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RE-OCCUPANCYI, APPLICATION FOR CERTIFICATE OF RE OCCUPANCY , hereby apply for a certificate to re- occupy the single family residence known as : (address) , 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, 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 Comments: Buyer Seller Realtor Application Fee (550) paid: Cash Inspected by: Print Name **************************************_******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** For purposes of conducting the inspection required by Section 902 of the Miami Shores Land Development and Zoning Code, please contact: Contact Name: Approved PAGE I OF 2 Date 7 L Telephone: 7 ' 2 - _., ; -7/ Company Name C /%-° Check No. /720 Denied Date 7/ Z--?- CER 1 It ICATE 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 tb 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. THIS CER i LE. ICATE VERIFIES THAT THE REFERE PROPERTY HAS BEEN INSPECTED BY IVIIAMI SHORES VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE MIAMI SHORES LAND AND DEVELOPMENIi - 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 INTERES1EL) PERSONS ARE ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE PREM. IISES IN ORDER TO DE TERM Ni E THE CONDITION, THEREOF. PAGE2 OF2 MIIAjv1I SHORES VILL GE, FLORIDA By: Date of Certification: Legal Description: APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY off- ce hereby apply for a certificate to re- occupy the single family residence known as : (address) 8 &3 .Ai y 9 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, 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 L/� Date 2 Print Name 7 7Ze **** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * For purposes of conducting the inspection required by Section 902 of the Miarni Shores Land Development and Zoning Code, please contact: Contact Name: �//'e //e- Telephone: -s 7 Buyer Seller Realtor /_-,or Cpany Name,% Application Fee ($50) paid Cash Check No. / S 2. Inspected by: Comments: Approved PAGE 1 OF 2 , Miami Shores, Florida. Denied 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. CER1INNCATE OF RE- OCCUPANCY PAGE 2 OF 2 MIAMI SHORES VILL , FLORIDA By: Date of Certification: Z /z- a, THIS CERTIFICATE 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 INTERES 1 Ell PERSONS ARE ADV ISF.D AND ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE PREMISES IN ORDER TO DETERMENE THE CONDITION, THEREOF. MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Application is hereby made for the approval of the detailed statc..,ent of the plans and specifications herewith submitted for the build ine or other structure herein described. This application Is made in compliance and conformity with the Building Ordinance of Miam( Shows village. hlnrida. and all provisions of the Laws of the State of Florida, all ordinances of Miami Shores Village and all rules and r; gulations of the Building Divisinn of Miami Shores Village shall be complied with, whether herein specified or not. A copy of approved plus and specifications must be kept at building during progress of the work. �I F O ncr s Name and Address ./ , ,,, -- ,__........ _. No. ----. Street—A1.7.g-T... Fcgistered Architect and /or I~ntincer ,,.„ ame and address of licensed contractor.... rt�.. Location and legal description of lot to be built on: Lot Block u rvision ....... ........ Sue t and lumber whey, work is to be done (�.. ».» (iY.v.._._. 1.. . » .. �._.....^ ___ Mate work to be done and purpose of building (by floors).. ..U. ..1 _ 1..1C.1.. ». ».�.»_.._._» ._..__._.. • - and for no other purpose. Addition Repairs No. of Stories _ New Building Remodeling To be constructed of Kind of foundatiott Estimated Total cost of improvements i...r . 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 • f Coz( Disapproved �.� \....�.L Date Sigoed) "^' "^ �' °" Notary Public, State of Florida Building Inspector My Commission Eapires.... »._.... 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 Isn.lrr signed applicant for this building permit does hereby certify that he understands and accepts his obligation% a% an employer of :Thor under the Honda %Vorktnen's Compensation Act. being Section 59(iG. Compiled General Laws of Florida, Permanent Supplement, .,r.ii has complied with the provisions thereof, and will require similar compliance from all contractors or sub - contractors employed by him :n 1I:e 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 r.ouccs as are required by the Act. The undersigned agrees to employ only such bcontract • on k beg per d under this pcnnit, as are licensed by Miami Shores Village. r ' _. (Signed) I T If STATE OF FLORIDA, COUNTY OF DADE. I ss ' Bcfore me, the undersigned authority. a notary public, duly authorised to administer oaths and take acknowledgments. personally ap- G eared _.»._.—..__. »..._...._ ............. • 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.. nn// S Permit No.._...a2..� - ./8 ... Date .. �� / . »._._ Read, Sworn to and Subscribed before me. PLANNING BOARD DATE Chairman `.icrt,tber — Member _ Mombcr .. ..... ....._......_..._._....._. ... - 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 (min ti,c I'Ltnnit,_ Bu.ud. A rt.-inspection Ice of $1.00 will be charged when such re- inspection is made necessary by Improper notice for inspection or faulty materials anu /or workmanship.