361 NE 102 St (5)APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY
hereby apply for a certificate to re- occupy the single family residence known as: (address)
p i-/Yl 141/ ' l tjf 16'2 �i flami Shores, Florida.
Legal description:
Lot: /9 r ,Block: 3/ ,PB&PG: / - �U
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, Florida, 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 ro the condition of the dwelling or
other structures on such property.
Applicant: E%, - f
Print Name: 60
** * * * * * * * * * * * * * * * * * * * * * **
For the purposes of conducting the inspection required by Simon 902 of the Mani Shores
Development and Zoning Code, contact:
Contact Name: �S7If 6e--
Buyer Seller. Realtor.
Application Fee (550) Paid: Cash: Check umber: ° /
Date:
e7124 Telephone:
0007
Company Name: ?tz/ d/0777Az
Inspection: B y . � Approved: ✓ Denied: Date: ' 2 ?
Comments:
93-
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. ' GE, FLORIDA
By
Date of Certification: • !�'.�/
THIS CER TIHC.�TE VERIFIES THAT 1" lib, REFERENCED PROPERTY
HAS BEEN INSPECTED BY M142vII SHORES VILLAGE AND HAS BEEN
DETERMINED TO PRESENTLY COMPLY WITH THE SCHEDULE OF
REGULATIONS OF THE MJA1vH SHORES LAND AND DEVELOPMENT
CODE PERTAINING SOLELY TO IELE 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 LN TERESTED PARTIES ARE "
ADVISED AND ENCOURAGED TO MAKE i "HEIR OWN INSPECTION
OF THE PREMISES IN ORDER TO DETERMINE THE CONDITION
THERE OF.
L `
PERMIT N° 13285
BUILDING
ELECTRICAL
PLUMBING
ROOFING
Owner of
Building
Architect
Contractor
or Builder
Legal
Description
Address of
Building
Lot
F Work to be performed under this 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 application
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 responsibility for work
done by his agents, servants or employees.
Signed • BY
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 or specifications submitted to the proper authorities of Miami Shores Village.
In accepting this permit I assume responsibility for all work done by either, myself, my agent, servant or employee.
CONTRACTOR OR BUILDER
MIAMI SHORES VILLAGE, FLORIDA
BI.
Subdi-
vision
Value of
Project $
BY
DATE y- 195
Contractor's
License No
Amt. of
Permit $ !
AUTHORITY
BUILDING INSPECTION DEPARTMENT
APPLICATION FOR 5,1.JILDING PERMIT
Application is hereby made for the approval of the detailed statement of the 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 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.
Owner's Name and Address
Registered Architect and /or Engineer.
Name and address of licensed contractor
Location and legal description of lot to be built on:
Lot Block Subdivision
Street and Number where work is to be done
State work to be done and purpose of building (by floors)
STATE OF FLORIDA,
COUNTY OF DADE. ss.
MIAMI SHORES VILLAGE
Date 4L ' , 19 •
No Street
and for no other purpose.
New Building Remodeling Addition Repairs No. of Stories
To be constructed of Kind of foundation Roof Covering
Estimated Total cost of improvements $ 0 Amount of Permit $
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 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 such subcontractors, on work to be performed under this
permit, as are licensed by Miami Shores Village.
Remarks (Signed)
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.
,.
Permit No S Date Read, Sworn to and Subscribed before me.
Disapproved • • • Date
Notary Public, State of Florida
( Signed)
Building Inspector My Commission Expires
PLANNING BOARD DATE
Chairman Member
Member 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 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.
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