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.