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REOC-3-19-609Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 RE- OCCUPANCY APPLICATION Contact Name: Victor M. De Jesus Buyer: Ruben Dinamarca Realtor: Bernardo Hermilla Property Address: 150 NW 99th Street to FIM Permit No. /P 3 I — C1Vq Phone #: 787 -236 -3548 Seller: Victor M. De Jesus Company Name: Coldwell Banker Residential Real Estate City: Miami Shores State: Florida Zip: 33150 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 AFFIDAVIT: I certify that all the foregoing information is accurate. Applicant N Signature: s The foregoing instrume as acknowledged before me ltis 20 Jai day of rCC , 20 A , by V I (AQV. M . JI. JS who is personally known to me or who has produced ft�1�Q� 11 C4ns-e As i nti ation and who did take an oath ARYIPUBLIC: Sign: Print: My Commission Expi Building Officials A REV 4 -10 YANADY PRIETO MY COMMISSION # FF 214031 _T1 ;.;; EXPIRES: March 25, 2019 Bonded Thru Notary Public Underwriters Re -Occ $60.00 Notary $5.00 - n.m Total $ CURES MIAMI SHORES VILLAGE Building Department rrs =` 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 �Lp1pR Tel: 305 - 795 -2204 Fax: 305 - 756 -8972 Permit No. REOCC -03 -19 -609 Certificate of Re- Occupancy Address: 150 NW 99TH ST City: Miami Shores State: FL Zip: 33150 This certificate verifies that the reference property has been inspected by Miami Shores Village and has been determined to presently comply with schedule of regulations of 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 the premises described herein, or any aspect of such condition, and interested persons are advised and encouraged to make their own inspections of the premises in order to determine the condition thereof. Building Approval