RC06-366 Inspection Worksheet
Miami Shores Village
L- •,� 10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
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Inspection Date: 02/14/2006 Permit Type: Residential Construction
Inspector: Grande,Claudio Inspection Type: Re Occupancy
Owner: FISCHER, DIANNE Work Classification: Re-Occupancy
Job Address: 1173103 Street NE
Miami Shores Village,FL 33138- Phone Number
Parcel Number 1122320310070
Project: <NONE>
Block: Lot:
Contractor:
Building Department Comments
EMILIO VEGA
(786)287-4288
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Inspector Comments
Passed
Failed
Correction
Needed
Re-Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re-inspection fee is paid.
Monday, February 13,2006 Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores,Florida 33138
D �,� Q� Tel: (305)795-2204
RE-OCCUPANCY EOVED Fax:(305)756-8972
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--- Loc ID
Date 2-
Contact
Contact Name L, o Phone# Ze'C a7 y�
Buyer Seller Realtor Com any Name �7,J S0AWP ll
Prfk operty P
Pro e Address A) 0 le � /®
City Miami Shores State Fl zip .3
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 the property.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate.
Applicant Na e tC4je f�o �--
Signature
The foregoing instrument was acknowled,,, ed before�me this I3• day o F3P .x;'20 CDG,
i7;�.C�c 64�A�&6 is��pers ally known to me or who has
produced 1D as identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBT,IU`PA`PR OF FLORIDA
Yorleny Hernandez
mmission#DD476455
Sign: ices: SEE 27 200 Re-Occ. $60.00�L
c Bonding Co.,h
Prin : Notary $5.00
My mission Expires: CCF $0.60
Total CD
Building Officials Approval:
(Rev.10/02/03)
FEB 13 PAID