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PW-10-20-2253Miami Shores Village 10050 NE 2 Ave Miami Shores FL 33138 305-795-2204 Location Address Parcel Number 352 NE 98TH ST, Miami Shores, FL 33138 1132060135690 Contacts RAUL NOBILI Owner VIP CONSTRUCTION GROUP LLC Contractor 35298 RICHARD OSPINA 5890 SW 19 ST, MIAMI, FL 33155 Business: 7865251739 Inspection Requests: Description: WALKWAY PAVING Valuation: $ 400.00 s I 305-7624,949 d TotalSq Feet: 38.00 Fees Amount Education Surcharge $0.20 Public Works Permit Fee $100.00 Scanning Fee $3.00 Technology Fee $2.50 Total: $105.70 Payments Date Paid Amt Paid Total Fees $105.70 Check # 9399 10/15/2020 $105.70 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 AFFIDAVjT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulatirfg construction and zoning. Futhermore, I authorize the above named contractor to do the work stated. z' Authorized igAtuie" Qwner / Applicant / Contractor / Agent Date October 15, 2020 Page 2 of 2 �TVEID �.. Miami Shores Village O C _f 0 52020 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): Raul Nobili Owner off the following described property: Legal Description: Lot Block Folio #; 11-3206-013-5690 Address: 352 NE 98 Street - Miami Shores, FL 33138 UTILITY NAME: Qualifier/Authorized Agent: Address: City: Telephone: State Certification or Registration #: Email: Subdivision State: Permit#: PW-ID-2_0 - 2253 ZIP: Certificate of Competency # CONTRACTOR NAME: VIP Construction Group, LLC - (Richard F. Ospina) Qualifier/Authorized Agent: Address: 6890 SW 19 ST, City: Miami State: FL ZIP: 33155 Telephone:786-525-1739 Email: al1richin@aol.com I IJv!)Si .iCtOLtd, (OVA State Certification or Registration #:L15000000948 Certificate of Competency #:CGC1519571 Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of way: Walk way paving - 38 Sqf. Detals and Measurement enclosed Type of Work: M Paving ❑ Utility ❑ Sidewalk ❑ Electric ❑ Irrigation ❑ Landscape ❑ Antenna ❑ Other: DESIGNER: Architect/Engineer: Address: City: State: Telephone: Email: Registration #: ZIP: Value of Work for this Permit: $400 Square/Lineal Footage of Work: 38 Sqf ***** Fees ***** Permit Fee $ 100.00 Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $ Bond $ (if required) Total Fee Now Due $16 � 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 sgFh posted nAce, the inspection will not be approved and a reinspection will be charged. Signature ppcant or AuthoriziLd Agent The foregor ment was acknowledged before me this -vr day of 20 2- , by .N& Vet tl who is personally known to me or who has produced FL t7t as identification. � ,A qu %Oc��ICI NOTARY PU Signature —struan y Agent The faregoin mstrumt m en as acknowledged before me this 200P day of 0L , 20?A_, by who is personally known to me or who has produced FL,.0 as identification. 8 �� � C�� NOTARY PUBLIC/�/� Sign: t Sign: ,/ t Print: Print: SEAL: �� %� •.. JOSE vun. SEAL: ter': •,,dh NotaryPublic . State of Florida DOSE vi tlL Commission # GG 934755 Notary Public State of Florida My Comm. Expires Nov 25, 2023 I •••..oFv 5r �' Commission x GG 934755 Bonded through National Notary AssnMy Comm. Expires Nov 25. 2023 Bonded through National Notary Assn. ********************************************** APPROVED BY: Public Works Director, or Designee MIAMI SHC-)RES VILLAGE 2017-04-15 P(.�I R I„�.( VVI R`S V;, 1 iv r ld Miami Shores Village Public Works Department (305)795-2210 Public works forms are available from the building department, 10050 NE 2"d Ave., Miami Shores, FL 33138 COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY CFH 202OR0540028 OR Bk 32112 Pas 1139-1141 3 P9s RECORDED 09/23/2020 10:47:12 HARVEY RUVINr CLERK OF COURT' MIAMI-DADE COUNTY► FLORIDA Whereas, (hereby referred to as the owner) Raul Nobili Of the following described property: Legal Description: Lot Block Subdivision Folio #; 11-3206-013-5690 Address: 352 NE 98 Street, Miami Shores FL55138 Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of way: Paved walkway extension. From existing pedestrian paths to existing parking area Tot Sqf 38 See enclosed Detail 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 Miami -Dade County to make repairs or maintain said items within the public right of way including restoration of the 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 herby agree to indemnify and hold Miami Shores Village or Miami -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 14 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 obligation has been cancelled an affidavit filin the Public Records of Miami -Dade County, Florida by the Village Manager of Miami Shores Village (or �t isf fully a4horijeh representative). u Signature State of fifil'G/it�a� t< County of�j� Th regoing instrument was acknowledged before me this _a day of 20 by who is personally known to me or who has produced tification. NOTARY PUBLI Sign: 11 A1.04112!1. = MY COMMISS16N i GG 103 9 Print: %'IA&IV EXPIRES: May 11, 2021 1 SEAL: Documents are recorded at the Clerk of the Courts, MIAMI-DADE COUNTY RECORDER, COURTHOURSE EAST, 22 N.W. First Street, 1st Floor, Miami, FL 33128. 2017-04-11 Notice to Owner - Workers' Com Miami shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 nsation Insurance Exemation Florida Law requires Workers' Compensation insurance coverage under Chapter 440 of the Florida Statutes. Fla. Stat. § 440.05 allows corporate officers in the construction industry to exempt themselves from this requirement for any construction project prior to obtaining a building permit. Pursuant to the Florida Division of Workers' Compensation Employer Facts Brochure: An employer in the construction industry who employs one or more part-time or full-time employees, including the owner, must obtain workers' compensation coverage. Corporate officers or members of a limited liability company (LLC) in the construction industry may elect to be exempt if 1. The officer owns at least 10 percent of the stock of the corporation, or in the case of an LLC, a statement attesting to the minimum 10 percent ownership; 2. The officer is listed as an officer of the corporation in the records of the Florida Department of State, Division of Corporations; and 3. The corporation is registered and listed as active with the Florida Department of State, Division of Corporations. No more than three corporate officers per corporation or limited liability company members are allowed to be exempt. Construction exemptions are valid for a period of two years or until a voluntary revocation is filed or the exemption is revoked by the Division. Your contractor is requesting a permit under this workers' compensation exemption and has acknowledge that he or she will not use day labor, part-time employees or subcontractors for your project. The contractor has provided an affidavit stating that he or she will be the only person allowed to work on your project. In these circumstances, Miami Shores Village does not require verification of workers' compensation insurance coverage from the contractor's company for day labor, part-time employees or subcontractors. BY SIGNINI BELOW�OU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS CONTENTS. I Signature: State of Florida County of Miami -Dade The for 7 oing was ack By q % Notary: SEAL: r before me this day of , 20,a-. who is persona y known to me or has produced as t-ommiss& # GG 103959 EXPIRES: May 11, 2021 xi Thru Notsry Pubiia underwriters VIP CONS—R"' GRC-j' wwwAipConstructionGrou ---P!COM CON-fNACTOR PROPOSAL I.W. 4 MCA I-519571 Date: September 25, 2020 State: Florida County: Dade Before me this day personally appeared Richard Ospina who being duly sworn, Deposes and say: That he will be the only person working on the project located at: 229 NE 98 ST, Miami Shores, Fl 33139,md 352 NE 98 ST-- Sworn to and suscribed before me, this _3p7'day of her 2020 Personally known Or Produced Identification 171_ I — Type of Identification Produced ----------- JOSE VUL Notary Public - State of Florida ion GG 934755 Commission 02 Ay Comm. Expires Nov 25, ]2023 Bonded through National Notary Assn. I I • • •• •• •• • p q�µ o E�!#d?wry Survey � {"%v [>�.*f S.:1I4�':l mil. D�'� I L.�- „F t i^ CACP - 1. PROPERTY ADDRESS: 352 Nf� 98 STREET CND CAE=; T", H F E #- MIAMI SHORES VILLAGE PUBLIC WORKS REVIEW APPROVED DATE l0�-)-,v Proposed ►rtg Area to City Pavement through Grass Area Address: 35.21 NE 98 St Pronosed F ntrance Path - Fxtension Nebo" Pavcd Path :Material: -Chicago Queens Foundation: Gravel {- `sand I )imc nnsions: 44" X i "" 4- lot Area: 38 SQ1. NE98 Street ery F\kiin4, Pawl f'aif Area En (1ri1 iJ Are. t:xisting f'averrient Existing House Entrance Path 352 Nf 98, Strect a. • ••• • • • ass • e • s • • • • s e • • s• • •• •• • s • •• •• J�