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REOC 06-19-1267Miami Shores Village Building Department JU" ° zo, 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: Esaie Dumervil Permit No. O(- L9 i " Phone #: 786- 266 -0877 Buyer: Camila Kallmann and Sebastian Aguirre Seller: 45 NE 103RD STREET LLC Realtor: Madeleyne Sutton Property Address: 45 NE 103rd Street City: Miami Shores Company Name: ONE Sotheby's International Realty 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 Name: Elvis Dumervil on behalf of 45 NE 103rd Street LLC Signature: The foregoing instrument was acknowledged before me this day of�Z4,I 3 , 20 /'�, by who is personally known to me or who has produced As identification and who did take an oath NOTARY PUBLIC: Sign: Prisit My Commission Expires: C)LJ'1 ©Cjf 2-2— Building Officials Approval: REV 4 -10 ZZOMC/90 saAX3 r y +v :i� 9S LC ''1;) U09'ZS1LU 00 dVq e1naewwi Re -Occ $60.00 Notary 5.00 Total $ °R Is 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 -06 -19 -1267 Certificate of Re- Occupancy Address: 45 NE 103RD 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