210 NE 102 St (6)CERTiiFICATE OF OCCUPANCY
MIAMI SHORES VILLAGE, FLORIDA
BUILDING DIVISION
N° 1882
Miami Shores Village, Florida
•
,s
Owner, Agent or Tenant of Building ` '( °' yr�
Lot ( Block Subdivisio
Street Address ;,,. « Y
Approved use by occupancy
'I 1"
Remarks• e;
This Certificate of Occupancy is issued to the above named
for building at above named location only upon the express provision that the applicant will
abide by and comply with all conditions of Ordinances Nos. 92, 93, 94 and 97, known as the
Zoning, Electrical, Plumbing and Building Ordinances of Miami Shores Village pertaining to
the erection, construction, alteration or remodeling' p buildings structures. •
Y *r
BUILDING DIVISION
APPLICATION FOR BUILDING PERMIT
Application is hereby made for the approval of the detailed statement or ine plans and specifications herewith submitted for the build
ing 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 Divisinn 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 prp of the work.
Owner's Name and Address ..... 2.a. 6 -: gar. v.L:z._ Street_ ...a.l4_?D -
Registered Architect and /or Engineer.••.. •....10.0.414s1?111. 11t?:42,,.44e ;R
Name and address of licensed contractor F ..e4'k... �fdt1.4T• S• '?5.-X1•�Y :-7. . •:• .••1114 k 14,1 'FLA. • 3!?1i 6
Location and legal description of lot to be built on: `' 512.
Lot 1 Block 3i 1 Subdivision....... Y.t�C2.t 4�4 Z-__�� . N ' 10k 5T
Street and Number where work is to be done t: • 2— 4 4_._1.0 2 s •r' „__ _ _ ...._,
State work to be done and purpose of building (by floors).._ w • C. e S •
MIAMI SHORES VILLAGE
Building Inspector
BUILDING INSPECTION DEPARTMENT
ate
_. _ __..._.:......and for no other purpose.
Ncw Bui!ding ✓ Remodeling Addition epairi No. of Stories 1 _
To be constructed of ...C1 5 Kind of foundation
ROAM- CztMCQ Roof Covering...l�Q 1M11��1 ..Tl..�Q _
Estimated Total cost of improvements S•..50..e.Q.CI.d..` Amount of Permit S. 1376 ` 5.0
Zone cubage required plan Cubage Vitt i i l
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
be sent to..
The undersigned applicant for this building permit does hereby certify that he understands and
of labor under the Florida Workmen's Compensation Act, being Section 5966, Compiled General L
and has complied with the provisions thereof, and will require similar compliance from all contract
in the work to be performed under this permit; and will post or cause to be posted for inspection
or notices as arc required by the Act. The undersigned agrees to employ only such subcontracto
pennit, as are licensed by Miami Shores Village.
Remarks (Signed)
Notary Public, State of Florida
My Commiuion Expires
PLANNING BOARD DATE
and its construction
s his obligations a
Florida. Per►nxn
sub - contractors
site of the wor
work to be
may
yer
cent,
y him
c notice
under this
STATE OF FLORIDA, 1 .
COUNTY OF DADE. j ss.
Before me, the undersigned authority, a notary public, duly authorized to administer oaths and take acknowledgments, personally ap-
peared
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..
No. 't IV) Date LH I Read, Sworn to and Subscribed before me.
Disapproved
(Signed)
Chairman Member
\Icrr.bcr Member ...
Member.. ... _ ....._......_..._.— ...._....... 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 P1.rr►nir.g Board.
A re-inspection fce of 51.00 will be charged when such re- inspection is made necessary by improper notice for inspection or faulty
materials anti /or workmanship.