RE-OCCUPANCYAPPLICATION FOR CERTIFICATE OF RE- OCCUPANCY
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to re- occupy the single family residence known as : (address)
L 3 E 9/ a-¢' , Miami Shores, Florida.
Legal Description:
Lot: Block PB & PG:
I hereby certify that understand that the zoning of the property is single-family residential use
and that it unlawful for more than one family to reside therein. also understand that any
Certificate of Re- Occupancy that may be issued by Miami Shores Village, 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.
Applicant
Print Name �J i4 iU
*********************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
For purposes of conducting the inspection required by Section 902 of the Miami Shores Land
Development and Zoning Code, please contact:
Contact Name: X 1 4- )L= E �� k /i /1)
Buyer Seller Realtor , Company Name
Application Fee ($50) paid:. Cash
Inspected b
Comments:
Check No. 7 Z , 7
pproved D en i ed
PAGE 1 OF 2
, here d_zta44.,cx
pply for a certificate
Date / 2 -./F
.jd S 7 J — 2-6
Telephone:89 3 -92 0 /
Date
L %y
CERTIFICATE OF RE- OCCUPANCY
On behalf of Miami Shores Village, Florida, the undersigned certifies that the property
described in the above application has been inspected for 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 above applicant for single - family residential purposes.
MI
By:
S VILLAGE, FLORIDA
PAGE 2 OF 2
Date of Certification: 12.2 / I0)
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 PERSONS ARE ADVISED AND
ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE
PREMISES IN ORDER TO DETERNIINE. THE CONDITION,
THEREOF.
kz„
BUILDING
ELECTRICAL
PLUMBING
ROOFING
1. ., i
Owner of
Building
Architect
Contractor
or Builder
Legal Lot
Description
Address of
Building
MIAMI SHORES VILLAGE. FLORIDA is
❑ DATE A 195
❑ PERMIT N? 4659 Contractors
License No Z'
❑
❑ Work to be performed under this Permit
Bl
Subdi-
vision
Value of
Project $
Amount of
Permit $
This permit is granted to the contractor or builder named above to construc the building or to install the equipment or device described in the application
herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans,
drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any
time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is
granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations
pertaining to the work covered hereby whether shown on the plans or drawings 9r in the statements or specifications and that he assumes responsibility for work
done by his agents, servants or employees.
Signed. BY
INSPECTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all o ces and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shotes,Village. In ac-
cepting this permit I assume responsibility for all, work done by either, myself, my agent, servant or employee.
cm;-01.1R UI J .
BUILD
UIL BY AUTHORITY e