REOC17-1906 APPMT 2
iarm' Shores Village
Building Department
10050 N.E..2nd Avenue, Mimi Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
RE—OCCUPANCY Permit No.Tt(Q�_ ` 1 CIO
APPLICATION
I hereby certify that I understand that the zoning for this 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 the property.
APPLICANT'S AE"II)AV'IT: I certify that all the foregoing information is accurate.
20 tN e co a (P (10 LPC ae 5
Building Officials Approval:
REV 4-10
L* cps
MARnU RAMOS
Notary Public, State of Florida
Commission# FF 939596
Mr Comm. Wes Nov. 30,201 9
Re-Occ $60.00
Notary- HQ::
Total $ �d