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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