526 NE 97 St (3)STATE OF FLORIDA,
COUNTY OF DADE. ss.
and who, being
of the above de
therein by him s
me first
ribed co
ated are
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 specification:; herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with 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
regulations 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.
/ J. Date + �J _L__ iL. __7 �___ , 19__a
Owner's Name and Address 412 __' �e__$___,� J. _c_u_S hi_N4A34 o Street
Registered Architect and /or Engineer____l__ ' 4AI /G Ite .5 a Q„IJ ___,S //
Name and address of licensed contractor _ ____R_i__�! s� – _4 _G._L_2'S /VC
Location and egal description of lot to be built on:
Lot4_7 a Block Subdivision s___— 67- S �4 C_
Street and Number where work is to be done 21=: i(,t
State work to be done and purpose of building (by floors) 'S' L_E f LL
New Building `r' Remodeling
To be constructed of C . • li?• Kind of dation
d o
Estimated Total cost of improvements $____Z . O O p
Zone cubage required .7" aflir @!?_
Distance to next nearest building__ 240 )
Maximum live load to be borne by each floor
Addition Repairs No. of Stories_____
a Roof Covering! _E
• Amount of Permit $ ��
I t
_Plan Cubage
_Size of Building Lot .1 0 4 C _
I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may
be sent to - - - - - - . 6 7 ? - _ // Y_ dE -- — 7 ? ST - - - - —
The undersigned applicant for this building permit does hereby certify that he understands 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,
and 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 o • site of the work such public notice
or notices as are required by the Act. The undersigned agrees to employ only such subcontra work to be performed under t is
permit, as are licensed by Miami Shores Village. — 6 .
Remarks (Signed
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
y sworn, upon oath deposes and says that he is the
truction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
e.
Date Read, Sworn to and Subscribed before me.
Permit No
Disakarcateel-- ; __ D '
Bui ding Inspector
PLANNING BOARD ¢ DATE
Chairman
Member M
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 is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
∎.
M mber
ber
Member
4
and for no other purpose.
to me well known,
Notary Public, State of Florida
y Commission Expires
•
c
/
CONTRACTOR
New Construction
Name ra� -eor 4 I � ' r
' Pr
License o.Gc ., 99 DC f0
o ci i i c
Address 339 / v" 69
&R b9 i ,Q ?J,2r
Repair
Telephone .75-7 77 y Fax
l��,(
Qualifier Name D A V 1 11 1 _6c_,
Demolish
PROPERTY OWNER
New Construction
Name
' Pr
Address /�
5_6 !V °
o ci i i c
Home Te ephone
Repair
Business Telephone
Alteration Interior
Fax
Demolish
TYPE OF MANAGEMENT (✓ )
New Construction
Enclosure
Alteration Exterior
Repair
Alteration Interior
Demolish
Relocation of Structure
Shell Only
Foundation Only
Add'l Attachment
Other
Add'I Detachment
Other
Step I.
Master Permit No.
* • aa
Subsidiary Permit No.
PERMIT APPLICATION
INSTRUCTIONS - The following steps must be taken to obtain a permit from the Miami Shores Village:
Complete the attached permit application which must be signed by the property owner and qualifier. Both signatures must be notarized. Please
print or type to allow for a more accurate processing of your application. If roofing work will be done, a roofing application must be submitted
along with this permit application.
Step 2. Submit the completed application with all necessary documents to the Building, Planning and Zoning Department for processing. During the
processing of your application, you may be asked to submit additional information.
APPLICATION
Job Address: 5,q6 N E `'7 S + - m 1 / r ' Yviet
Address Apt. City State Zip
Folio Number 11, 32 6 (a 0 11 1 S 3 C Description of Work R'e f l ACe, 6A-Mthe b7oR
Lot �0 4D f IA) C' Block 9R
Linear Feet
PERMIT TYPE (✓ )
Building
Electrical
Mechanical
Plumbing
LPGX
Roofing
Fence
Other
PERMIT CHANGE (✓ )
Chg. Contractor
Renewal
Revision
Extension
Supplement
Reinspection
ARCHITECT
Address
Name
License No.
Telephone
Fax
Subdivision PB PG Zoning , }�
Current Use of Property f&Itr,Ar Square Feet 1 a B T Units Floors
Proposed Use of Property S W 4 6_ 0<Value of Work // 0 ' S a Bldg Value
Tenant Information Tax Assessed/Appraised Value
Flood Zone Base Floor Elev.
ENGINEER
Name
Address
T
one
Fax
Page 2
IMPORTANT NOTICES
DO NOT BEGIN ANY WORK WITHOUT HAVING RECEIVED YOUR VALIDATED PERMIT AND PERMIT CARD. Applying for a permit does not grant
the right to begin construction. HOURS OF CONSTRUCTION are limited to: Monday through Friday from 7:30 a.m. to 6:00 p.m., and Saturday from 8:00 a.m.
to 5:00 p.m. No inspections will be conducted on weekends or holidays.
2. All construction of demolition areas MUST BE MAINTAINED IN A CLEAN, NEAT AND SANITARY CONDITION free from construction debris.
3. STREETS AND NEIGHBORING PROPERTIES SHALL BE KEPT FREE FROM DIRT AND DEBRIS.
4. SWALES MUST BE PROTECTED FROM BEING DAMAGED BY EQUIPMENT OR VEHICLES, AND MAY NOT BE USED FOR STORAGE. A bond is
required for work in or near the street/sidewalk.
5. CONSTRUCTION TRAILERS ARE PROHIBITED ON SINGLE FAMILY RESIDENTIAL CONSTRUCTION SITES. Other construction may have a trailer
which requires a separate permit.
6. PORTABLE TOILETS for a construction site require a separate permit.
7. DO NOT DISCHARGE WATER INTO THE RIGHT OF WAY OR STORM DRAINS without approval from the Building, Planning and Zoning Department.
8. EQUIPMENT AND MATERIALS SHALL BE STORED at least 10 feet from the edge of pavement.
9. Department of Health and Rehabilitative Services (HRS) approval is required for applications involving septic tanks. Department of Environmental Resources
Management (DERM) and/or Miami -Dade Water and Sewer Department (MDWASD) approval is required for applications involving sewers.
1.
AFFIDAVIT - Please read carefully.
Application is hereby made to obtain a permit to do work and installation as indicated. I, the OWNER of the property, 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, POOL, EXTERIOR DOOR, MECHANICAL, WINDOW, FENCE, DRIVEWAY,
ROOFING and SIGNS and there may be additional permits required from other governmental agencies.
I, the OWNER of the property, have disclosed all information related to any work at the property performed in the prior twelve
months to the Building Official. Further, I am fully aware that if the cumulative cost of work to my home or business under this and
any other permit equals or exceeds fifty percent (50 %) of the fair market value of the structure, the entire structure must meet the
present federal flood criteria for finished floor elevation. I am also fully aware that if the total cost of work to my home or business
under this and any other permit exceeds fifty percent (50 %) of the replacement cost of the structure, then the entire structure must
conform to the current code requirements of the Building Code.
WARNING TO OWNER: Your failure to record a NOTICE OF COMMENCEMENT may result in you paying twice for
improvements to your property. If you are spending more than $2,500 or intend to obtain financi you may wish to consult with
your attorney or lender before recording your Notice of Commencement. The Notice o ' omm- cement must be recorded at:
22 N.W. 1st Street, 1" Floor, (305) 679 -1078. Once recorded, the Notice of Commence = t must bePOSTED AT THE JOB SITE in
accordance with Section 713 -35 of Florida Statutes. Review the brochure at lage Hall Construction Lien Law and
Choosing a Contractor.
E OF FLO ID TY OF MIAMI -D
Signature of 77" actor / Qualifier
nA t 16 L
Print ame Print Name
om to and subscribed before me this 1 cl—clay o
S�gnatu� of Owner
L E—
c
1P PUd OFFICIAL NOTARY SEAL
ANGELA M BECKER
COMMISSION NUMBER
CC786697
� • MY COMMISSION EXPIRES
F OF FLO NOV. 15,2002
ri " o rYotary Pu
SEAL:
Personally known
OR, Produced Identification
Type of Identification Produced:
STATE 0
Sworn to and subscribed before me this ( day of L.P
Imo%
/
. ..., i _ �, II . .1•_-- _ .
m atur e of ` I Lary Public State .f Flo
SEAL:
Personally known
yERMIT APPLICATION
A, COUNTY OF MIAMI -DADE
OFFICIAL NOTARY SEAL
♦PaY PUe ANGELA M BECKER
2 i r o n OOAIMISSION NUMBER
N II' % * CG78 6697
9 , -' � O MY COMMISSION EXPIRES
• ®, Prodil ld
Type of Identification Produced:
ELECTRICAL
TypE
Minimum Fee
QTY.
TYPE,
Dryer
QTY.
'FYPE
Outlet, Appliance
QTY.
TYPE
Service Repair
QTY.
A/C Central 1 -3 Ton
Heating Strips, each
Fan
Outlet, Wall
Service, Temporary
Paint Booth
A/C Central 4 -7 Ton
Fire Pump
Outlet, Switch
Piping, Flammable Liquid
Signs
A/C Central 8 -15 Ton
Fixture - Fluorescent
Process/Pressure Piping
Oven
Space Heater (kw)
A/C Central 16 -20 Ton
- Pressure Vessel
Fixture Light
Parking Lot Lights
Spas/Hot Tubs
A/C Central 20+ Ton
Flood Lights
Plugmold/Strip
Subfeeds, No. of Amps
A/C Window
FPL - Load Central
Posts
Swim Pool, Commercial
Air Conditioners
Garbage Disposal
Range/Range Top
Swim Pool, Residential
Chiller
Generators, etc.
Receptacles
Switchboards
Clear Violations
Heat Recovery
Refrigerator, Comm. (p/PH)
Temp Serv., Construction
Compactor
Low -volt, Burglar
Refrigerator, Domestic
Temp for Test - 30 days
Deep Freezer
Low -volt, Fire
Renew - Temp Service
Water Closet
Demolition
Low -volt, Intercom/Teleph.
Repair Circuits
Water Heater
Dishwasher
Low -volt, Television
Service, Number of Amps
Water Heater New
MECHANICAL
TYPE
Minimum Fee
Q'TY.
TYPE
Condensate Drain
QTY. TYPE
Generator
QTY. TYPE
Refrigeration, Tons
cm'.
A/C Central, Tons
QTY.
Cooling Tower
Heating Strips, each
Vent Hood, Cost
A/C Wall/Win. Tons
Dryer Vents, Number of
Paint Booth
Ventilation, Cost
Air Handler, Tons
Ductwork, Cost of
Piping, Flammable Liquid
Periodic Inspections
Barbecue
Fire Sprinkler System
Process/Pressure Piping
Pump and Abandon
Bath Fan - Vented, #
Fireplaces, Number of
- Pressure Vessel
Gas - Appliance
PLUMBING
TYPE
A/C Condensate
QTY.
TYPE
Drains, Roof
QTY.
TYPE
Miscellaneous Fixture
QTY.
TYPE
Soakage Pit
QTY.
Bath Tub
Drinking Fountain
Miscellaneous Repairs
Solar Water Heater
Bidet
Filter Replace
Pool Piping
Sprinkler Repair
Cap - Fixture
Fountain
Pump and Abandon
Sprinkler System
Cap - Water
Gas - Appliance
Pump, Domestic
Supply, AC Well
Cap - Sewer
Gas - Natural
Pump, Fire Stand
Temporary Toilet
Catch Basin
Gas - Propane
Pump, Re- circulate
Temporary Water Closet
Clothes Washer
Gas Piping
Pump, Replace - Pool
Urinal
Dental Chair
Grease Trap
Pump, Sprinkler
Utility - Sewer
Discharge Well
/Ice Maker
Pump, Sump
Utility - Water
Dishwasher
IIndirect Wastes
Relay Repair
Vacuum Pump
Disposal
IInterceptor
Roof Inlet
Water Closet
Domestic Well
Landry Tray
Septic Connection
Water Heater
IIDrainfield, 4" 'II'ile/Res.
Lavatory
Septic Tank
Water Heater New
Drains, Area
Meter Set (Gas)
Sewer Connection
Water Re -pipe
Drains, Floor
Minimum Fee
Shower
Water Service
Drains, French
Miscellaneous Equipment
Sink
Well, Supply
Page 3
PERMIT APPLICATION
INSTRUCTIONS: Please indicate the type of work being performed and quantity(ies) in the space provided below.
RECEIVED AND REVIEWED P(: :A.._:
Page 4
OFFICE USE ONLY
CI- IECKLIST
❑ OWNER - BUILDER FORM
(Attach)
L I FIRE DEPARTMENT
APPROVAL (Commercial /
multi- family)
❑ CONCURRENCY
(New Construction)
❑ OTHER
(Specify & Attach)
❑ PROOF OF OWNERSHIP
(Attach)
Metropolitan Dade County (C.C.F.) $
Inspector State Educational Fund $
State DCA (Radon) $
Code Enforcement Fine
Zoning Review
❑ HRS / DERM APPROVAL
(Septic / Sewer)
❑ IMPACT FEE
(New Construction)
❑ OTHER
(Specify & Attach)
PERMIT FEES
$3.00 per page (Scanning Fee) $
Miami Shores Village
Bond
$ 0
i
$
ISSUING OFFICIAL
REVIEWED AND PREPARED BY:
SECTION
Zoning
Electrical
Mechanical
Plumbing
Fire
Public Works
Structural
Building Official
BY
DATE
- / > -
(sq.ft. = x/1000
x ¢.60)
(¢.005 /sq.ft.)
(¢.01 /sq.ft.)
PEk1VIT APPLICATION
❑ CONDO ASSOCIATION APPROVAL
(Attach)
❑ BPR APPROVAL (Restaurants)
❑ CONTRACTOR REGISTRATION
(On File)
TOTAL $ 6'C _ A 0
DATE:
CONDITION OF APPROVAL
Revised July 2001
10050 N.E. 2ND AVE., MIAMI SHORES, FL • (305) 795 -2207 • FAX (305) 756 -8972 • http : / /www.miamishoresvillage.com
STATE OF FLORIDA,
COUNTY OF DADE. ss
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 specifications herewith submitted for the build-
ing or other structure herein described. This application is made in compliance and conformity with 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
regulations 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. j
r l
n O r
r Date �!, ' , 19..:.4„...
J v
Owner's Name and Address . ._._ ' a �� -- �..�1i._li.�..,_. s-. _ - . No. .» StreetN__,' L ' ,.
Registered Architect and /or Engineer
Name and address of licensed contractor____ '
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors) i� ,`._ 1 % L'
t - '
and for no other purpose.
New Building Remodeling Addition._ Repairs No.. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ P� � �% Amount of Permit $
Zone cubage required plan Cubage
Distance to next nearest building 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 sent to
The undersigned applicant for this building permit does hereby certify that he understands 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,
and 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 notices as are required by the Act. The undersigned agrees to employ only such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks
(Signed)._ ��
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
to me well known,
and who, being by me first duly sworn, upon oath deposes and says that he is the
of the above described construction, that he has carefully read the foregoing application, and that he did sign the same, and that all facts
therein by him stated are true.
Permit No
Disapproved
(Signed)
7v2
Date `
Date-4
Read, Sworn to and Subscribed before me.
Notary Public, State of Florida
Building jnspector My Commission Expires
PLANNING BOARD DATE
Chairinan 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 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials and /or workmanship.
PAID BY
YEAR
ANNUAL TAX
PERIOD USED
AMOUNT PAID
DATE PAID
RECEIPT
NUMBER
L. J. Cushman
��
ADDRESS 526 N. E. 97th Street
Lot 6,7 & E �5' Lot 8, Block- 99
LEGAL : iami Shores Sec 4 RECORD GARBAGE TAX
CUSIM N, L. J.
526 N. E. 97th Street
x
OWNER'S NAME
JOB LOCATION (ST. OR AVE.)
GENERAL CONTRACTOR
Perry 2. Willits, Inc.
BUILDING PERMIT NO 9
ZONE REQUIREMENTS 23,000
DRAWINGS. SPECIFICATIONS. RESTRICTIONS AND CUBE CHECKED BY: JDH
NEW CONSTRUCTION
REPAIRS
ALTERATION
ADDITION
SUBMITTED TO PLANNING BOARD
RE- SUBMITTED TO PLANNING BOARD
SUBMITTED TO VILLAGE COUNCIL
DATE 8 /9/5 0
APPROVED
CU. FT.
PLAN CUBE
PRESENT ADDRESS
45 N. E. 104th Street
LOT BLOCK
7 & L 8 99
ADDRESS
882 N. E. 79th Street
PERMIT FEE S 31.00
TYPE STORIES ROOF CONSTRUCTION
CBS 2
i9.842 CU. FT.
DESCR IPTION
DESCRIPTION
Miami Shores Sect.
REMARKS
( , A
CERTIFICATE OF OCCUPANCY NO{, .. - ISSUED Y ' BY ,; =! � TO
BUILDING PERMIT AND INSPECTION RECORD - MIAMI SHORES VILLAGE
LICENSE NO.
SUBDIVISION
PHONE NO.
89 -2024
BUILDER•S
PHONE NO.
LICENSE NO.
33
BOND
NO. DATE Trans.
EST. COST $ 27,000.00
DATE
REJECTED REFERRED TO COUNCIL REASONS
8/1/5o
INTERIOR CONSTRUCTION
Tile Oak Floors - Plaster Walls
Liv Rm - Liv Porch - Din Rm - Kit - Br. Ibn - Study - 1 Bed Rm - 1 Bath d=
4 Bed Res - 2 Baths - Open Deck up - 2 car gar w /ldry area - st. rm & sho
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
FOUNDATION
8/17/50
P h
FEE
TEMPORARY SERVICE
8/17/50
$ 1.00
BEAMS & LINTELS
9-150 - , ..,)'
P�
10/9/50
Tv
JDH
SEWER
FRAMING
$
SOLAR HEATER
$
$
GAS
$
$
$
$
FINAL
DATE
BY
R IN ECT b
ut
RE- INSPECT
BY
CLEAN -UP
8/30/50
PG
10 2 50JDH
pp BY
%'�UGHING
CONTRACTOR Futch and Roberts
PHONE
L C
PERMIT NO. 9875 DATE 8/16/
FEE $ 17025
NEW BLDG. Oa 1 ALTERATION
ADDITION
REPAIRS
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
TEMPORARY SERVICE
8/17/50
$ 1.00
S
SEPTIC TANK Pennell
9902
8/22/50
$ 1.00
SEWER
$
$
SOLAR HEATER
$
$
GAS
$
$
$
$
INSPECTIONS
DATE
BY
R IN ECT b
ut
RE- INSPECT
BY
ROUGHING
8/30/50
PG
10 2 50JDH
pp BY
%'�UGHING
GAS
H. W. HEATER CONN
SEWER
RANGE CONN.
SEPTIC TANK -
p
8/23/50
PG
SOLAR HEATER
FIXTURES & FINAL. 3/a/
pM
FIXTURES
CONTRACTOR Jernin Elec.
PHONE
PERMIT NO. 10288 DATE 11.17...50
FEE $ 21,30
NEW BLDG. 1 ALTERATION 1 ADDITION
REPAIRS '
SPECIAL PERMITS
PERMIT NO.
DATE
FEE
Jc I CL
TEMPORARY S ERVC
9882
8/17/50
$ 1.00
H. W. HEATER CONN.
$
RANGE CONN.
$
MOTORS
$
FIXTURES
$
$
INSPECTIONS
DATE
BY
RE- INSPECT
BY
RE- INSPECT
BY
TEMP. SERVICE
8/17/50
PG
%'�UGHING
H. W. HEATER CONN
RANGE CONN.
FIXTURES & FINAL. 3/a/
pM
BUILDING INSPECTIONS
PLUMBING PERMITS & INSPECTION
ELECTRICAL PERMITS & INSPECTIONS
APPROVAL. TO POWEyCO. /OR SERVICE DATE 3 2 3 fl BY A'///
N9 1561
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
Miami Shores Village, Fla ,
Owner, Agent or Tenant of Building
Lot -' -° Block ( 7 Subdivision
_ .
L �� ,
Street Address A r
t
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
MIAMI SHORES VILLAS
PERMIT N° _9838
to be performed under this Perini
Owner of --
Building_
Architect,,.
Contractor
or Builder
Legal
Description
Address of
Building
BUILDING
ELECTRICAL
PLUMBING
Value of
Project
This permit is granted to the contractor o .ut7d!r named atve to construct the building or
herefor in strict compliance with all ordinances pertaining thereto and with the un r ing th
drawings, statements or specifications that may have been submitted to a
time if the work is not done in compliance with such ordinances or if the
granted is the understanding that the contractor or builder named abov
pertaining to the work covered hereby whether shown on the plans or
done by his agents, servants or employees.
Prop
DA /Contractor's
License No
Signed "." BY
. i i4PHCTOR
In consideration of the issuance to me of thispermit I agr- - to perform the work „:covered hereunder in comp
pertain' thereto a in strict conformity with the pi a, drawing statements o cations submitted to the
In acs this p ut I ssume responsibility for all k do fry either, , my 2g u_ slahi er employee.
CONTRACTOR OR BUILDER BY
Amt. of
Permit
the equipment or device described in the a
e work will be performed in compliance ivlth
unicipal authorities. This Permit may be revol
• ation. A further condition upon which th s pe
ledge of the oranoes isthd
that he mimes
AUTHORITY
N° 1561
CERTIFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
Miami Shores Village, Fla., w t..-
Owner, Agent or Tenant of Building
Lot { - 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.
BUI.DING DIVISION