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Miami Shore Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
BUILDING
PERMIT APPLICATION
Permit Type: BUILDING
JOB ADDRESS: 1201 NE 97th Street
City: Miami Shores
Folio/Parcel #: 11- 3205 - 009 -0370
Is the Building Historically Designated: Yes
County:
MA's j 6 2014
FBC 20 t,
Permit No.
Master Permit No. ge, k
NO X Flood Zone: N
OWNER: Name (Fee Simple Titleholder): Douglas M. Seaton & W. Tracy A. Seaton phone#: 305 - 6104999
Address: 1201 NE 97th Street
City: Miami Shores
Tenant/Lessee Name:
Email:
State: FL
zip: 33138
Phone#:
CONTRACTOR: Company Name: Mother Creatio
Address: 1535 NW 180 Terrace
City: Miami
, Inc.
State: FL
Qualifier Name: Nathaniel T. Curry, II
State Certification or Registration #: CGC1519372 Certificate of Competency #:
Contact Phone#: Email Address: natecurry@anothercreationhomes.com
DESIGNER: Architect/Engineer: Mark A. Campbell phone#: 305 - 528 -3037
Phone #: 888-591 -8291
zip: 33169
Phone#: 888- 591 -8291
Value of Work for this Permit: $ 30,000.00 Square/Linear Footage of Work: 333
Type of Work: DAddition °Alteration UNew °Repair/Replace
Description of Work: Master Bathroom and Closet Renovation.
°Demolition
Color thru tile:
********* * ****** ** ********************* Fees* ***** ********* **** *** * ******************* **
Submittal Fee $ " L Permit Fee $
Scanning Fee $ Radon Fee $
CCF $ CO /CC $
DBPR $ Bond $
Notary $ Training/Education Fee $ Technology Fee $
Double Fee $ Structural Review $
TOTAL FEE NOW DUE $
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 will not be approved and a reinspection fee will be charged.
Signature
Owner or Agent ter• ntractor
The foregoing instrument was acknowledged before me this foregoing h
g g 'I g going instrumem was acknowledged before me this
day of Apv t , 20 N by Tr.%cy Seca. + 20 j, by '/✓s tnoe 111. &ry
who is personally known to me or who has produced I?
$350 -$o 1— % -4As den ification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print: �i4
-Thor
My Commission Expire ►. aEtH THOMAS
? s 'MY COMMISSION #FF089882
''^a°Q' EXPIRES November 12, 2017
(407) 398.0183
********0000**** ************ ***w �s.r re)44 l *4lI i***************$***BVr�* ******qi, . lM ;' `, "O"'
o me or who has produced
as identification and who did take an oath.
RY PUBLIC:
My Commiss
iii m, ua.ir ■
o,,........`.., 11 "V- V v AS
s Y COMMISSION #FF069882
,ear EXPIRES November 12, 2017
APPROVED BY
Examiner
Structural Review
(Revised 3 /12/2012 )(Revised 07 /10/07)(Revised 06/10/2009)(Revised 3/15/09)
Zoning
Clerk