!� BOnded
foregoing instrument was acknowleageore me this �_ day of �� ^ 20 2� , by
who is personally known to me or who has prodi4ced
as identific
NOTARY PUBLIC:
i SEAL:
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 02/12/2020
Location Address Parcel Number
171 NE 102ND ST, Miami Shores, FL 33138 1132060131840
Contacts
Permit No.: PW-02-20-329
Permit Type: Public Works
Work classification: Public Works
Permitstatus: Approved
Expiration: 08/ 10/2020
CAROL HOFFMAN Owner CHAMPION CONCRETE Contractor
171 NE 102 ST, MIAMI SHORES, FL 33138 JAIME BASILIO
Home: 3056132325 10280 NW 63 TER 105, DORAL, FL 33178
Business: 3052528055 jaimechampion@yahoo.com
Other: 7864024802
Description: TO REPLACE 2 BROKEN SIDEWALKS Valuation: $ 400.00 Ins ection Requests:
305-762-4949
TotalSq Feet: 50.00
I�OIIIIO�III1�1�
Fees
Amount
Education Surcharge
$0.20
Public Works Permit Fee
$100.00
Sunning Fee
$9.00
Technology Fee
$2.50
Total:
$111.70
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$111.70
Credit Card
02/12/2020 $111.70
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 construction and zoning. Futhernore, I authorize xte above named contractor to do the work stated.
Authorized Signature: Owner / Applicant N, 6ntractor / Agent
Date
February 12, 2020 Page 2 of 2