Reocc-1998110 Applicant:
Print Name:
Contact Name:
•
APPLICATION FOR CERTIFICATE OF RE
hereby apply for a certificate to re- occupy the single family residence known as: (address)
71 W e )00
Shores, Florida.
Legal description: 11— 3 av _ DI 3 — 5-100 `) Jicam. �• - - -, —1—
Lot: 3N- 7 ,Block: ,PB&PG:
I hereby certify that I understand that tlie oiling 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 -0ccupancy that may be issued by Miami Shores Village, Florida, certifies only
that the referenced property is being used for single - family purposes and that such Cerdicate does
not constitute any representation; warranty or certification as to the condition of the dwelling or
other structures on such property.
140)%k-- POtL)
- PG u ) Telephone: 769- V Pc
Buyer. Seller: Realtor/C Company Name: (r'U�e..,,-, — i 0,4)
****************************_***** * * * * * * * * * * * * * * * : : * * * * * * * * * * * * **
For the purposes of conducting the inspection required by Section 902 of the Miami Shores
Development and Zoning Code, contact:
Application Fee (S50) Paid Cash: Check /Number: 40 a 1.
/Denie± Date:
9F
z ()es?' -
CERTIFICATE OF RE- OCCUPANCY
On behalf of Miami Shores Village, Florida, the undersigned certifies that the property described
in the application has been inspected for the 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 applicant for single - family residential purposes.
MIAMI SHORES ii 4GE; ORIDA
.6.
By:
Date of Certification
9P
THIS CERT VERIFIES THAT THE REFERENCED PROPERTY
-HAS BEEN BY MIAMI SHORES VILLAGE AND HAS
OF
DETERMINED TO PRESENTLY COMPLY WITH [1 E SCBIDULE
REGULATIONS OF nil 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 DWELLLNG PURPOSE ONLY; HOWEVER, THIS
CERTIFICATE DOES NOT CONSTITUTE ANY REPRESENTATION OR
WARRANTY AS TO THE CONDITION OF '1 HE DWELLING OR OTHER
STRUCTURES ON THE PREMISES DESCRIBED HEREIN, OR ANY
ASPECT OF SUCH CONDITION, 'AND INTERESTED PARTIES ARE
ADVISED AND ENCOURAGED TO MAKE rktEIR OWN INSPECTION
OF THE PREMISES IN ORDER TO DETERMINE 1 CONDITION
THEREOF.
1 '
Applicant
Comments:
APPLICATION FOR CERTIFICATE OF RE-OCCUPANCY
��f L cJ /';l ✓ S
to re- occupy the single family residence known as : (address)
- / S �
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 unla..ful for rr.ere than one family to reside therein. I also understand that any
Certificate of Re- Occupancy that may be issued by Mami Shores Village, certifies only that the
referenced p erty is being used for single - family purposes and that such Certificate does not
constitute y representation, warranty or certification as to the condition of the dwelling or other
structure on su¢+ property.
Print : ne (,4.6 L c ; •�'' -' - � /� - ' / ts
* ** ** ** ****# __ *** **************************** * * * * * * * *x * * * * * ** * * * ** **** * * * * **
For purposes of conducting. the inspection required by Section 902 of the Miami Shores Land
Development and Zoning Code, please contact: 7g. t _ 3 8 9' •
,u c:
Contact Name.
A G ' ` s Telephone: --3DJ " 9/ - QC ) 9 e 'c
Buyer Seller x- Realtor . Company Name
Application Fee (S50) paid: Cash 5C Check No.
it Inspected bv: F. LUBIEN Aecroved Y Denied Date 10 /11/ 99
, hereby apply for a certificate
. Miami Shores, Florida.
Date /0 7- 99
CER 11F ICATE OF RE- OCCUPANCY
On behalf of Miami Shcres Vi1iaCe Florida, the undersigned certifies that the property
described in the above application has bee inspected for purposes of re- occupancy pursuant to
Sections 901 and 902 of the 1L?mi Shores Land Development and Zoning Code and that such
property may be re- occupied by the above applicant for singie- family residential purposes.
MIAMI SHORES VILLAGE, FLORIDA
By: '
Date of Certification:10 / 13 / 99
THIS CER1 ICATE VERIFIES THAT THE REFERENCED
PROPERTY HAS BEEN INSPECTED BY MIAMI SHORES
VILLAGE A_N'D HAS BEEN DETERMINED TO PRESENTLY
COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE
MIAMI SHORES LAND AND DEVELOPMENT CODE
PERT_A1NTh G 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 CER III ICATE DOES NOT CONSTITUTE ANY
REPRESENTATION OR WARRANTY AS TO THE CONDITION
OF THE D W aLING 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 D ORDER TO DETERMINE THE CONDITION,
THEREOF.
PAGE 2 OF
Miami Shores Village
Building Department
10050 NE 2 Ave, Miami Shores, Fl 33138
Tel: (305)795 -2204 • Fax; (305)756 -8972
PLEASE PRINT
DATE: 0 g (0 - O 6 TIME: 1 2' eQ
NAME OF PERSON REQUESTING FILE: (a-- Lo (44 O ?)...mo r
PHONE #: 5_ 2 1 6 - 2 2 1
ADDRESS OF FILE REQUESTE
INFORMATION REQUESTED: _
I understand that all documents
that NO documents may be rem(
copies (8x11) size, additional co
including any blue prints. If blue.
responsible for the quality of the
Acknowledged by:
FILE RETURNED TO: INITIA
Type Insp'n
Permit No.
Name
Address
Company
Phone #
For Inspector: 3-, 6 -0z
Approved
Correction
Re- Insp'n Fee
MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305 - 795 -2204
Building Inspection Request
Date,• oZi
Time
MIAMI SHORES VILLAGE
Name & Date
L 4-a..a-
a