299 NE 99 St (11)ti
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APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY
6a(0 if e IJc ( x1h )
hereby apply for a certificate to re- occupy the single family residence known as: (address)
j9 ( / f , Miami Shores, Florida.
Legal description:
Lot: ,Block: ,PB&PG:
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, Florida, 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.
• Applicant: Date:
Print Name:
****************************:*** * * * * * * * * * * * * * * * * *m * * * * * * * * * * * **
For the purposes of conducting the inspection required by Section 902 of the Miami Shores
Development and Z • • Code, contact:
Contact Name:
Buyer. Seller
Inspection: By:
• Comrrients:
Telephone:
ompanyName: 1A.X-Gui2 ...(
Application Fee ($50) Paid: Cash: Check: Number. 5 93/ .
Droved: 1/ Denied: Date:
j�I- 3 2J / ,� 3
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1 4 ' V
CERTIFICATE OF RE- OCCUPANCY
On behalf of Miami Shores Village, Florida, the undersigned certifies that the property described
in the application has been inspected for the 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 applicant for single - family residential purposes.
MIAMI SHORES AI GE, FLORIDA
BY
Date of Certification: cor
THIS CERT1r'ICATE VERIFIES THAT '[ HE REFERENCED PROPERTY
HAS BEEN INSPE(; IED BY MIAMI SHORES VILLAGE AND HAS BEEN
DETERMINED TO PRESENTLY COMPLY WITH lriE SCHEDULE OF
REGULATIONS OF fliE 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
W AS TO THE CONDITION OF THE DWELLING OR OTHER
STRUCTURES ON THE PREMISES DESCRIBED HEREIN, OR AMY
ASPECT OF SUCH CONDITION, AND INTERESTED PARTIES ARE
ADVISED AND ENCOURAGED TO MAKE 1'HEEIR OWN INSPECTION
OF THE PREMISES IN ORDER TO DETERMINE '1 HE CONDITION
THEREOF.
Application is hereby made for the approval of the detailed statement of the plans and specifications herewith submitted for the building 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.
Owner's Name and Address ' 1 r o 2 C` No.� l
Registered Architect and /or Engineer
Name and address of licensed contractor (��.: N0.M (-"; S b X - 2i <) dZ ( 3 K ? O 3 o / <.=
Location and legal description of lot to be built on: , / 3. 1.3 H 0 '
Lot 4 D-3 Block Subdivision ✓\'-•- ' vs"- ' S � ^ ` Le'■ r+ A&P
S . Street and Number where work is W be done 9 1 9 5Th S
State work to be done and purpose of building (by floors), state exterior colors (submit samples)
and for no other purpose.
New Building Remodeling
1b be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements s 33 Amount of Permit S /046
4d
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 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 obligatons 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 agree-.to employ only such subcontractors. on work to be performed
under this permit, as are licensed by Miami Shores Village.
Remarks (Signed)
STATE OF FLORIDA
COUNTY OF DADE.
}SS.
MIAMI SHORES VILLAGE
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Addition
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared
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. 2 9
Disapproved
(Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member Member
Member Member
Council Approved Date Disapproved Date
NOTE: A charge of S25.00 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 825.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials anchor workmanship.
Date
Date
Repairs No. of Stories
Read. Sworn to and Subscribed before me.
Notary Public, State of Florida
/lC_ 19
Street ( iv`-