PW-02-22-294Miami Shores Village
10050 NE 2 Ave
Miami Shores FL 33138
305-795-2204
issue Date: 02/08/2022
Location Address Parcel Number
925 NE 98TH ST, Miami Shores, FL 33138 1132060143430
Permit NO.: PW-02-22-294
Permit Type: Public Works
Work Classification: Public Works
Permit5tatus: Approved
Expiration: 08/08/2022
Contacts
LEONEL PUENTES Owner DIMANY CONTRACTOR & FLOORING Contractor
925 NE 98 ST, MIAMI SHORES, FL 33138 ERNESTO SANCHEZ
LPINTERNATIONAL.PUENTES@GMAIL.0 8765 NW 168 ST, MIAMI LAKES, FL 33018
OM Mobile: 7865142010 dimanyinc@yahoo.com
Description: SIDEWALK Valuation: $ 1,500.00 Inspection Requests:
305-762-4949
Total Sq Feet: 70.00
nI-e a
Fees
Amount
Education Surcharge
$0.40
Public Works Permit Fee
$100.00
Scanning Fee
$9.00
Technology Fee
$2.50
Total:
$111.90
Building Department Copy
Payments Date Paid Amt Paid
Total Fees $111.90
Credit Card 02/08/2022 $111.90
Amount Due: $0.00
In consideration of the issuance to me of this permit, 1 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.
I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
and zoning. Futhermore, I authorize the above named contractor to do the work stated.
02-OV - 2
Owner / Applicant / Contractor / Agent
Date
February 08, 2022 Page 2 of 2
• 21 2622-
Miami Shores Village
" Public Works Department
(305)795-2210
C� Public works forms are available from the building department,100S0 NE 2" Ave., Miami Shores,
PUBLIC WORKS PERMIT APPLICATION
F B 0 3 2022 D
33138
By
Permit Type: Work in the Right -of -Way on Miami Shores Village or Miami -Dade Property
Permit#:rbJu
Name of Applicant (if utility see below): �,� 4i. Q (=. F`✓
Owner off the following described property
Legal Description: Lot {b Block g� Subdivision
Folio#; ll-3tio6— osti- 343�:'
Address: cAZr a& cis S • fA kv F1 33138
UTILITY NAME:
Qualifier/Authorized Agent:
Address:
City:
Telephone:
State Certification or Registration #:
Email:
State:
CONTRACTOR NAME: VI MItew "M t I^"Ivr
Qualifier/Authorized Agent: I vl—+.Lir�
Address: lice Ib8 J�
City: Mn L'4tH State
Telephone: ftJ1 4. Z42 Email: (.Ltiy�
State Certification or Registration #: GEC O �06 S
ZIP:
Certificate of Competency #
t' oa,ry t 7:1`
ZIP:
rtificate of Competency
Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of
way:
Type of Work: ❑ Paving ❑ Utility
❑ Landscape ❑ Antenna
DESIGNER: Architect/Engineer:
Address:
Citv:
Telephone:
Registration #:
Value of Work forthis Permit:
_ State:
Email:
Sidewalk
❑ Other:
❑ Electric ❑ Irrigation
r3®
�n °'f !
$ -7'�a Square/Lineal Footage of Work:
***** Fees *****
Permit Fee $ 100.00
Notary $ Training/Education $ 0.20 Technology Fee $ 0.80 Scanning $
Bond $ (if required) Total Fee Now Due $ It 1� •''t 0
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 rei spe ion will be charged.
ppr ant or Authorized Agent
The fore ng inst rumep Vas acknowledged before
m this day of n j 20 1- by
✓ who
is personal) kn or who has produced
as
identification.
NOTE
Sign:
Print:
SEAL
Signature
om /Utility Agent
The foregoing instrume t was acknowledged before
met day of 20 � by
is personally known to me or who hAs produced
NOTE
Sign:
Print:
SEAL:
as
•._ * ssss�`1O
APPROVED BY: /ll 3�z2 Public Works Director, or Designee
2017-04-15
Miami Shores Village
Public Works Department
(305)795-2210
Public works forms are available
from the building department,
10050 NE 2n' Ave., Miami Shores, F§AR6)F
I HEREBII
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
CFN 2022ROO99362
OR BY. 32998 Ps 844 (iPss)
RECORDED 02/02/2022 13:07:21
HARVEY RUVINr CLERK OF COURT
MIAMI-DADE COUNTY, FLORIDA
k, COUNTY OF MIAMIZAIDE
that this Is a true copy of the
ffc4 Qn day of
and
County Courts
I Ia. wra.�v�v a a y1N I YLL71
Whereas, (hereby referred to as the owner) hCA PJ 9., -'e.5
Of the following described property -
Legal Legal Description: Lot I Block 011 Su`bdi-visionl{•j�/Yt� Z4olio#: ��-3Z0b
Address: 9 7 F a g� J"I +rv. r 14ory F'l_ 33t 58
Requests permission to install (describe work, attach separate page if necessary) in the adjoining right of way:
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 by an affidavit filed in the Public Records of Miami -Dade County, Florida by the Village Manager of Miami Shores
Village (or his fully authorized representative).
Signat
/71�r or Authorized Agent
State of F�o
County of j'%✓n t The foregoing instrument was acknowledged before me this 0 day of Q+4i+ %O g 20 2Z by
who is personally known to me or who has produced
as identification
NOTARY PUBLIC:
Sign:`/
Print: U,•'iA CX9,2; 4, SEAL:
,,_ ottltd 6aaCg:,yB:.d J`u(I�y
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
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Miami shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
41 Fax: (305) 756.8972
Notice to Owner — Workers'
on 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 SIGNING BELOW YOU ACKNOWLEDGE THAT YOU HAVE READ THIS NOTICE AND UNDERSTAND ITS
CONTENTS.
S' r
Owner
State of Florida
County of Miami -Dade
The foregoing was acknowledge before me this day of (" b^ 20Z2
By tQ-0 rt d 1' Vla1n�2S who is personally a or has produced
/ as identification. (;,,.,,�
Notary: t/
I (V� 1208" �
SEAL:
Contractor & Flooring Inc.
C.G.C.1517068
Date: DZ. 03_ 20L1.
Stateof t10Nh
County of
Before me this day personally appeared (06 i es'N C " who, being duly sworn, deposes and says:
That he or she will be the only person working on the project located at:
0ax N L C1$ -4 - ,4,-%; Ct.-*y A 3313 8
Contracto ig t e
Swor}}�� to (or affirmed) and subscribed before me this 0 day of . 20 L2
by
Personally know
OR Produced Identification
Type of Identification Produced
IIj85. �V �W� ZQ�. Print, Type, or Stamp Name of N
8765 NW 168 ST MIAMI LAKES, FLORIDA, 33018
Cell: 786 514 2010
E-mail: dimanyinc@yahoo.com