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PW-07-22-1700, 166 NW 98th StMiami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 166 NW 98TH ST, Miami Shores, FL 33150 1131010260040 Contacts Julio Abarca Owner Julio Abarca Applicant 166 NW 98TH ST, Miami Shores, FL 33150 166 NW 98 Street, Miami shores, FL 33150 Other: 3057332893 julioa@nipromed.com BRICK PAVER GROUP INC Contractor JOSE FERNANDEZ 350 W. PARK DRIVE, #101, DORAL, FL 33172 Mobile:3055846570 NATHALIE@BRICKPAVERGRP.COM __..-.-................ ....._...-....._............ Description: INSTALLATION OF PAVERS to replace _._-..................__.......... Valuation: _.................... $ 852.25 nspeconR PW-7-18-1824 1305-762-4949quests: Total Sq Feet: 532.00 Fees Amount Payments Date Paid Amt Paid 50% Renewal Fee $50.00 Total Fees $50.00 Total: $50.00 Credit Card 07/15/2022 $50.00 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 Signatur6: Owner / Applicant / Contractor / Agent `Date July 15, 2022 Page 2 of 2 XTV T '10,11 a E D JUL 0 6 NR .. Miami Shores Village Public Works Department (305)795-2210' 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 Name of Applicant (if utility see below): \xJlib %(,.e, Owner off the following described property: Legal Descri ion: Lot Block Subdivision Folio#; It /v1C 'CcD 4 0 Address: ILA N 96 1 UTILITY NAME: Qualifier/Authorized Agent: Address: Citv: Telephone: State Certification or Registration #: CONTRACTOR NAME: LAMN 14 Qualifier/Authorized e .t: Address: City: Ntaml Telephone: �jE SJ4-l. % State Certification or Registration #: State: Email: Permit#: T Ali~ ol-27- "11 Ux1 ZIP: Certificate of Competency # Email: Certificate of Competency #: Eogwils, Requests,permission to install (describe work, attach separate page if necessary) in the adjoining right of way: Cyff )'4n4eu:(ZA 1;� PV-1-t9-1%ZLt Type of Work: 2� Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation ❑ Landscape ❑ Antenna ❑ Other: DESIGNER: Architect/Engineer: Address: City: Telephone: Registration #: State: Email: ZIP: Value of Work for this Permit: $ � o J15 Square/Lineal Footage of Work: Permit Fee $ 100.00 Notary $ Bond $ *****Fees***** _Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $ (if required) Total Fee Now Due $� • C�' 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 an4a rei+pection will be charged. Signature Ap lica t or Authorized Agent The foregoLng instru t was acknowledged before me this _ _ day of t.Jl. 20 CT�, by 73�A%,o Ab0.rf`C Q� who is personally known to me or who has produced as identification. NOTARY PU Sign: g� Print: , S WENDY SOTO 4�v P" '� az ;Notary Public -State of Florida Commission # HH 211893 My Commission Expires Janu&Ly 12, 2026 APPROVED BY: ility Agent acknowledged before -A : by is personally known to me or who has produced identification. NOTARY PUB Sign: Print: SEAL: as WENDY SOTO Notary Public -State of Florida # HH 211893 „�A`Commission My Commission Expires 1 January 12, 2026 - Public Works Director, or Designee 2017-04-15 ORf Miami Shores Village `5t!S �h 10050 N.E. 2nd Avenue NW Miami Shores, FL 33138-0000 L'FCORLDAy Phone: (305)795-2204 Project Address 166 NW 98 Street Miami Shores, FL Parcel Number 1131010260040 Block: Lot: Applicant JULIO ABARCA I Owner Information Address Phone Cell JULIO ABARCA 166 NW 98 Street (305)733-2893 MIAMI SHORES FL 33150-1739 Contractor(s) Phone Cell Phone BRICK PAVERS GROUP (305)591-8700 Fees Due Amount CCF $0.00 DBPR Fee $0.00 DCA Fee $0.00 Education Surcharge $0.20 Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $0M Total: $104.00 Valuation: 852.25 Total Sq Feet: 532 Pay Date Pay Type Amt Paid Amt Due Invoice # PW-7-18-68141 07/17/2018 Credit Card $ 54.00 $ 50.00 07/03/2018 Credit Card $ 50.00 $ 0.00 Available Inspections: inspection Type: Excavation Review Public Works Final Public \Alorks -- --- a0i49 In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in comp) ince with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the prol =r authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my ^ger", server' e r_^�, !c;== I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAi., WINDOWS, DOORS, ROOFING and SWIMMING POOL wor <. OWNERS AFFIDAVIT: I certify that `all the foregoing information is accurate and that all work wil; be done in com )liance with all applicable laws regulating construction a ni Ig> uthermorH,\I authorize the above-na�r actor to do the work stated. Ik Ju 117,2018 Au t d?i2io ure wner \ / Applicant / Contractor / Agent Date Building Department Copy July 17, 2018 1 Miami Shores Village J L O Public Works Department (305)795-2210 BY: Public works forms are available from the building department, 10050 NE 2"d Ave., Mia Shores, FL 33138 PUBLIC WORKS PERMIT APPLICATION Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property Permit#: S (U 2-3 Name of Applicant (if utility see below): 7j u V'k c, P �- c 4 Owner off the following described propertv: 1 Legal Description: Lot 4— Block Zt Subdivision Folio #; It ` 3(0 I -o �G - oca Address: iG6, VAJ q%':,:A .,MC-Au£ve-, VL 33/55 UTILITY NAME: Qualifier/Authorized Agent: Address: Citv: State: ZIP: Telephone: Email: State Certification or Registration #: Certificate of Competency # CONTRACTOR NAME: � r kc� �_�% U e t Gc c7 u i Qualifier/AuthorizedA gent: 5o=�cv,dr�d� 2 Address: 3 5) W. ���c V _ `= , # City: , a State: V L ZIP: '� 1 7 a Telephone:,3os' Sq1 - 2700 Email: ,,e; e cif bvi eC c4 C P State Certification or Registration #: CC Ck ii 5 Certificate of Compe ncy #: E06?00 1 1 y Requests permission to istall (describe work, attach separate page if necessary) in the adjoining right of way: 4 (�, S*1 r ��- Type of Work: ® Paving ❑ Utility ❑ Landscape ❑ Antenna DESIGNER: Architect/Engineer: Address: City: Telephone: Registration #: ❑ Sidewalk ❑ Electric ❑ Irrigation ❑ Other: 2r ,+c_ c2k � o +-\ ok vim: S . State: ZIP: Email: Value of Work for this Permit: $ I &.If Permit Fee $ 100.00 Notary $ Bond $ Square/Lineal. Footage of Work:- ***** Fees***** _Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $ (if required) Total Fee Now Due $ 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 4rehrts ction will be charged. Signature A licant or Authorized Agent The foregoing instr Vent was acknowledged before me this 8 day of Fe b r LUL 20 by .J ulr 0 -tb0 C—, who is personally known to me or who has produced as identification. NOTARY PURI 1 . Sign: /� 14 Signature I I I ill . Co pa Utility Agent The foregoing instru ent as acknowledged before me this i- day o � e vu,- c V . 20 1 , by �O vc �1 �svland�z who is p rc�y known to me or who has produced as identification. NOTARY PUB Sign: Print: Print: SEAL: E +u,WENDYSOTO SEAL: State of Florida -Notary Public hld�% WENDY SOTO Commission # GG 172254 :W-0 AState of Florida -Notary Public ��= My Commission Expires Commission # GG 172254 �"`+ January 12, 2022 =�My Commission Expires �'+�l%% January 12, 2022 APPROVED BY: 9 Public Works Director, or Designee 2017-04-15 iwf ,.`1Ait: co- T'l.1GMA, CA't:i4•1 Y OF DAp'c e r Miami Shores Village of Ale g ' Building Department aFXititSf tiiEdt tr r� Gfl —�--_ cff,J oI t, AG�__ , ,� N 10050 N.E.2nd Avenue ;hES�kxrkwe�c 'Miami Shores, Florida 33138 HAmC-Y� �.�+�� � ,ems Tel: (305) 795.2204 I _ Fax: (305) 756.8972 VENANT OF CONSTRUCTION WITHIN RIGHT OF WAY Whereas, (owner) hereinafter referred to as the owner of the following described property (address): Legal Description Bo i, Lot L!- Block —z- Subdivision Folio# Requests permission to install (describe work): Within the public right of way of (address) i o r. it3 W 1-1,�; 1;�L -3 m3 i tso 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 Ma ger of Miami Shores Village (or his fully authorized representative). Signature Qe�Wner or Agent The foregoing instrument was acknowledged before me this _ day of J rt; ► -r �,l, 20 Le , by c who is personally known to moor who has produced as identification and who did take an oath. NOTARY BlrlC`;'� l �, Sign: Print: My Commission Expires: WENDY SOTO M1VP' :State of Florida -Notary Public Commission S GG 172254 My Commission Expires °.`..".� January 12, 2022 DOCUMENT COVER PAGE 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. (Space above this line reserved for recording office use) Document Title: Cov (Mortgage, Deed, Etc.) Return Document To / Prepared By: 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 - inch space at the top right-hand corner on the first page and a 1- inch by 3 - inch space at the top right-hand corner oneach sub sequentpage shall be leftblank andreserved for use by the clerk of court. CLK/CT 155 Rev. 08/16 Clerk's web address: www.miami-dadecierk.com