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33 NE 93 St (5)To Whom It May Concern: I, David F. Kaiser here state that I will be responsible for any injury that could happen during the construction of my Florida room addition at 33 NE 93 St. I will in no way hold the Village of Miami Shores responsible and I also state that this note is necessary because of my inability to obtain Workmens' Compensation Insurance. The above statement was subscribed and sworn to before me this lath day of March, 1973. MY NOTARY PUBLIC, STATE of FLORIDA at LARGE COMMISSION NDED THROUGH FRED W. DI HORST March 13, 1973 / Lot Owner I s Zone Req.Cu.Ft. Plat Restriction Checked by To Planning Board ' 1= Approved Rejected Re- Submitted to P.B. Approved Rejected Plans & Spec. Checked by _ ( / ( , New Construction Ten 0 e K. } General Block ,Name Lic.No. Contractor Lic.No. Add. or Phone ^ervice O.K. to Power Co. To Council Approved _ Rejected Bldg. Permit No. ° "` Date / Fee ` Cost ; u Type Stories Subdivision No* Strew; Alterations Eleccrical Inspection e Da y /4 Fixtures Final Roof Repairs Cu.Cont. By Plumbing Permit No. Septic Tank Sewer Mis c +1 New Const. 'Electrical Permit No. 9. ✓ Date )/:/ Fee Fixtures 11 11 Heater ►+ ++ Motors 11 11 Mi s c + l New Construction Alteration Repairs Date r+ n 11 Fee n 11 11 Alteration Repairs Add. or Phone Cert.Occup.Issued 7 Building Inspection Date By Re-insp By Re-Insp By Foundation Beams & Lintels / /,.,. Final Final Clean -Up Plumbing Inspection Pap:/ Roughing 13 2— Re -insp By Re-Insp By g g � , Fixtures Sewer Septic Tank Solar Heater Final Certificate Re -insp By Ro -Insp By APPLICAT]ON FOR CERTIFICATE OF RE- OCCUPANCY H I X v h S v L t // 4 / I / , hereby apply •for a certificate to re- occupy the single family residence known as : (address) 2 2 /1//:" 1 NEa ni Shores, Florida. Legal Description: Lot: Block PB & PG: I hereby certify that I understand that the zoning of the property is for single- fanufy 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 VlIage, certifies only that the referenced property is being used for single - family purposes and that such Certificate does not constitute any representation, warranty or certiucation as to the condition of the dwelling or other structures on such property. Applicant / l 1. Print Name � / /-P h / / /1/' * 2 3 ** ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * For purposes of conducting the inspection required by Section 902 of the Mlarni Shores Land Development and Zoning Code, please contact: Contact Name:4/ :-J gee ,, / F e� Telephon4 3�s� � Y� J J Buyer Seller Application Fee ($S0) paid: Cash _ Check No. 1 0 l Realtor Company Name .` e_ A • • PAGE I OF 2 Date / "�(7 u Denied Date — 2 2 - 0 i CER 1 it ICATE 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. ' THIS CER i Lk ICATE 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 INTERES 1EL) PERSONS ARE ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE PREMISES IN ORDER TO Dh thR iNE THE CONDITION, THEREOF. PAGE OF • MTAM[ SHORES VILLAG FLORIDA - By: Date of Certification: /—