PW-09-20-2167, 9705 NE 2nd Ave (2)Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address
issue Date: 01/22/2021
Parcel Number
9705 NE 2ND AVE, Miami Shores, FL 33138 1132060134230
Contacts
Permit NO.: PW-09-20-2167
Permit Type: Public Works
Work Classification: Public Works
Permit Status: Approved
Expiration: 07/22/2021
Cochran Miami Shores LLC Owner
AWESOME CONSTRUCTION, INC. Contractor
97052
ROBIN DEAN
laura@fitzgeraldgroup.com
3766 NW 124 AVE, CORAL SPRINGS, FL 33065
Business:9543456776 robin@awesomeconstruction.com
Mobile: 5617560742
Description: PARKING LOT ASPHALT MILLING PAVING 3 Valuation: $ :_2LOOOO
,542.00 Inspection Requests:
STRIPING. CONCRETEE CURB AND SIDEWALK REPAIRS AS 1305-762-4949
REQUIRED BY VILLAGE CODE VIOLATION Total Sq Feet:
Fees
Amount
Education Surcharge
$0.80
Public Works Permit Fee
$100.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$112.30
Payments
Date Paid Amt Paid
Total Fees
$112.30
Check # 1952
01/22/2021 $112.30
Amount Due:
$0.00
Applicant Copy
For Inspections, Call (305) 762-4949 or Log on at https://bidg.miamishoresvillage.com/cap/.
Requests must be received by 3pm for following day inspections.
NOTICE: In addition to the requirements of this permit, there may be AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER
additional restrictions applicable to this property that maybe found in the GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICTS,
public records of this county. STATE AGENCIES, OR FEDERAL AGENCIES.
January 22, 2021 Page 1 of 2
Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Issue Date: 01/22/2021
Location Address Parcel Number
9705 NE 2ND AVE, Miami Shores, FL 33138 1132060134230
Contacts
Permit NO.: PW-09-20-2167
Permit Type: Public Works
Work Classification: Public Works
Permit status: Approved
Expiration: 07/22/2021
Cochran Miami Shores LLC Owner AWESOME CONSTRUCTION, INC. Contractor
97052 ROBIN DEAN
laura@fitzgeraldgroup.com 3766 NW 124 AVE, CORAL SPRINGS, FL 33065
Business:9543456776 robin@awesomeconstruction.com
Mobile: 5617560742
Description: PARKING LOT ASPHALT MILLING PAVING 3 Valuation: $ 3,542.00 Inspection Requests:
STRIPING. CONCRETEE CURB AND SIDEWALK REPAIRS AS 305-762-4949
REQUIRED BY VILLAGE CODE VIOLATION Total Sq Feet: 200.00
Fees
Amount
Education Surcharge
$0.80
Public Works Permit Fee
$100.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$112.30
Payments
Date Paid Amt Paid
Total Fees
$112.30
Check # 1952
01/22/2021 $112.30
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.
Authorized Signature: Owner / Applicant / Contractor / AgenrAv�� � Date
1`aa.-A
January 22, 2021 Page 2 of 2
F-1
Miami Shores Village C1 IIZ3
Public Works Department I
(305)795-2210
Public works forms are available from the building department,10050 NE 2"d Ave., Miami Shores, FL 33138
2-D
PUBLIC WORKS PERMIT APPLICATION
Permit Type: Work in the Right -of -Way on Miami Shores Village or Mlaml-Dade Property
++ (�
Permit#:
Z i ��-
Name of Applicant (if utility see below): Pk%,ebow.. C�eg rodAy K I , \
Owner off the following described property: +,'.—
Legal Description: Lot _ Block Subdivision
Folio #;a-3
Address: _� _OJ_G ��
UTILITY NAME:
Qualifier/Authorized Agent:
Address;
City: State: ZIP:
Telephone: Email:
State Certification or Registration M Certificate of Competency b
CONTRACTOR NAME:
Qualifier/Authorized Agent: 0141 (1 L.
Address: 37&& u7
city: S 'n State. ZIP: 3„�C
Telephone: S-6 7 7G Email: je4
State Certification or Registration #.-L&r 1 Certificate of Competency #:
i Requests permission to Install (describe work, attach separate page if necessary) in the adjoining right of
way:
Type of Work: Paving ❑ Utility
❑ ndscape ❑ Antenna
[j Sidewalk ❑ Electric ❑ Irrigation
❑ Other:
DESIGNER: Architect/Engineer.
i Address:
City: State: ZIP:
Telephone: Email:
Registration #:
L
Value of Work for this Permit: $ 35 Z ' Square/Lineal Footage of Work: --200 S r
***** Fees **a**
Permit Fee $100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
Bond $ (if required) Total Fee Now Due $ 2l L _�_-p - _
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 notIcA the Inspection will not be approved and a reinspection will be charged.
Signature 1'9 11 � `- •�
Xpp 'ca t or Authoriz ent
The foregoing Ins ru ej�t was ackr�i dged before
me this A day f 7, J 20 by
aJ!`r iP "q F7 t7=1 -r V who
,Is personally kriow o me or who has produced
as
identlflcation.
NOTARY PUBLIC:-
Sign:
Print:
SEAL:
�,a+"'r" "•,, REGINA L. MASCIARELLI
ed` °`�'•E Notary Public - State of Florida
'• « : •@ Commission N FF 928644
MY
:a• io,:
-�•�rf'f� +RPM-, Bof
Signature
Company/Utility Agent
The foregoing Instrument was acknowledged befnre
me this day of 20____j by
who
Is personally known to me or who has produced
as
Identification.
NOTARY PUBLIC:
Sign:
Print:
SEAL:
Ascn
'Iblb Public Works Director, or Designee
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 relnspection will be charged.
�f Signatur Signature
j N — Company/Utility Agent
The fore Ing Insiru nt was ackn ]edged before The foregoing Instrument was acknowledged before
m hi dayiu? 20L by me this day of 20_ by
L Q �J►A�i who
Is personally known to me or who has produced ersonally known to me or who has produced
MCVF,A� Identification. � r1P�o us oo�o e tlFlcatlon. as
NOT/PUBLIC: RVAN
V9ic'r",II NOTARY PUBLIC,
Sign, Kyly'�' �— -
1
I Print: ` C Print:
SEAL. �d�;..I!k ELIZABETH J ALLENSEAL;
� * Commission*00183309
y o� Expires February 6, 2022
r6O OWWInn BudWNodrrSmAM
APPROVED BY:
2017-04-15
rt�htM#�*rtrtsss4�rt�rtr*�rtTrt#+lrtrt�k*#N�K+F*rt����rts�rpMs
Public Works Director, or Designee