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REOCC-01-20-2 (2)
Miami Shores Village 2,4E�VF_D Building Department JA E 0 Z020 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 Permit No.:hrOC 01—uto APPLICATION Z� ©a -01 -76 - 2- Contact Name: _ �1� VAA) LIA2 Phone#: _� D S 3 E .2&c74 Buyer: kh4ea Du.'iet Seller: AC w �x loc +t� ybl q) L(, c- )4 Realtor: 7AQ DAL) 1,P) Company Name: Property Address: 131; A/1- jq+K St, 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. Applicant Name: QAV_ aa 1 II Signature: The Foreg ing instrument was ack1nowled ed before rite this 2n� day of 01 , 20Z , by 1I iQ Gn .1r1 , who is personally known tome or who has produced identification and who did take an oath Print: My Commission Building Officials Approval: REV 4-10 Ca�Ux #GG287268 ���jI11C, •STA.�,�'o�� Re-Occ $60.00 Notary $15.000 Total $ 1 f� H°RE MIAMI SHORES VILLAGE �W ,j[INT P Building Department 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 At. o Rive` Tel: 305-795-2204 Fax: 305-756-8972 Certificate of Re -Occupancy Address: 135 NE 98TH ST City: Miami Shores State: FL Zip: 33138 Permit No. REOCC-01-20-2 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