320 NE 97 St (4)Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING Permit No.4P y
PERMIT APPLICATION Master Permit No.
FBC 2001
;
----- - ----.
Permit Type (circl • Building; Electrical Plumbing Mechanical Roofing
,„
/
Owner's Name (Fee Simple Titleholder)'' i' 4--- - i -- z.O'r ic - , 4: - /y/14.`; Phone # _ ,,‘ ., ' - , 7
Owner's Address Av ( / /-1
City ,,,),;% ,/,/ / // ' State if Zip ) > , / '' ).*
.2 /7-
Tenant/Lessee Name Phone # ." ,, ,/,',1 7'
Dat
Type Insp'
Permit No.
Name
Address
Compan
Phone #
Inspection Date
Approved
Correction
Re-Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305-795-2204
B ilding Inspection Request
171
Miami-Dade
0 , >-e'
' /
Zip . J
Phone #
Zip
Phone #
Square Footage Of Work:
ENew Repair/Replace LI Demolition
-A F
CCF $ I r 0 co/cc
( Technology Fee $
Zoning Bond $
eview.
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 ELECTRICAL WORK, PLUMBING, SIGNS,
WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and 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 absence of such posted notice, the
inspection vi not be approved a i a reins/ ection fee will be charged.
Owner o A 't Contractor
The The e; o' ng instrument �� : ac �. owledged b re me this � The foregoing instrument was acknowledged before me this
day o !� . 2(o k b , , ��. . day of , 20 by
who isnally known to me or who has produced who is personally known to me or who has produced
as identification and who did take an oath.
NOTARY BLI
Sign:
Print: c—
My Commission Expires:
(Certificate of Competency Holder)
State Certificate or Registration No. Certificate of Competency No.
************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION APPROVED BY:
Chc 12/15/03
As identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Cominission Expires:
,V,(6,k7
****** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
AN 1 6 2flf!'
Plans Examiner
Engineer
Zoning
Date
U Owner's Name
N i Owner's Address /pro / fe/ fly
Job Address (where the work is being done)
City Miami Shores Village County Miami-Dade
Is Building Historically Designated YES NO___›.-
/A� /L __. Phone Jai 70°?-076z__
Contractor's Company Name (if applicable)
***************************************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
All elements on the site must be listed and indicate the color to be painted
Walls
cia
D Cap /drip Edge
So it \
. of i
lower bins J , 1 —
hutters
ings IV l
oors and door jams
arage doors N / A
Railings c k
Fences
Decorative metal
All brick (simulated or regular)
Stucco banding
y other stucco features
Acc sory Buildings
imney
Other
Miami Shores Village
Paint Color Approval and Agreement
' ta.„ 2_ o c k_ Ph ,.;1(-/ J am " / 1/4) ` / / �Z
r
///E:
************************************************************************************************************
OWNER'S AFFIDAVIT: I certify that all � e foregoing information is accurate and that all work will be done in compliance with all
applicab a la s regulating constru on and oning.
APPL"ATION APPROVED BY:
Owner or Agent
P& Z Offtral
P "33I .3P
Zip ,3_7
Date
Date
0,
chc 6/18/03
Miami Shores Village
10050 NE 2nd Avenue
Printed: 1 /20/2004
Applicant: JAMES LEVEROCK
Owner: LEVEROCK JAMES
JOB ADDRESS: 320 NE 97 ST
Contractor
Local Phone:
Parcel # 1132060135860
Signed: (INSPECTOR)
Building Permit
Phone: 305 - 795 -2204 Permit Number: BP2004 -54
Contractor's Address:
Page 1 of 1
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 9 BLK 43 LOT SIZE 50.000 X
Fees: Description Amount
FEE2004 -526 Building Painting Fee $60.00
FEE2004 -527 CCF $1.20
FEE2004 -528 Notary Fee $5.00
FEE2004 -529 Training and Education Fee $0.40
FEE2004 -530 Technology Fee $1.50
Total Fees: $68.10
Total Fees: $68.10
Total Receipts: $68.10
Permit Status: APPROVED Permit Expiration: 7/13/2004 Construction Value: $1,400.00
Work: EXTERIOR PAINTING
;AN 2 0 pm
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY: