PW-11-19-2713, 991 NE 93rd StMiami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
Location Address Parcel Number
991 NE 93RD ST, Miami Shores, FL 33138 1132060350050
Contacts
Olga Gonzalez Owner
991 NE 93 ST
I E CONTRACTORS Contractor
ILEANA ESCORIZA
15116 SW 63 TER, MIAMI, FL 33193
Business: 3057885594 iecontractors62@gmail.com
Description: PLAIN CONCRETE DRIVEWAY ( SQUARE PLACE AT Valuation: $ 1,200.00 Inspection Re nests:
BETWEEN EACH) TO BE FILL WITH STONE APPROACH 305-762-4949
Total Sq Feet: 500.00
Fees
Amount
Education Surcharge
$0.40
Public Works Permit Fee
$100.00
Scanning Fee
$3.00
Technology Fee
$2.50
Total:
$105.90
Payments
Date Paid Amt Paid
Total Fees
$105.90
Credit Card
12/19/2019 $105.90
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 re uired for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
O NER AFFID V 1 certify that he foregoing information is accurate and that all work will be done in compliance with all applicable laws
egulati g tru ion and zo/ng. F he ore, I authorize the above named contractor to do the work stated.
Owner / Applicant / Contractor / Agent
December 19,
Page 2 of 2
�s Miami Shores Village Q V 4 2
Public Works Department
(305)795-2210 By;
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 adt�
Permit#: - e���� A 14-1 i 1 ppp�
Name of Applicant (if utility see below):
Owner off the following described property: 01,91 A& ®13 . ww+w► S'ka es FL 3 313 6 .
Legal Description: Lot (O. Block b (O. Subdivision ► 6jeet 4 gauo k to s .
Folio#; t1-3'xo`- 0)T.0050.
Address: 49ai1 AS 113 St. 9haftr k 3313e _
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City:
Telephone:
State Certification or Registration #:
Email:
State:
CONTRACTOR NAME: ;;�-' &""CADrL ;7"x— .
ZIP:
Certificate of Competency #
Qualifier/Authorized Agent: $UAc n'. i:�Scyemc..
Address: VS a le Sty 6 3 T w%
City: s.1:A t; State: F*L- ZIP: 33t4
Telephone:(AOS) 169,55'%4 Email: tee To & - �..�.1��..
State Certification or Registration #: CertificateVbf Competency #:
Requests permissio to install describe work, attach separate page if n cessary) in the adjoining right of
way: atn neo�i �� -is 6� dooe IccIf "et" a -
Type of Work: ❑ Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation
❑ Landscape ❑ Antenna ❑ Other:
DESIGNER: Architect/Engineer:
Address:
City:
Telephone:
Registration #:
State:
Email:
�.
�r
Value of Work for this Permit: $ 10 ®'' Square/Lineal Footage of Work: ;SC)o JtV'r•
***** Fees *****
Permit Fee $ 100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
Bond $ (if required) Total Fee Now Due $ jam( • on
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 certifythat 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. a
"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 approve nd a reinspection will be charged.
Signature Signature &4n L.6«, Y c
A Authorized Agent ompany/Utility Agent
The,foregoing instrument as acknowledged before The foregoing ins u'ment was acknowledged before
me this O'5 day of 20 by me this®` day of 20 2, by
6NN who- _l who
is personally known to me or who has produced is personally known to me or who has produced
as :FL -DOJ ( E?n: C-A a0-3 as
identification. identification.
Sign:
Sign:
Print:
SEAL: SEAL:
p8;;;, SINDIA ALVAREZ
P4Y COMMISSION # GG 238273 SINDIA ALVAREZ
EXPIRES: Se tEmber 3, 2022 ! c MY CCPv1�;11SS10N tf GG 2
Bonded Thru NotaP Public Underwriters Y��y'c.` E;{pIRE 38273
S: September 3, 2022
Bonded Thru Notary Public Underwriters
r
APPROVED BY: V) \, Public Works Director, or Designee
2017-04-15
DOCUNENT COVERPAGE
For those documents not providing the required 3 x 3 inch
space on the first page, this cover page must be attached.
An additional recording fee for this page must be remitted.
DocnmentTitle: �O,\jC_na 4_4
(Mortgage, Deed, Etc.)
Return Document To / Prepared By:
FOR. BK 3161"
C! Pas 4141-4142 (2P-qs)
1114111 --GHI [ :;ilJ;' - F:_:,q NDA.
i
I
I
1
I
I
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I
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(Space above this lime reserved forrecording ofBce use)
-�- we
i ors U���_tri �ich
J
Rule 2-520 (d) On all ... documents prepared ...which are to be recorded in the public records of any county ... a 3 -inch by
3-in ispaceatthetoprighthandcomeronthefirstpageanda1-mrhby3-inchspaceatthetraprighhfhandcomer
an ea stibsequentpageshallbeleftblankandreservedfor use�e clerk of court -
CWCT 155 Rev. 08/16
Cledes web address; www.mlaml-dadeclerlccom
IM
L-AST PAGE
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) Gtd• OOniar�x . hereinafter referred to as the
owner of the following des ed property address): 991 9P- 113 �f„�;a,r,; Shores.
f
Legal Description e a&On1Lot 5CO. Block Subdivision
Folio # t I- 3" - 0,3 - Oo 60.
Requests permission to install (describe work):
Within the public right of way of (address)
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 b an affidavit filed in the Public Records of Dade County, Florida by the
Villa an of Miami Shoor Village (or his fully authorized representative).
Signature
'-----Gw er or Agent
The foregoing instrument as acknowledged before me this Q S day of
)�E G6N who is personally known to me or who has produced;72,(� C.cN SE-s
as ident' is tion and who did take an oath.
NOTARY,PUBLIC:
Sign:
PrinK ' Si
My Commission Ex ires:
*: * IA AVAREZ
G
3R273SIND,'0NY COMMISSION# G 2
+;� o EXPIRES; September 3, 2022
Bonded Thru Notary I'LiNk Underwriters
STATE OF FLORIDA, COUNTY OF I41IANIi-DADr
I HEREBY CERTIFY that this is a true Copy of the
originsl 1-15(1 in this, offiry clay of
AD 20
WITNESS MRhar1t-1'..
�nrtS