941 NE 92 St (7)CORAL GABLES 83 -7461 • MIAMI SHORES PL. 9 -2431
PERRINE 817 -2471 NORTH MIAMI BEACH 816 -4711
■
k,• AFFIDAVIT
STATE OF FLORIDA) i
COUNTY OF BADE
-r
of the Village of Miami Shores,, County of Dade and
State of Florida, being duly sworn, doth depose and say: that under the provisions
of Section B -368, Sub- section .(d), of the Building Code of Miami Shores Village
. he desires to build � c e- ` - . 'r/110 4 4-w-e on Lot 1 :/ / ',4,-
Block ' of Ag4 a.kh subdivision; that he is the owner of said
property, a 11 do the work personally, and that he will, at such times as are
required by the Zoning and Building Director: -
1. File plans and specifications and obtain approval of Village Planning Board
and of the Building Inspector.
2: Apply for and secure a permit.
3. Pay the required fees for license and for permit.
4• Execute the work in accordance with the provisions of the Zoning, Building,
and Electrical Codes of Miami Shores Village.
5. Apply for inspections.
6. File with the Building Inspector certificates that provision has been made
to carry the necessary Workman's Compensation, Public Liability and 'roperty
Damage Insurance.
7. File with the Building Inspector as the job progresses certificates showing
the payment required by the Federal Social Security Act to the State of
Florida or the United States of America.
8. Assume tho responsibility of not employing contractors or subcontractors
other than those properly licensed by Miami Shores Village or any part or
portion of the work including, but not limited to, general contracting,
plumbing, heating, electrical, septic tank, solar system, lathing, tile,
torrazo, painting, roofing and shoot motel work or installation.
9.. Not sot himself up as a "Contractor ".
10. Execute Builder's Bond.
And further this Deponent says not.
1.
SUBSCRIBED A N D S W O R N TO BEFORE ME THIS2e D A Y of /Cr mil -- _ A. D., 19
2.
1. Signature of Applicant.
2. Signature of Officer administering oath.
-
IL,
c■-s•
""" 07
0/23/.
1440,
-".
t, 1
to the undersigned of a permit to construct improvements upon the
property hereinafter referred to, the undersigned hereby agree that
no part of the premises will. be used for rental. purposes, or for any
purpose which is in violation of any of the ordinances of Miami. Shores
Vi1 cage .
MIAMI SHORES VILLAGE
Florida
0
In consideration of the issuance by MIAMI SHORES VILLAGE
It. is further agreed that if the premises are used for a
purpose contrary to the terms of said ordinances that an. injunction may
be applied for and granted forthwith and without notice to us, or those
c. aiming under us.
The said property is described as fo).i:owso
Lot Z. and l2;as cf 5, ,lock 1, Colc?en Cate 'ark Sub.
STATE OF FLORIDA )
) SS
COUNTY OF DADE )
Before me, the subscriber, a Notary Public in and for said
State and County personally appeared the persons who signed the above
agreement., who are we.l.l known to me and known to me to be the persons
described in said agreement and each of said subscribers acknowledged
to and before me that'7The t executed the same freely and voluntarily
for the purposes therein a pressed.
WITNESS my hand and seal this / day of
7. 954:0
Notary Public, State of 44.47;1 r
My Commission expi.r
St ct 6��� a, Court r� Dade.
.�s irstr7on t teccTd
AY') a /'° M. and racorJcc ... ..- :.-
oa.z..
2/er,
1
7.. 1. LEA'i ;-ERvAN
CIresui Court
0
FF1281'73
FILED FOR RECORD!
MS AUG 23 P11 4: 09
E. D. LEATHERMAN
01 DADE GO. FLA.
STATE OF FLORMAI
COUNTi OF DADE f
Thiti instrument was filed for record
/
2 3 'du of AUG 165 6'.at .m.
and duly recorded in
book '<tW on page_e
Record verified.
E. B. LEAT - 7 RMAN Clerk Circuit Court
0'
71 1
ile±Y
APPLICATION FOR CERTIFICATE ICATE OF RE- OCCUPANCY
P 6)- - no4a4 , ` - "._.0PF 4 -/-
to re- occupy the single family residence known as : (address)
9 /A/ N E 9 2, S , Miami Shores, Florida.
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 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 such property.
Applicant &J -{ .WE- . 1E74.0 7P-6 - Date 9
Print Name
** * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** # * * * * * * * * * ** sass *s *s *s * * ** * * * * * * * * * * * * * * **
For purposes of conducting the inspection required by Section 902 of the Miami Shores Land
Development and Zoning Code, please contact
Contact Name: TW/nf -�- NE 2 & 1, 4U ? D€
Buyer
Seller Realtor Company Name
Application Fee ($50) paid: Cash
Check No. ) 03/9.
, hereby apply for a certificate
Telephone: 7c1 -
Inspected by: F. LUB I EN`/ Approved X Denied Date 5/11/99
Comments:
PAGE I OF 2
CERTIFICATE OF RE- OCCUPANCY
On behalf of Miami Shores Village, 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 Miami Shores Land Development and Zoning Code and that such
property may be re- occupied by the above applicant for single - family residential purposes.
MIAMI SHORES VILLAGE, FLORIDA
BY 1 4(
Date of Certification: 5 / 11 / 99
THIS CER11thICATE VERIFIES THAT THE REFERENCED
PROPERTY HAS BEEN INSPECTED BY MIAMI SHORES
VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY
COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE
MIAMI SHORES LAND AND DEVELOPMENT CODE
PERTAINING SOT ,F.T.Y TO THE REQUIREMENT THAT EACH
ONE - FAMILY DWELLING IS USED AND INTENDED TO BE
USED FOR A ONE - FAMILY DWELLING PURPOSE ONLY;
HOWEVER, THIS CERTFICATE DOES NOT CONSTITUTE ANY
. REPRESENTATION OR WARRANTY AS TO T HE CONDmON
OF THE DWELLING OR OTHER STRUCTURES ON 'niE.
PREMISES DESCRIBED HEREIN, OR ANY ASPECT OF SUCH
CONDITION, AND INTERESTED PERSONS ARE ADVISED AND
ENCOURAGED TO MAKE THEIR OWN INSPECTION OF THE
PREMISES IN ORDER TO DETERMINE THE CONDITION,
THEREOF.
PAGE 2 OF 2
Af ))4/t-i- , hereby apply for a certificate
to re- occupy the single family residence known as : (address)
q ti/ cio? . , Miami Shores, Florida.
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 unlawful for more than one farnily to reside therein. I also understand that any
Certificate of Re= Occupancy that ii . be issued by Miami Shores Village, certifies only that the
referenced property is being use :• r single -family purposes and that such Certificate does not
constitute any representation, • / or certiuc- ion . to the condition of the dwelling or other
structures on such property. ����
A4 / #
Print Name
* * * * * * * * * * * * * * * * * * ** * * * * * * * * ** * * * * * * * * _ *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
For purposes of conducting the inspection required by Section 902 of the Miami Shores Land
Development and Zoning Code, please contact:
Contact Name:
Buyer
Application Fee ($50) paid: Cash Chick No.
Inspected by:
Comments:
APPLICATION FOR CERTIFICATE OF RE OCCUPANCY
Seller Realtor V Company Name e- _'
Gaps F. U —Cc n-A-E o / 7
Approved V Denied
PAGE I OF 2
Telep one:
//
Date 40 1
CERTIFICATE OF RE- OCCUPANCY
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.
MA J. SHORES VILLAGE, FLORIDA
B
Date of Certification:
THIS CER 111.1CATE VERIFIES THAT THE REFERENCED
PROPERTY HAS BEEN INSPECTED BY MIA1'VII SHORES
VILLAGE AND HAS BEEN DETERMINED TO PRESENTLY
COMPLY WITH THE SCHEDULE OF REGULATIONS OF THE
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 DWELLING PURPOSE ONLY;
HOWEVER, THIS CERTIFICATE DOES NOT CONSTITUTE ANY
REPRESENTATION OR WARRANTY AS TO THE CONDITION
OF THE DWELLING OR OTHER STRUCTURES ON T_ E
LND
BUILDI
NG CONTRACTORS
75421
057429
APPLICATa3N FOR CERTIFICATE OF RE- OCCUPANCY
I, , hereby apply Tor a certificate
to re- occupy the single family residence . known as : (address)
9 0 `J
Legal Description:
Lot:
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,Mi'iami Shores Village, certifies only that the
referenced property is being used for single- farauy purposes and that such Certificate does not
constitute any representation, warranty or cert cation as to the condition of the dwelling or other
structures on such property.
Applicant / / .0
Print Name
* * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * * ** ..****** * * * * * * : * * * * * * * * * * * * * * * * * * * * * * **
For purposes of conducting the inspection required by Section 902 of the Miami Shores Land
Development and Zoning Code, please c ntact:
I
Contact Name: ' 'i L / elephone:
n
Buyer Seller Realtor Company Name
Application Fee (S50) paid: Cash Check No. �l C — � a v ,
Inspected by
Block PB & PG:
(Le_=( / Ad /ii% Yte l°7�0 /2
Comments:
1
Approved
PAGE I OF 2
, Hand Shores, Florida.
Denied Date PI
I
APPLICAT)ON FOR CERTIFICATE OF RE- OCCUPANCY
to re- occupy the single family residence . known as : (address)
/\ /-t 9 `J , Muni Shores, Florida.
Legal Description:
Lot: Block PB & PG:
I hereby certify that I understand that the zoning of the property is for single - family iesidential use
and that it is unlawful for more than one fanugy to reside therein. I also understand that any
Certificate of Re= Occupancy that may be issued by Mani 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 such property.
Contact Name:
Comments:
Applicant /
Application Fee (S50) paid: Cash
Inspected by-
For purposes of conducting the inspection required by Section 902 of the 11dianai Shores Land
Development and Zoning Code, please c ntact:
iipLae- i
— Print Name
* * * * * * * * * * ** * * * * * * * * * * * * * * * * * * * ** ******* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
Approved
PAGE I OF 2
•
hereby apply Tor a certificate
,Telephone:
Buyer Seller Realtor Company Name
checkNo lz — #/ 00
Denied Date / ?��
I.1eYS being the legal property owner, for the property
Located at: ck L a NC c 2_ SG'_ Wia`h -J 54c;
Legally described as
Do hereby petition the Village of Miami Shores to act as my own contractor pursuant to the laws of the
State of Florida, F.S. 489.103(7),,And I have read and understand the following disclosure
Statement, which entitles me to AVrork as my own contractor, I further understand that I as the owner
must appear in person to complete all applications.
OWNER BUILDER DISCLOSURE STATEMENT
Owner
VILLAGE OF MIAMI SHORES
BUILDING DEPARTMENT
DISCLOSURE STATEMENT
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor
even though you do not have a license. You must supervise the construction yourself. You may build or
improve a one - family or two- family residence or a farm out - building. You may also build or improve a
commercial building at a cost of $25,000.00 or less. The building must be for your own use and occupancy. It
may not be built for sale or lease. If you sell or lease a building you have built yourself within one year after the
construction is completed, the law will presume that you built it for sale or lease, which is a violation of this
exemption. You may not hire an unlicensed person as your contractor. It is your responsibility to make sure
that people employed by you have licenses required by state law and by county or municipal licensing
ordinances. Any person working on your building who is not licensed must work under your supervision
and must be employed by you, which means that you must deduct F.I.C.A. and with - holding tax and
provide workers' compensation for that employee, all as prescribed by law. Your construction must comply
with all applicable laws, ordinances, building codes and zoning regulations.
Proof of ownership provided ( ) initial of reviewing clerk. The foregoing instrument
Was acknowledged before me this 5 day of , 20
By who is personally known to me or who has
as identif, ion and who did take an oath.
Not
Mabel Vargas . i,
Commission #DD231984
"::Q_ Expires: Jul 13, 2007
9 ' .4z7 � Bonded Thru
-- 'i� ' OF f ■
Atlantic Bonding Co., Inc