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REOC -05-19-1215Miami 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 ILL - OCCUPANCY APPLICATION Contact Name: Buyer:�.� 1 Y2ECEIVED Y 2 8 2019 Permit No. l Seller: r4 ;-7zl� - �/00 -36J5 Realtor: r 641 a L4'"I Company Name: 63PI (j 7kL -- . j�' Property Address: �j LIJ 9 11�1 k City: Miami Shores State: Florida Zip: 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. A<A7— ✓l 41L, � Applicant Name:' l� 1 a — Signature: The Foregoing instrument was acknowledge d before this G C day of. y 20 ft, bylrVr`k N who is personally known to me or who has produced As identification and who did take an oath NOTA14Y PUBLIC: Sign: _ Print: My Commission Expires: Building Officials REV 4 -10 slMm ALVAREZ mmissim li 00 23827) iES: September ,3, 20 Re -Occ $60.00 Notary $5.00 Total $ (95 • M °R MIAMI SHORES VILLAGE Building Department tires�N °� 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 Tel: 305 - 795 -2204 Fax: 305 - 756 -8972 Permit No. REOCC -05 -19 -1215 Certificate of Fie - Occupancy Address: 34 NW 97TH 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: