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270 NE 100 St (7)Miami Shores Village Buil4 Anent 1 P 5 V.25 RE- OCCUPANCY APPLICATION Date °� / `� /•0' k_en "- viz Phone # j3f ‘-3S 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 Permit No. Z -5 a Loc ID Contact Name Buyer Seller Realtor c/ Company Name L_G %t /� Property Address � ) / d� � _ ` - 'S ✓ - City Miami Shores State Fl Zip 3 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 the property. OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate. The foregoing instrument was acknowledged before me this day of 0401 , 20 Q� , by �v /� I ? o v f 'mac who is personally known to me or who has produced as identification and who did take an oat Sign: Print: My Commission Expires: Building Officials Approval: (Rev. 1/ 2/03) 1 Re -Occ. $60.00 Notary $5.00 CCF $0.60 Total :0 T cr • s'r \ ht . , f ? © • • ' 2� � "Tr • Vs, , 4`, • • " f ) ' - r 41(11/1, In all reeisSig Iva be #1 • , . - tits:LOIS* • t 1- r ` 7 : • • • a ' . • • .., n • • • • • • 4.. • • • • • wtot1114,*; • tMt 4' •'ffro ow o VA ,• • . • • • " ifigintifte tte.? • • • 41,041 fed i * f1/4 '43 /4 a II etb fir •*]]; UV' ';.. 'XV t .117 , 4/4) uoiess , thetilt,th 1 3t ft or I t 4seisseittor•, /AA wl, th *be vee • . . : 1114140 ina, 0111,10 4,0, isoi, entowoof vtith • * ..v e siot11. 'shall'. Ile .• - *ere ' Obit* on IL erprillme . ,tiresse Viril or ,;-„. tre , 'WOOS. ViMit . ito*064 fru*. iry NON* • g ? \ « ' u' . ep.n tee «n \ % 1/ � { i} $ 1, / • \ k A ' y: � \. a . r 2 a f7 ;!¥? • ,., T 2 E .8 �. ,1 Estimated Total Zone cubage Chairman Member Member APPLICATION FOR BUILDING PERMIT 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 regula- tions 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. Registered Architect and /or Engineer ( --- j) Owner's Name and Address__ Name and address of licensed contractor Locati n and legal description of lot to be built on: Lot_! • , a_ 22 °_? Block__________ Subdivision —r` Street and Number where 'work is to be done 7- 4 - 2 State work to be done and purpose of building (by floors) New Building_ To be constructed be sent to STATE OF FLORIDA, COUNTY OF DADE. j ss. Disapproved (Signed) _ Council Approved_ Remodeling Addition 1 ° f undation_ cost of improvements $ _ 191L "� _Amount of Permit $ Distance to next nearest building Size of Building Lot Maximum live load to be borne by each floor_____ _______________— ___________ —__ I hereby submit all the plans and specifications for said building. All notices with reference to the building and its construction may —Plan Cubage_ The undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations 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 ctors, on work to be performed under this or notices as are required by the Act. The undersigned agrees to employ only suc permit, as are licensed by Miami Shores Village. Remarks (Signed) _ therein by bim stat • are, true. Permit No MIAMI SHORES VILLAGE __ Kind of BUILDING INSPECTION DEPARTMENT Before me, the undersigned authority, a notary public, duly authorized appeared ___— 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 regoing application, and that he did sign the same, and that all facts / Date Date_ Building Inspector ,,-P ..ANNING BOARD / Date v . _— Street — Wi 11 g and for no other purpose. Repairs No. of Stories_ _./ --- R of ov ring - - — Read, Sworn to and Subscribed before me. 1 9_ t E 2 , � to administer oaths and take acknowledgments, personally to me well known, Notary Public, State of Florida My Commission Expires DATE Member -------- ------- ------ ----- - - - - -- -- — — Member Member _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 from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. (over) 1. General Building Contractor. 3. Electrical. LIST OF CONTRACTORS, SUB - CONTRACTORS, ETC. REQUIRING OCCUPATIONAL LICENSES MIAMI SHORES VILLAGE G z 2. Plumbing, Heating, Ventilating, Air Conditioning and Gas Fitting. - •V• 5. Excavating, grading, filling and Landscaping. 6. Moving or wrecking. 4. Architects, Engineer, Surveyors, Landscape Architects and Interior Decorators. 7. Septic Tank and Drain Field. 14. Roofing, Sheetmetal and Skylights. 15. Solar Water Systems. ^ ✓`�, 8. Brick, Stone, Tile, Cement Block, Concrete, and Gypsum. 9. Carpentry, Millwork, Awning and Shutters. 16. Well drillers. 17. Sprinkler Systems of all kinds, including those for Buildings, Lawns, etc. 18. Structural and Reinforcing Iron and Steel. 19. Tile, Terrazzo, Marble, Granite and Cut Stone. 20. Electric Fixtures. 21. Illuminated Signs. 10. Cement, Linie, Stucco, Lathing and Cast Stone. 11. Decorating (interior and exterior) , Painting, Waterproofing, Damp- Proofing and Paper- hanging. 12. Flooring, sanding or finishing; wood, rubber, composition, linoleum and other flooring not otherwise specified. 13. Ornamental Iron, Bronze and Steel, Steel Sash, Over -head Doors. 22. Bridge, Bulk- heading, Drainage Sewer, Water and Gas excavation and Construction, Dredging, Irriga- tion System, Pile Driving, Sea Wall, Paving, Sidewalks, Curb and Gutter or similar work. 23. Every person, firm, co- partnership, Corporation, Association or other organization engaged in the bus- iness of supplying, furnishing or delivering building materials for any construction project within the Village Limits and not having a regularly established and licensed place of business in the Village. STATE OF FLORIDA, COUNTY OF DADE. ss. 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 regula- tions 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. ( ( v � � y Owner's Name and Address___! '�✓�' .��•.. Registered Architect and /or Engineer �-�! " �. Name and address of licensed contractor , �.: Locatti ?n d legal description of lot to be built on: AI Block__ " Subdivision ` -_ Street and Number where work is to be done _ ii` State work to be done and purpose of building (by floors) (Signed) MIAMI SHORES VILLAGE BUILDING INSPECTION DEPARTMENT APPLICATION FOR BUILDING PERMIT Disapproved _________________________ Date ;/: s i Permit No Date No.q U _Plan Cubage (over) _and for no other purpose. New Building 1 0°R Remodeling A d;tion Repairs No. of ,St 'es____� To be constructed of__ .__L_ _ Kind of f undation L ' _ 1 :•• • ""°°•"••••• " • _Roof Covering C i Estimated Total cost of improvements Amount of Permit $ Zone cubage required /e___26 Distance to next nearest building Maximum live load to be borne by each floor 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 undersigned applicant for this building permit does hereby certify that he understands and accepts his obligations 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 agrees to employ only suc ctors, on work t be pe cif }ned under this permit, as are licensed by Miami Shores Village. _Size of Building Lot _____ Remarks ____________ (Signed) _ ►: _ :r_ _ Street__ Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally appeared 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 stat,ed are true, Read, Sworn to and Subscribed before me. to me well known, Notary Public, State of Florida Building Inspector My Commission Expires PLANNING BOARD DATE Member Member Member — Membe r 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 from the Planning Board. A re- inspection fee of $1.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty materials and /or workmanship. LIST OF CONTRACTORS, SUB - CONTRACTORS, ETC. REQUIRING OCCUPATIONAL LICENSES "- MIAMI SHORES VILLAGE 1. General Building Contractor. 2. Plumbing, Heating, Ventilating, Air Conditioning and Gas Fitting. 3. Electrical. 4. Architects, Engineer, Surveyors, Landscape Architects and Interior Decorators. 5. Excavating, grading, filling and Landscaping. 6. Moving or wrecking. 7. Septic Tank and Drain Field. 8. Brick, Stone, Tile, Cement Block, Concrete and Gypsum. 9. Carpentry, Millwork, Awning and Shutters. 10. Cement, Lime, Plastering, Stucco, Lathing and Cast Stone. 11. Decorating (interior and exterior) , Painting, Waterproofing, Damp- Proofing and Paper- hanging. 12. Flooring, sanding or finishing; wood, rubber, composition, linoleum and other flooring not otherwise specified. 13. Ornamental Iron, Bronze and Steel, Steel Sash, Over -head Doors. 14. Roofing, Sheetmetal and Skylights. 15. Solar Water Systems. 16. Well drillers. 17. Sprinkler Systems of all kinds, including those for Buildings, Lawns, etc. 18. Structural and Reinforcing Iron and Steel. 19. Tile, Terrazzo, Marble, Granite and Cut Stone. 20. Electric Fixtures. 21. Illuminated Signs. 22. Bridge, Bulk- heading, Drainage Sewer, Water and Gas excavation and Construction, Dredging, Irriga- tion System, Pile Driving, Sea Wall, Paving, Sidewalks, Curb and Gutter or similar work. 23. Every person, firm, co- partnership, Corporation, Association or other organization engaged in the bus- iness of supplying, furnishing or delivering building materials for any construction project within the Village Limits and not having a regularly established and licensed place of business in the Village.