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RE-OCCUPANCYI, to re- occupy the single family residence known as : (address) Legal Description: Lot: I hereby certify that I understand that the zoning of the ro e and that it is unlawful for more than one family to reside therein is I also uders -sand that residential use Certificate of Re :Occupancy that may be issued by Miami Shores Village, certifies only that to 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 ** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** 4c# *** * * * * * * * * * * * * * * * * * * * * * * * * * * * ** For purposes of conducting the inspection required by Section 902 of the Mrarni Shores Development and Zoning Code, please contact: Land Contact Name: Buyer Application Fee ($50) paid: Cash Inspected by: Comments: APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY O i-,'3 L 9 P Seller BIock Realtor A- Company Narne Approved Check No. PAGE I OF 2 Miami Shores, Florida. PB & PG: Date s1G hereby apply for a certificate Telephone: .eilA Denied - _____ Date (1. /t ki CER11r 1CATE 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. PAGE 2 OF 2 MIAMI SHORES VILLs. ORIDA By: Date of Certification: f 1i' 2 THIS CER I II 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 INTERES1Ell PERSONS ARE ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE PREMISES IN ORDER TO DETERMENE THE CONDITION, THEREOF. I, (e APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY Alta C (S C a 6-e to re- occupy the single family residence known as : (address) /093 Air 9e Miiami Shores, Florida. Legal Description: Lot: e Applicant Block , hereby apply for a certincate PB & PG: 2-7? Date 74/O/ 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 such property. v ' Print Name 6 % �_ �� fL For purposes of conducting the inspection required by Section 902 of the Miami Shores Land Development and Zoning Code, please contact: Contact Name: e -e rn Zc - /e_Z Buyer Seller Realtor t "< Company Name 1 'c/a_ 7?-4_ /7 Application Fee (S50) paid: Cash 9 Inspected by: Comments: Approved Check No. /LS 0 PAGE _ OF 3 Telephone: 75V-9 > ? e,., • 3 D / Denied Date 7-- /2 — G� CER 1 "I IC AT E OF RE- OCCUPANCY On behalf of Miami Shores Village, Florida, the undersigned certifies that the property described in the above application has bee 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. PAGE 2OF2 MIAMI HORES VII. FLORIDA By: Date of Certification: THIS CERTIFICATE VERIFIES THAT THE REFERENCED PROPERTY HAS BEEN INSPECTED BY MIAMI SHORES VILLAGE AND HAS BEEN DETERM{NED 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 CER I HCATE 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 1"ED PERSONS ARE ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE PREMISES DN ORDER TO DETERMINE THE CONDITION, THEREOF. peared IAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT , AI\PL CATION FOR BUILDING PERMIT Application is hereby erode for the aj proval of the detailed statement ur the plans and specifications herewith submitted for the build • inc 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 Divisinn of Miami Shores Village shall be complied with, whcther herein specified or not. A copy of approved plans and specifications must be kept at building during prggreu of the work. Owner's Name and Address .. ....' ► .. : Registered Architect and /or Enginee !. ... '! :... Name and address of licensed contractor.....Y.1 .........r.. -t- }fir rt i1,2...k..E.q Location and legal description of lot to be built on: oD Lot e Block J 1 ,? Subdivision e,—'.4 x'' - .. » Street and Number where work is to be done ../.0. .1/3 >. _ ! State work to be done and purpose of building (by floors). Amount of Permit $. Q - 0 D But • ing Inspector My Commiuion Expires v ._ No>.v_A>... _..r Street. s,$ .G(5 New Building Remodeling Addition To be constructed of Kind of foundation Roof Covering Estimated Total cost of improvements $..... and for no other purpose. Repairs No. of Stories 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 ubmitt ill the tans and specif r said building. All notices wwitlreff c to the building and its construction may be sent to^ ei _ L fr•^ -L fI`� ll" f r+la( ,..1`,3—Z ' de t5 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 %Vorkmen'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 hint 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 arc 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) AA,. STATE OF FLORIDA, COUNTY OF DADE. j ss. Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally op- 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. a a' i... 0 Date.? - ? D .1 Read, Sworn to and Subscribed before me. Disapproved �.. :� • Date Notary Public, State of Florida (Signed) PLANNING BOARD DATE Chairman _. Member MIcrnbcr 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 frrnn 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.