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1180 NE 100 St (10)S r, rp,r H hereby apply for a o`ic;ate to re- occupy the situ& fe ridgy known as: (address) Mani Stores, Florida. Legal desc-iptioa: Lac APPLICATTON FOR CERTIFICATE OF RE -OCCUPANCY Ii tocfc p&�.aG: I hereby cer�r that I and that k is that the zo of tfie property Es 51t shuck-a unlawtu! . use Certificate or'Re � Qzore than one �t�t reside � 1 also residua( Ce r the refereRe- P - tar maybe wed by M Shores Yu7a ; Florida, � des only being used nor sin �Y constitute any tea � Y puruoses and that such �� o won, waI;aary or certir,�oa as al ar" does other structur oa suet JrooeTy. p as (lithe a g or nr .Name: E A i . � H : _ :**_ : * : *s :sue _ _ '� For the �_�" ; �,._s t:_ :_ Development and o Zo� �deQO'a requ by Szcioa 902 of the Shores corn= C o m te N a m e . / @ JA Telephonc 3 �� Buyer Seiler. R. Company Name: Application Fee (S54) Pain: Ca* Caenki Number: . toy • 0y- 30-gg , ©W I.%e !^ as CER 1 1HCAT E OF RE-OCCUPANCY On behalf of Miami chores Vage, Florida, the naciersisped =hie' s chat the g roperry desc i c" in the application has been inspected for the purposes of re-o=pancy pursuancro Sec 901 and 902 of the Mi Shores Land Development and Zoning Code and that such property may be re-occapied by the app for singie-kniiy residential purposes. THLS CERi iCATE VERIFIES THAT ili REFERENCED PROPERTY HAS BFFN ENSPECTED BY MIAMI SHORES VILLAGE AND HAS BZN DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE MIAMI SHORES LAN) AND DEVELOPMENT CODE PERTAINING SOLELY TO THE REQUIREVIENT THAT EACEE ONE-FAMILY DWELLENG IS USED AND INTEND ED TO BE USED FOR A ONE-FAMILY DWELLENG PURPOSE ONLY; HOWEVER, THIS CERiiieiC.ATE DOES NOT CONSTITUTE ANY REPRESENTATION OR WARRANTY AS TO THE CONDITION OF Ito.; DWELLING OR 0113ER S'i.RUCTURES O• PREMISES DESCRIBED BEREThf, OR ANY ASPECT OF.SUCH CONDITION, AND INTERESTED PAR= ARE ADVISED AND ENCOURAGED TO MAKE THEIR OWN INSPECTION* OF TEE PREMISES EN ORDER TO DETERMINE 1±L CONDITION THEREOF. rf, • 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. 1 ' wner's Name and Address /23,/e t /r 1 /eZ z Registered Architect and /or Engineer me and address of licensed contractor APPLICATION FOR BUILDING PERMIT Location and legal description of lot to be built �� 1/ g Lot 3 Block /7 r . 5 �� Subdivision / / / j tee / ! / 316;1 /1 / /t'0 NF /00 street and Number where work is to be done Ce work to be done and purpose of building (by floors), state exterior colors (submit samples) ...ft/ . ,1 .. Div . './.e .ti ✓i / / and for no other purpose. New Building Remodeling To be constructed of Kind of foundation estimated Total cost of improvements S �'0 MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT Addition S'T l4 T PaYnOCk The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligatons Compensation Act, being Section 5966, Compiled General Laws of Florida. Permanent Supplement, and has comp compliance from all contractors or sub-contractors employed by him in the work to be performed under this p on the site of the work such public notice or notices as are required by the Act. The undersigned agre under this permit. as are licensed by Miami Shores Village. ✓ Remarks (Signed) Repairs No. of Stories IC vering Amount of Permit S , Amount of Permit S f 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 STATE OF FLORIDA COUNTY OF DADE. } ss. 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. 4z 2, /7 d (p Date Disapproved (Signed) ivr Date 0 / Read. Sworn to and Subscribed before me. Date / / 9° ,/ . 19 /410 Cl �� Na Street 0 .]1! an employer of Labor under the Florida Workmen's with he provisions thereof, and will require similar will p cause to be posted for inspection contractors. on work ye performed Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Chairman Member Member Member Member Member Council Approved Date Disapproved Date NOTE: A charge of $25.00 will be made for making corrections or changes to this application after approval has been obtained from the Planning Board. ailk re- inspection fee of $25.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. BUILDING ELECTRICAL PLUMBING ROOFING Owner of Building MIAMI SHORES VILLAGE, FLORIDA o DATE . 19 o PERMIT N9 4 210 Contractor's CONTRACTOR OR BUILDER Work to be performed under this Permit B Y License No. Architect Contractor or Builder` 1 Legal Lot Subdi- Description I BI vision Address of , .-' , R Value of •� I Amount of Building i - ,' C) E, '. ' Project $ ,tit " I Permit $ "',. This permit is granted to the contractor or builder named above to construct the building or to install the equipment or device described in the applica- tion herefor in strict compliance with all ordinances pertaining thereto and with the understanding that the work will be performed in compliance with any plans, drawings, statements or specifications that may have been submitted to and approved by the proper municipal authorities. This Permit may be revoked at any time if the work is not done in compliance with such ordinances or if the plans are changed without authorization. A further condition upon which this permit is granted is the understanding that the contractor or builder named above assumes the responsibility for a thorough knowledge of the ordinances and regulations pertaining to the work covered hereby whether shown on the plans or drawings or in the statementspf specifications and that he assumes respon- sibility for work done by his agents, servants or employees. 4 Signed $° .y ` INSPECTOR In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements dr specifications submitted to the proper authorities of Miami Shores Village. In ao cepting this permit I assume responsibility for all work done by either, myself, y agent, servant or employee. AUTHORITY 411 eOT *a-4'