525 NE 93 St (4)N° 1142
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
Miami Shores Village, Fla ,
Owner, Agent or Tenant of Building
Lot i Block Subdivision
Street Address
Approved use by occupancy
Remarks.
This Certificate of Occupancy is issued to the above named
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to
the erection, construction, alteration or remodeling of buildings or structures.
BUILDING DIVISION
Date
-11-Ft Job Address
ature of owner and/or Condo President
FEES: PERMIT Ye). O 0 RADON
5
Yo. P.; , MARK A. NSTAG
ylY COMMISS!.,( 0 CC 179749
EXP!R S: .rch 7, 1958
Bender' Thar h. r Public Underwriters
ate
PERMIT APPLICATION FOR MIAMI SHORES VILLAGE
NE VJsrTaxFolio //3 'g ® ,6 — /V0MO0
Legal Desciiption6 tan�,t��u 1s , i` ter , ° 23 1037 ,1�7' A f 7 Historically Designated: Yes No i
as Ac7r Cali (\
Owner/Lessee /Tenant O tJ aJ P PCC / r 1 L/ S �C J' ecJ Master Permit # qq
Owner's Address C i "S ' Phone (51 , -C, k 3 7
Contracting Co. 1L\ He Address
Qualifier SS# Phone
State # Municipal # Competency # Ins. Co.
Architect/Engineer Address
Bonding Company Address
Mortgagor f) & e_ Address
Permit Type (circle one): BUILDING ELECTRICAL PLUMBING MECHANICAL ROOFING PAVING FENCE SIGN
WORK DESCRIPTION �� i�1, o4
a f r o, (r/► f Q� P�10 / / l �n. 1 iii ce
Square Ft. Estimated Cost (value)
S O
WARNING TO OWNER: YOU MUST RECORD A NOTICE OF COMMENCEMENT AND YOUR FAILURE TO DO SO 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.)
Application is hereby made to obtain a permit to do work and installation as indicated above, and on the attached addendum (if applicable). I
certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate
permits are required for ELECTRICAL, PLUMBING, SIGNS, POOLS, ROOFING and MECHANICAL WORK.
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. Furthermore, I authorize the above -named contractor to do the work stated.
Signature of Contractor or Owner- Builder Date
Notary as to Contractor or Owner- Builder Date
My Commission Expires:
C.C.F. , �� NOTARY TOTAL DUE 4 /0 . ,� O
APPROVED:
SC ��.
Zoning Building ' ` ` Electrical
Mechanical Plumbing Engineering
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