1249 NE 91 Terr (2)hereby apply for a certificate to re- occupy the single family residence known as: (address)
a v L1- • 9/ , Miami Shores, Florida.
Legal description:
Lot:
APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY
i . L LA fa. 7 A
,Block: ,PB &PG:
I hereby certify that I understand that the zoning of the property is for single- family residential use
and that it is unlawful for more than one family to reside therein. I also understand that any
Certificate of Re- Occupancy that may be issued by Miami Shores Village, Florida, certifies only
that the referenced property is being used for single- family purposes and that such Certificate does
not constitute any representation, warranty or certification as to the condition of the dwelling or
other structures on such property.
Contact Name:
Inspection: By:
Comments:
Applican f' i t Date: C' - 7 ' 1 7
Print Name: /.4 ( P. 12
* * * * * * * ** # *Els* * * * * * ** 44 4 *4 * * * * * * *** * * * * * Aii * * * *2. * **
For the purposes of conducting the inspection required by Section 902 of the Miami Shores
Development and Zoning Code, contact:
1
�(,( / /1/ Telephone:
Buyer: Seller. /Realtor: Company Name:
Application Fee ($50) Paid: Cash: Check Number. (0 1 I .
Approved: Denied: Date:
CERTIFICATE OF RE- OCCUPANCY
On behalf of Miami Shores Village, Florida, the undersigned certifies that the property described
in the application has been inspected for the purposes of re- occupancy pursuant to Sections 901
and 902 of the Miami Shores Land Development and Zoning Code and that such property may be
re- occupied by the applicant for single - family residential purposes.
MIAMI S O i / AGE, FLORIDA
By:
Date of Certification:
THIS CERTIFICATE VERIFIES THAT THE REFERENCED PROPERTY
HAS BEEN INSPECTED BY MIAMI SHORES VILLAGE AND HAS BEEN
DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF
REGULATIONS OF THE MIAMI SHORES LAND AND DEVELOPMENT
CODE PERTAINING SOLELY TO THE REQUIREMENT THAT EACH
ONE - FAMILY DWELLING IS USED AND INTENDED TO BE USED FOR
A ONE - FAMILY DWELLING PURPOSE ONLY; HOWEVER, THIS
CERTIFICATE DOES NOT CONSTITUTE ANY REPRESENTATION OR
WARRANTY AS TO THE CONDITION OF THE DWELLING OR OTHER
STRUCTURES ON THE PREMISES DESCRIBED HEREIN, OR ANY
ASPECT OF SUCH CONDITION, AND INTERESTED PARTIES ARE
ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION
OF THE PREMISES IN ORDER TO DETERMINE THE CONDITION
THEREOF.
For Inspector:
Approve
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Building Inspection Request
Date Time
Type Insp'n
Permit No.
Name
Address
A Air 7/7L12 _
Company
Phone #
8
O Name & Date
`"
Address
Company
Phone #
Correction
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT -
305-795-2204
Building Inspection Request
Date Time
- .
"e
- I
Type Insp'n
Permit No.
Name
For Inspector:/
Approve' •
Re-Insp'n Fee
1 •
Name & Date