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695 NE 93 St (4)Rev. 10/02/03) RE- OCCUPANC APPLICATION Contact Name City Miami Shores State Signatur by pro.uced Sign: Print: My Com Building Officials Q . Miami Shores Village Building Department PUBLIC: - ILky - 2i[31 An 2E0 Z Buyer ,���� ; , .. � v Seller _ Realtor O Company Name Property Address (0175- N 3 S D Fl 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 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 the property. OWNER'S AFFIDAVIT: I e ffy that all t ,fo- -_oing information is accurate. Applicant Name /� � � � _it!'.;; . � f� The foregoing instrument was acknowledged before me this • lion ission Expires: pproval: J rwti„�o FL i/I ��r�c Rn d� an Snn� 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 Permit No. Z- -' / 1 �? Loc ID Phone # 10 sThr (I Z oa day of Zip 33/ 3) who is personally known to me or who has as identification and who did take an oath. 200 , Re -Occ. $60.00 i Notary $5.00 CCF $0.60 Total A1160 9 PAID G!6 -4* 1 4q Lo Owner's General Block Name L i c.Ivp. Add. or Phone Contractor Lic.No Add. or Phone Zone Req. Cu.Ft . / C 6 Cu. Cont ._ By Approved V Rejected Plat Restriction Checked by To Planning Board Re- Submitted to P.B. Approved Rejected Plans & Spec. Checked by Council Approved Rejected_ 31dg. Permit No. f',', Date Foe ) .'': '( " Cost C ,'" is Type Stories / Roof New Construction G°`" Alterations Plumbing Permit No. Septic Tank Sewer Mis c ' 1 New Const. !lectrical Permit No. Fixtures Heater Mot ors Misc'l New Construction Building Inspection Foundation Beams & Lintels Final Final Clean -Up Date Plumbing Inspection Date By Re-insp By Re -Insp By Roughing Fixtures Sower Septic Tank ,� e Solar Heater Final Certificate Electrical Inspection Date Rcugning Fixtures Final 11111=111==101111110P INPICEINC=1011C ►► n u n 11 ►1 Alteration Repairs Date Fee 11 - ►1 By By ►1 0 11 Alteration Ter1 o O.K. ©i'v:ice O.K. to Power Co. Jert.Occup.Issued t Subdivision No. Street Date Fee Re-ins p Repairs ►► ►► n Repairs By Re -Insp By .-insp By Re -Insp By BUILDING ELECTRICAL PLUMBING Owner of Building MIAMI SHORES VILLAGE, FLORIDA PERMIT N? 4081 Work to be performed under this Permit DATE 194_ Contractor's License No. Arch:itect Contractor or Builder Legal Lot Bl. Subdi- Description vision Address of Value of Building__ Project This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the appli- cation herefor in strict compliance with all ordinances pertaining thereto and w ith the urn erstanding that the work will be performed in compliance with any plans. drawings, statements or specifications that may have been submitted to a nd approved by the proper municipal authorities. This Permit may be revoked at anv 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 assume s the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plan s or drawings or in the statements or specifications and that he assumes respon- sibility for work done by his agents, servants or employees. Signed. • Amt. of Permit By INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER BY AUTHORITY STATE OF FLORIDA, COUNTY OF DADE. j ca Before me, the undersigned authority, appeared Name and address of licensed contractor MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statement of the plans and :: pecificadons herewith submitted for the building or other structure herein described. This application is made in compliance and conformity 'pith the Building Ordinance of Miami Shores Village, Florida, and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and regula- tions of the Building Division of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plans and specifications must be kept at building during progress of the work. Owner's Name and Address Registerec Architect and /or Engineer__ Distance to next nearest building fi r ' Building Inspector therein by him stated are true. Location and legal description of lot to be built on: *A "t Lott ti. P a i' Block L Subdivision ;/ i Street and Number where work is to be done. r State work to be done and purpose of building (by floors) ' 1 Remarks (Signed) Permit No._ Date Disapproved Date (Signed) New Building ` Remodeling_ ___________ Addition To be constructed of_CL "' a __ Kind of foundation Roof Estira ed Total cost of improvemets $mount of Permit $ _ ' Zone cabage required__ ' Plan Cubage Size of Building Lot Maximum live load to be borne by each floor I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may be cent to The undersigned applicant for this building permit does hereby certify that he un6:erstands and accepts his obligations as an employer of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General Laws of Florida, Permanent Supplement, ant. has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him in the work to be performed under this permit; and will post or cause to be posted for inspection on the site of the work such public notice or totices as are required by the Act. The undersigned agrees to employ only such suhco tractors, on work to be performed under this permit, as are licensed by Miami Shcres Village." • a notary public, duly authorized to admiiister Date- - / /;{– 61 1 9 — -- • 19 No._ L __ Stree / Re ?airs No. of Stories___1__ Covering / oaths and take acknowledgments, personally and who, being by me first duly sworn, upon oath deposes and says that be is the " ° r -- cf the above described construction, that he has carefully read the foregoing application, and that be did sign tne same, and that all facts Read, S wo :n to and Subscribed befq ate. Notary Public, State of Florida My Com:nission Expires - is made necessary by improper notice for __and for no other purpose. to me well known, PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved _Date NOTE: A charge of $1.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection inspection or faulty materials and/or workmanship. • THE PLANS FOR C '" O HAVE BEEN TAKEN TO BE PHOTOSTATICALLY COPIED AT THE REQUEST OF THE OWNER OF SAID PROPERTY & WILL BE RETURNED WITHIN 3 (THREE) DAYS. COMPANY TELEPHONE .5/..1//72 DATE BUILDING ELECTRICAL PLUMBING Owner of Building Architect Contractor or Builder Legal Lot , Description c. Address of MIAMI SHORES VILLAGE, FLORIDA DATE 194 PERMIT N9 2713 Work to be performed under this Permit Bl. i Subdi- vision Contractor's License No. Value of Amt. of Building = fr �: Project Permit This permit is grated to the contractor or builder named above to construct the building or to install the equipment or device described in the application herefitor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, d swings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at afitime 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 shc,wn on the plans or drawings or 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 ordinances and regula- tions pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servant or employee. CONTRACTOR OR BUILDER Bl AUTHORITY