REOC-06-19-1468Miami 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: Jeff Koebel
RECEIVED
J 2 LBY,.
i'
Permit No.A4 K - (� 1q ) ! 0'J
►s--) &
305 - 892 --9t-1-
Buyer: Suzan Lam & Nunzio Casalinuovo Seller: James B & Jennifer Merr
Realtor:
Jeff Koebel
Property Address:
879 NE 97th ST.
City: Miami Shores
Company Name: Montgomery & Koebel, Inc.
State: Florida Zip:
33138
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
Signature:
The fore26
James a Merry
was acknowledged bore me this 25th
day of June , 20 1 9, by James B Merry
who is personally known tome or who has produced drivers
license As identi ication and who did take an oath
MOT Y UBLIC:
Sign:
Print: Herminia Marrero
My Commission Expires: 9/25/2022
Building Officials Approval:
REV 4 -10
HERMINIA MARRERO
•`i Notary Public - State of Florida
CommisSion ti GG 239452
?or�r� My Comm. Expires Sep 25, 2022
����8onded through National Notary Min,
Re -Occ $60.00
Notary
Total $ l Q .o0
5 ORES
.� MIAMI SHORES VILLAGE
ma, ,i, Building Department
m 10050 N.E. 2nd Ave, Miami Shores, Florida 33138
®sit'
Tel: 305 - 795 -2204 Fax: 305 - 756 -8972
Permit No. REOCC -06 -19 -1468
Certificate of Re- Occupancy
Address: 879 NE 97TH ST
City: Miami Shores
State: FL
Zip: 33138
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