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REOC-19-2221RE- OCCUPANCY APPLICATION Miami 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 Permit No. I C) - a 9 9- l b 3 a 'qa 1 133 5 Contact Name: Phone#:(9 30! 301 OZ ion Buyer: Seller: / 'vje,`\ 1 ASS(aC_. Realtor: —Company Name:-- `�-M -_ Property Address: .�:? 3 A cF 10 v�� S'C City: Miami Shores State: Florida Zip: 33 I '_', l 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: Signature: t� The foregoing instrument was acknowledged before me this z3 day of -- "6F 20 [G1 , by Li4 I S VvLpt'(j who is R6ionally known to me rwho has produced As identification and who did take an oath NOTARY PUBLIC: Sign: C_ rLQ Print: C � \ V 6 VI cu- My Commission Expires J c6, VL c) k-&— JLlky z-� , zoo 3 Building Officials Approval: REV 4 -10 Re -Occ $60.00 Total $ CQ C) c._14� H °R MIAMI SHORES VILLAGE Building Department }it x.1111f� ``-41 10050 N. E. 2nd Ave, Miami Shores, Florida 33138 .0L ©RinA Tel: 305 - 795 -2204 Fax: 305 - 756 -8972 Permit No. REOCC -09 -19 -2221 Certificate of Ike- Occupancy Address: 73 NE 108TH ST City: Miami Shores State: FL Zip: 33161 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. MIAMI SHORES VILLAGE Building Department 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 4E" rE SiN -�� R1 Tel: 305 - 795 -2204 Fax: 305 - 756 -8972 Permit No. REOCC -09 -19 -2221 Certificate of Re- Occupancy Address: 73 NE 108TH ST City: Miami Shores State: FL Zip: 33161 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: