DS-16-659 .� Miami Shores Village ;
10050 N.E.2nd Avenue NE '
Miami Shores,FL 33138-0000
+meq �a Phone: (305)795-2204 -
F
Expiration: 1012312016
Project Address Parcel Number Applicant
550 NE 102 Street 1132060171041
IRENE HEGEDUS
Miami Shores, FL 33138- Block: Lot:
Owner Information Address Phone Cell
IRENE HEGEDUS 550 NE 102 Street
MIAMI SHORES FL 33138-
550 NE 102 Street
MIAMI SHORES FL 33138-
Contractor(s) Phone Cell Phone Valuation: $ 5,000.00
WE'R'ALL CONSTRUCTION LLC (786)229-0445
__�::...:...:. _ Total Sq Feet: 830
Approved:In Review Available inspections:
Comments: Inspection Type:
Date Approved::in Review Final
Date Denied: Foundation
Type of Work:NEW WALKWAY,DRIVEWAY AND SIDEW Additional Info: Review Planning
Bond Return: Classification:Residential Review Planning
Scanning:3 Review Building
Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Contractors Bond $500.00 Invoice# DS-3-16-58999
CCF $3.00 03/11/2016 Credit Card $50.00 $601.00
DBPR Fee $2.00
DCA Fee $2.00 04/26/2016 Credit Card $601.00 $0.00
Education Surcharge $1.00 Bond#:3062
Notary Fee $5.00
Permit Fee $125.00
Scanning Fee $9.00
Technology Fee $4.00
Total: $651.00
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-nam d ntr r to the work stated.
April 26,2016
Authorized Signature:Owner / Applicant / Contractor If Agent Date
Building Department Copy
April 26,2016 1
Miami Shores Village ;
Building Department M I 1A9 016
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949 -�
FBC 20 ( -4
BUILDING Master Permit NO.:D C C —G 1
PERMIT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
PLUMBING MECHANICAL PUBLIC WORKS ❑ CHANGE OF E]CANCELLATION E:1 SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: w d I D t S �tC S
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: ji —" 01
'" 041 Is the Building Historically Designated:Yes NO_f�
Occupancy Type:W&s Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): I 1 5 Phone#:
Address: ,5.5�� ru E Z 0-).4 61
City: Vy"k1 W^.`-5; State: zip:
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: 1` A Phone#: -7
Address:. 14Z S q
City: !'v�- �� L State: Zip:
Qualifier Name: TZ D DJi✓1 z..?) –k>,c;o K,,L o S Phone#:
State Certification or Registration MCC-5 C. /S/3 (Q' 0' Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/Linear Footage of Work: 030
Type of Work: ❑ Addition ❑ Alteration ❑ New [r Repair/Replace ❑ Demolition
Description of Work: 0 6 Lt_.) LL),A ccs A t-, Lc., eA
P II osis: CC7L-) c2g ` � -
._
Specify color of color thru tile:
Submittal Fee$ '`��' Permit Fee$��� Com",; k_ CO/CC$
Scanning Fee$ ��P CSU Radon Fee$ DBPR$ Q • CO Notary$ G �Jl�
Technology Fee$ T' Training/Education Fee$ 1 ' Double Feeee$ 0
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$ ®( W
(Revised02/24/2014) rr
V� `
Bonding Company's Name(if applicable) '
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work 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 regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC.....
OWNER'S 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.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. 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 building permit with an estimated value exceeding$2500, 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 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 building permit is issued. In the absenceo such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Alfs 1
t Signature Signature
OWNER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrume •was acknowledged before me this
q day of P1 ,20 �� 'by if ay of 20 .by
JLw /AW ,who is personally known to 4 0703 who is personally known to
Ll
me or who has produced as me or who has produced as
identification and who did take an oath. identification and who did take an oath.
f' NOTARY PUBLIC: NOTARY PUBLIC:
Sign: Sign
Print: mom Print: ce,
a
Seal: •,�•., DMLAS A.SEAMMU)DEZ Seal: ��� -,1 Angelica Maim
l`? Notary Public•State ot.ElolI" = iwi
_ COMMISSION#R'92268I
Q My Comm• x ov 4.2016 E)MRES: November 8,2019
s• E tes�l
` Connnission N FF 140441 ��i, ����`� www.AARoNNoTARY.com
APPROVED BY Plans Examiner l "t Zoning
Structural Review Clerk
(Revised02/24/2014)
March 8,2016
WE "B" ALL
CONSTRUCTION, LLC
M78&22SAM
UcenadmilimmW
To:City of Miami Shores
We are constructing sidewalk replacements and new parking pad with entry pad at
SSO NW 102nd St. Everything is to be exposed concrete driveway 6"x 19'x 20'.
Walkway is to be 4"exposed concrete and sidewalk 4"X 5'wide.
Thank you,
Alberto Martin _
We"It"All Construction
CERTIFICATE OF LIABILITY INSURANCE Pt2/17/15
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certlfiaats holder ld an ADDITIONAL INSURED,tha polley(les)must beendomed. N SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the
owlifleate holder in lieu of such endorsement(s).
PRODUCER wEr
Ocdde Ital Insurance 'P.Hm05)221-9859 FAx (305)221-6464
11400 W.FlIgler St$911L-ADDREocddentalinsure@bellsouthmet
Miami,FL 33174 INSURERS)AFFORDING COVERAGE MAIC S
Phone 30 221-9859 Fax 221-6464 INSURERA: GRANADA INSURANCE
INSURED INSURER B. PROGRESSIVE INSURANCE
We R All Construction Llc
13901 SW 18 St INSURER 0:
miarrti,FL 33175 (785)2294445 INSURER E:
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE ADDLSUBR POLICY NI�BER POLICY EXP LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00
®
COMMERCIAL GENERAL LIABILITY
DAMAGE TO Eagoaarerme $ 100,000.00
A ❑ ❑ CLAIMS-MADE ❑ OCCUR 0185FL00066420- MED EXP(Any one person $ 5,000.00
❑ 01!22/2015 01!22/2016 PERSONAL&ADV INJURY $ 1,000,000.00
❑ GENERAL AGGREGATE $ 2,000,000.00
GEWLAGGREGATE UMITAPPLESPER- PRODUCTS-COMP/OPAGG $
❑ POLICY ❑ PRO- ❑ LOC $
AUTOMOBILE LIABILITY coMsclaLED SINGLE LIMIT 1,000,000.00
❑ ANY AUTO BODILY NJURY(Per Penson) $
B ❑ LL OWNED ® SCHEDULED 02375257-1 09f081'2015 09 8/ 016 BODLY MURY(Per ecdderd) $
❑ HWEDAl1T03 ❑ U78gNON-OWNED P .=DAMAGE $
❑ UMBRELLA LIMB ❑OCCUR EACH OCCURRENCE $
❑ EXCESS UAB ❑CLAWSMADE AGGREGATE $
❑ DEC) ❑ RETENTION $
WORKERS COMPENSATION ❑WC STATU OTH
AND EMPLOYERS'UABUM Y t N
ANY PROPRIETORIPARTNERIEXECUTWE E.L.EACH ACCIDENT $
OFFICERdEMBER EXCLUDED? N I A
tf
In desraiNH) ❑ E.L.DISEASE-EA EMPLOYE $
8�RIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES Rdsch ACORD 101,A MIanal Reawks Sohe kft IF more space Is m*6v*
CGC15136N
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Miard Shores Village THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
Buikltlg Department ACCORDANCE WITH THE POLICY PROVISIONS.
10050 NE 2 Ave AUTHORIZED REPRESF.NTATWE
Miami Shores,FL 33138 ',"
01988.2010 ACS CORPORATION. All rights reserved.
ACORD 26 0101"QF The ACORD name and logo are registered nmrks of ACORD
ACCO CERTIFICATE OF LIABILITY INSURANCE °"3/15
/2016
THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If tim—certiticats holder Is an ADDITIONAL INSURED,the po es m subject to
the terms and conditions of the policy,certain policies nmy require an endorsement. A statement on this oertlfioate does not confer rights to the
certificate holder In Ileu of such endorsement(s).
PRODUCE Cathy Lewis
PtINE
Absolute Business Services Inc Me Eft 941-365-8123 ,No: 888.453-0827
5200 Station Way ADDRESS: insuranceGabsoluteinsuranceservice.com
INSURERS)AFFORD=COVERAGE MAIC S
Sarasota FL 34233 IISURERA: Retail First Insurance
INSURED INSURER 8:
We R All Construction,LLC INSURER C:
14442 SW 49th Street INSURER D:
INSURER E:
Miami FL 33175 INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER,
IS 13 To CERTIFY THAT THE POLICIES OF INSURANCE D BELOW 14AVE BEEN ISSUED TO THE IRMED NAMED ABOVE FOR THE POLICYIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY HE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE POLICYNUMBER LNaTB
COMMERCIALGENERALLIABILITY EACH OCCURRENCE $
CLAIMS-MADE F—]OCCUR PREMISES En ooaarenoe $
MED EXP(Any one person) $
PERSONAL&ADV INJURY $
GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
RPOLICY❑MT F�LOC PRODUCTS-COMPIOP AGG $
OTHER: $
AUTOMOBILE LIABILITY �amt $
ANY AUTO BODILY INJURY(Per person) $
ALL OOSWNED SCHEDULEDBODILY INJURY(Per ate) $
AUTOS
HIRED AUTOS NON-OAUTOS
p�aaadent $
$
UMBRELLA LIABOCCUR EACH OCCURRENCE $
EXCESS LIAR HCLAIMS-MADE AGGREGATE $
DED I I RETENTION$ $
WORIUM OOMPENSATION kATUTE ER
AND EIAPLOYMM LIABILITY
ANY PROPRIETOMPARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $ 1.000,000
A OFFICERIMEMSEREXCLUDED? ®NIA Submission#0520 043529 0000 3/6/2016 3/6/2017
(y tory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY wrr $ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 141,ami Remaria;Sohadule,may be attacked N more space Is requheQ
License#COC 1513698
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
Miami Shores Bldg Dept. ACCORDANCE WITH THE POLICY PROVISIONS.
10050 NE 2nd Avenue AUTHORIZED REPRESENTATIVE
Miami Shores FL 33138 �,L— *P--
- 0 1"W-2014
ACORD CORPORATION. All rIghft reserved.
ACORD 25(2014101) The ACORD name and logo are registered marcs of ACORD
4b
C— IT
VW
0000
.0. P
.. ,
0000..
•• •• 0000..
000.0• so ,
0000 ..0.0.
.. .. 0000.
00'00: 0.:00
Hegedus' Residence •"•• '
0000..
0000 0000..
• 0000:.
550 NE 102 street ••••••
Miami Shores, FL 33138 •
(305) 975-0979
Sidewalks Replacement and New Parking Pad
A-0 Site Plan
A-1 Demo Plan
A-2 Proposed Scope of Work
A-3 Details
Revised 3!29!16
it AV
6>56tco
r
UK Air 00 -j
MAR 3 0 2016 SH
0 r
.•. .�'.
1p -- _ 000.0• • �Z
• • • 2its
••• • 0.00.0 •..O
........................ --------------- •• ••.•
000.0• •�
•.••.. •0000•
•
.............................. ....................................... lo •• 0
�rlr1
• ' ..Mf..
s
............
•0-tom
....
T
LLI
r
; o s
... ........... �� e c
... s
'� a
Mi IT : I
ir ------ ---------
APPROVED BY DATE rn N— m 4 ui
ZONING DEFFif
E3L DG DEPT Cs�
r i_,N
(HLA-.=S AND REGULATIONS
•
10'-0" 5-2"� i Demolition NotElrS4:'�•• **so.: ....:.
1. Existing Single F8rj7V,5dsidsnce■ • . •
•
Q, 2. Existing sidewalkttatt?frnovedpdvaiplaced •.00 -00
;,�•
� �g 0) ! 3. Existing Public sidewalkdo be removgd and 0'�;
2 '
...e....;—* replaced,full length otpro4t&line. Plwlsi3lope 1t4 per
g ........................... y 5 ! foot. Match elevatior6of neighbors si lL Slope*•••:•
away from drain field! • 0 0000
• ' • •
4. Existing entry concrete pad to bewa&,&d and
o
replaced
�-5 r.......: ' 5. Existing septic tank and Septic drain field to
remain
bS. Existing palm trees and landscaping to remain
--A --- -------s
� t
b C
Existing E.J ' # ExfsBng EJ Existing EJ
a Existing sprinkler heads. Coordinate removal
Swale and relocation with sprinkler contractor
0
0
34r6- "
N JY
North
Hegedus'Residence
550 NE 102 ST
Street . A-1 Miami Shores,FL 33138
March 1,2018
Revised 3128118
■ Existing built-in planters . Notes: •••••• •••••• ••••••
�1 ; . 1. New front 19Ab'lenerete padt Zt�1G�4 thlok-min.••
(7 ' exposed aggreggjq i•• • ••••••
Existing built-in pl �'•. 2; ' 2. New Conca•te wq kway-8"m thickness,2,5a0�i••i
' Portland cemeAt naevi.Provide�yg*In betften •
19''0" segments •�•• •• 00 00400
' 7 '"'"' .........�....
.............h ? 3. Provide condyil'farf afore Iar�dlospixgtpath iigtgyygi•••
' •• •• •
• �;`.`_8 ••••
4. New 6°cx�nCfet6ygd for ddveway 20'-0"wide x•*••0•
' 19'-0"long. 2100 psi Portland ConcrA-Provide faux
grass betweeff panels • • • •
■ 8 4....;....r i
S. New sidawaik•f-r wide 4"thick-unrekdorged,2500
psi. Slope 114"!Odetn•tik to comthe requ Vince ma
„�'
. ; .. ■ the Public works department of fdtamLS a Village. •
' ••
� ; ! 6. Existing Trees to remain. Protect to•avoid damage
7. Existing palm trees to remain-protect during
2 ; ! construction.
■
........;.....................
� 8. Fadsting septic tank and drain field to remain.
■
Allh -a.?7]
75W,
,
� 5
' 2'-0"wide landscaping $_-
,
,
New Parking Are
(20'x19'
Swale
Faux Grass
,
20'-0"
center pad between the two trees North
29'-5"--
' Hegedus'Residence 12
'-------------------------------------- Street 550 NE 102 ST
AV3 A-2 Miami Shores, FL 33138
March 1,2018
revised 3/29118
•
0000
�•� ••.•' 0000.•
0000.. .• .•
Notes: •
a 1. New front entry concrete pad/2500 psi 4"thick-min. •••••• •' • s ••••
exposed aggregate •••' •• •• •••••
2. New Concrete Sidewalk-8"min.thickness,2,500 psi •••••• •••• • •
Portland cement concrete.Faux Grass between panels ••'••• • '••••
0000' 0000••
4. Provide conduit for future landscapingorthlighting
• •
2'-0"wide land b e: •
$ a? y 5. New concrete pad for driveway 20'-0"wide x 1 T-0" 06-41
4 f3 0; long. 2500 psi Portland Concrete- Provide a 2'-0" • • ....
landscaping buffer between the sidewalk and the 6 • • • •
••• •
0 066•
driveway. landscaping by others. Provide Faux Grass • 6
�
................... .. between panels N Parking Area ••'
3-8 6. New sidewalk 5'-0"wide-4"thick-urreinforced,2500 N
psi. Slope 1/4'. -'
7. Existing Trees to remain. Protect to avoid damage
20'-W A- .......... 8. Existing palm trees to remain-protect during Fac Joirrt "
g ;� 3 construction. p
9. Existing drain field to remain
10. E.J.every20'. 1"thick,control joints every
5'-0"to match city standards
ZP
8'- W-0"
10F�6 2 Parking area - Public
A 3 Right-of-Way
A 3 Residence Sidewalk North
Hegedus'Residence
550 NE 102 ST
Q-3 Miami Shores,FL 33138
March 1,2016
Rev 3129!16
• • • • • 'ssss
sssss s• ss
• • ssss •sssss
sssss � , • •
ssss ss ss
•sssss —
, sssss:
s • •
•sssss •sssss ,
• s
•
• •
•sssss• •ss
ssss •
s , , •
Mission: Rick Scott
To protect,promote&improve the health w` Governor
of all people In Florida through integrated
state,county&community efforts. Celeste Philip,MD,MPH
HInterim State Surgeon General
Vision:To be the Healthiest State In the Nation
April 15, 2016
We R All Construction
13901 SW 18 Street
Miami, FL 33178
RE: Modification to a Single Family Residence -No Bedroom Addition
Application Document Number: AP1233030
Centrax Permit Number: 13-SC-1672452
550 NE 102 Street
Miami, FL 33138
Lot: 6 &7 Block: 9 Subdivision: Miami Shores Sec 4
Dear Applicant,
This will acknowledge receipt of a floor plan and site plan on 04/01/2016 for the use of the existing
onsite sewage treatment and disposal system located on the above referenced property. Proposed
new walkway.
No objection letter was issued by C. Icaza on 04/15/16.
This office has reviewed and verified the floor plan and site plan you submitted, for the proposed
remodeling addition or modification to your single-family home. Based on the information you provided,
the Health Department concludes that the proposed remodeling addition or modification is not adding a
bedroom and that it does not appear to cover any part of the existing system or encroach on the
required setback or unobstructed area. No existing system inspection or evaluation and assessment,
or modification, replacement, or upgrade authorization is required.
Because an inspection or evaluation of the existing septic system was not conducted, the Department
cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use.
You may request a voluntary inspection and assessment of your system from s licensed septic tank
contractor or plumber, or a person certified under section 381.0101, Florida Statutes.
If you have any questions, please call our office at (305) 623-3500.
Sincerely
Carlo I
Engineer III
Department of Health in Dade County
Florida Department of Health www.florldshealth.gov
in Dade County• •,Florida TWITTER:HeaithyFLA
PHONE: (305)623-3500 FACEBOGULDepartmentArlealth
YOUTUBE:fldoh
CFH 2016RO168342
/ OR BK 300136 Pss 2530-2531 (2Pss)
-RECORDED 03/21/2016 12.27=11
1'1 ARV:-% RUVIN9 CLERK OF COURT
MIAMI-DADE COUHTYr FLORIDA
DOCUMENTCOVERPAGE
For those documents not providing the 3 x 3 inch
space on the first page,this cover page must be attached..
It must describe the document in sufficient detail to
prohibit its transference to another document.
E
An additional recording fee for this page must be remitted.
f
--------- ----------------------
(Space above this fuse re=ved for recording office use)
Document Title:
(Mortgage,Beed,Constru . n Lien,Etc.)
Executing Party: HP cied tLS
Legal Description:
(If Applicable). :
As more fully described in above described document.
Return Document To 1 Prepared By:
(Relevant excerpts)
Rule 2.520(d)On all..documents prepared......which are to be recorded in the public records of any
county...a3-inchby 3-inch space at the top right-hand corner on the first page and a1-inch by3-
uarhspaceai thetopright thandcorneroneadtsubsegttentpageshailbeleftblankandresenedfor
use by the clerk of court
p.3.695.26 Requirements for recordingiaotmineiib affecting realpropeM--
(1)No instrument by which the title to real property or any interest therein is conveyed,assigned,
encumbered,or otherwise disposed of shall be recorded by the clerk of the circuit court unless:
(e)A 3 nch by 3-inch space at the top right-hand corner on the first page and a 1-inch Icy Much
space at the top right-hand coater on each subsequent page are reserved for use by the clerk of the
court...
Miami Shores Village
,e Building Departrnent
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) f FeN6 GALOAkE HQcED o S hereinafter referred to as the
owner of the foilowin described property(address):
Legal Description 'Oapmd /Z.Lot Block 9T Subdivision 6
Folio# �,Za`
Requests permission to install (describe work): �_
Within the public right of way of(address) J�Pcvv 96 tot ST• M14A P-�S,Fl 33438
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) instal 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 Manager of Miami Shores Village(or his fully authorized representative),
Signature &14(( ._� ,
—7 Owner or Agent X21 ` �' No's
.The foregoing in trument was acknowledged before me this(_day of _, 20 1L_, by
vs who is personally known to me or who has produced Li.
as Identific
.02 n and who did take an oath.
NOTARY PUBLIC:
Sign: - A��' a.
Print:
My Commission Expires:
�' #FF
•: EVftES:March'2M tots
wo. n"Wr �