REOC-09-19-2055Miami Shores Village ` `° 7�4 ED
Building Department `�9
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 13 ��:
Tel: (305) 79 5.2204 Fax: (305) 756.8972
INSPECTION'S PRONE NUMBER: (305) 762.4949
RE- OCCUPANCY Permit No. `O C_ 69 —1
AP'PLICA'TION
Contact Name: +�✓ � cahviobro r305-) ?s
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Buyer:: rl � 2a G� �-t _ L- Q V4 _ Seller: l v 1V ( r5 i m cot
Realtor: C Li Company Name: )4 � � ` e.K W4 LW M
Property Address: ) 0 NC l ` _FC1n_6L ff
City: Miami Shares _ State: Florida Zip: -2 �1
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
The fo instrument was acknowled ed before me this
aayof j', byGGr G+ 0196 r o
who is personally known to me or who has produced VVIVM-3
l e As identification and whoi'd take an oath
NOTARY
Sign: 11
Print:4�.
My Commission Expires:
Building Officials Approval:
REV 4 -10
CHARLES M. KLUCK
4,6o Notary Public - State of Florida
e. , Commission 8 GG 009467
My Comm._ Expires 00 31, 2020
Bunded through National Notary Assn
Re -Occ $60.00
Notary $5.00
Total $
MIAMI SHORES VILLAGE
11, ,7:U1 Building Department
`'mot 10050 N.E. 2nd Ave, Miami Shores, Florida 33138
Tel: 305 - 795 -2204 Fax: 305 - 756 -8972
Permit No. REOCC -09 -19 -2055
Certificate of Re- Occupancy
Address: 910 NE 91ST TER
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.