1421 NE 101 St (12)I
APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY
J, 4j R_ G r4 L i rJ
to re- occupy the single family residence known as : (address)
( f v / /(J /3- / 0 1 , 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 .
Print Name d/4- /0 �� . G ,4 L �° i�✓
*********************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Comments:
For purposes of conducting the inspection required by Section 902 of the Miami Shores Land
Development and Zoning Code, please contact:
Contact Name:
Buyer Seller
Inspected by: F . LUB I EN- Approved X
PAGE 1 OF 2
, hereby apply for a certificate
Date / -a y -ca
Application Fee ($50) paid: Cash Check No. y ? .
Telephone: 3 - 1? p/ Xi L y
Realtor Company Name "12 U / 0 12 L j
Denied Dat
e
37., /00
CERTIFICATE 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.
MIAMI SHORES VILLAGE, FLORIDA
By:
Date of Certification: 1/26/00
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 INTERESTED PERSONS ARE ADVISED AND
ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE
PREMISES IN ORDER TO DETERMINE THE CONDITION,
THEREOF.
PAGE 2 OF 2
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building I l i
Address of
Building
MIAMI SHORES VILLAGE, FLORIDA
5 DATE - It 19.E
❑ PERMIT N9 7850 Contractor's f ike't S
License No.
❑ 1 C!•&... /e /:., 7 0._(4.,e -
in t e� .oi ,j - /7�Q�L •! "" `b _
❑ Work to be performed under this Permit '—
�
CONTRA CfO OR BUILDER
S L. JA
V
Architect
Contractor -
or Builder T. 1 — i C = -
Legal Lot
Description II Bl
C
c
c !—
S
Subdi-
vision
LR..�
Value of II Amount of
Project $ o.."" II 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 statements or specifications and that he assumes respon-
sibility for work done by his agents, servants or employees.
' ti
Signed Zoti; c / ... .. `... - IN CTOR
In consideration of the issuance to me of this permit I agree to perform the work covered hereunder in compliance with all vfdinances and regul
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of -Miami Shores Village. In ao
cepting this ermit ssui sponsibijlty ai11 work done by either, myself, my agent, servant or employee.
BY AUTHORITY
AY•OT