415 NE 102 St (10)MIAMI SHORES VILLAGE
BUILDING DEPARTMENT
305- 795 -2204
Bui .ing Inspection Request
Date 3
Type Insp'n gV05 .
Permit No. 9C:05 - 4a
gZZ
Name
Address ai l 1Q 1 4
Compan Ton 10 Cc
Phone #�
Inspection Date
Approved
Correction
Re- Insp'n Fee ❑
APPLICATION FOR CERTIFICATE OF RE- OCCUPANCY
t/ 5 'L--
to re- occupy the single family residence known as : (address)
Legal Description:
Lot: Block PB & PG:
I hereby certify that I understand that the zoning of the property is for single- farndy 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 ViilIage, 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.
Contact Name:
Buyer
Inspected
Comments:
Application Fee ($50) paid: Cash
PAGE I OF 2
, Miami Shores, Florida.
hereby apply for a certificate
Date / /U.
**************************************_ x ******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
For purposes of conducting the inspection required by Section 902 of the Miami Shores Land
Development and Zoning Code, please contact:
it) //;c
CU
Telephone: -. 6 25 , /7?
Seller k Company Name
Check No.
Approved (/ Denied Dat
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.
CER111-ICATE OF RE- OCCUPANCY
PAGE 2 OF 2
M[ALII SHORES VILLAGE, FLORIDA
Date of Certification`L_
THIS CER I I ICATE VERIFIES THAT THE REFERENCED •
PROPERTY HAS BEEN INSPECTED BY I,LLAMI SNORES
VILLAGE AND HAS BEEN DETER�IED TO PRESENTLY..
COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE
MIAMI SHORES LAND AND DEVELOPMENT CODE
PERTAINING SOLELY TO THE REQUIREMENT THAT EACH.
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 INTERES 1hL) PERSONS ARE ADVISED AND
ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE
PREMISES IN ORDER TO DE LEKLMLYE THE CONDITION,
THEREOF.