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REOCC-12-19-2891RE -OCCUPANCY APPLICATION Contact Name: J OVA,\ Buyer: "_�- a 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 M13 Realtor: _ C_ E c 1 C'k A_ C OQ oovn — Property Address: q S %\- o w 2 N-b RA c E c EC [j 5 /<y BY:_ Permit Phone#: ( S o 5) g' 1 Z— 1 Z S�r Seller: S►AAwNc\ Mr q-L0C\C, Company Name: City: Miami Shores State: Florida Zip: 33 t sU 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: The foregoing -nstrument was acknowledged be are m this day of S 2011 'by V A l ji who is pers lly kno(vMidcritification fl' me o who has produced l and who did take an oath Print: My Commi Building Officials Approval: a.� `�',f ��IflT iTAIiEO, 1,04`�,• 11 Re-Occ $60.00 Notary $5.00 Total $ L REV 4-10 ,oF.. RE r�MIAMI SHORES VILLAGE ' eft p Building Department 7Es to 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 N OR11D Tel: 305-795-2204 Fax: 305-756-8972 Permit No. REOCC-12-19-2891 Certificate of Re -Occupancy Address: 9314 NW 2ND PL City: Miami Shores State: FL Zip: 33150 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