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REOC -05-19-1183Miami 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: Isabella Petruzzelli Buyer: Angelo Masarin & Veronica D Alicea Realtor: Jack Coden '�EcE �� MAY 2 3 20 119 MIX z Permit No. loo(:, . 0 -1I " 1 133 Phone #: 786- 301 -6411 Seller: Denise O'Brien & Didier Gerard Company Name: Keller Williams Eagle Realty Property Address: 62 NW 108 St, Miami Shores, FI 33168 City: Miami Shores State: Florida Zip: 33168 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 Name: Isabella truzzeIIi Signature: IIlk /�`l The foregoing instrument was acknawler3ged hefar a this day of l . 20 11, by °1 �l _V (!ZG•f Il j who is personall nown to me or who has produced )Y NNE 1 l l 0,40k.-A.5 identification and who did take an oath NO AR PUBLI Sign: Print: V kk C 0 My Commission El. res: t Building Officials Approval: REV 4 -10 Re -Occ $60.00 Notary $5rr .00 Total $ l S v aREs MIAMI SHORES VILLAGE Building Department =� 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 Tel: 305 - 795 -2204 Fax: 305 - 756 -8972 Permit No. REOCC -05 -19 -1183 Certificate of Re-Occupancy Address: 62 NW 108TH ST City: Miami Shores State: FL Zip: 33168 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 a el