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REOCC-03-20-562MIAMI SHORES VILLAGE Building Department yW 10050 N.E. 2nd Ave, Miami Shores, Florida 33138 ORION Tel: 305-795-2204 Fax: 305-756-8972 Permit No. REOCC-03-20-562 Certificate of Re -Occupancy Address: 10151 NE 14TH AVE 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: 0� fl0le,J2 0 RE -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 RN'Ma EU MAR 13 2020 BY: G�� - - — Permit No. - 03- 2C)-5(,P2 Contact Name:(2114� / � Phone#: - 99&3 ` 6 3%D 2 Buyer: II )IJ q- 6/fA4ir___ Seller: e— Realtor: S �ha S717 Cif Cis Company Name: Property Address: X16; IV 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 Signature: The foregoing ins,/ ent"Cvas acknowledged before me this 13 day of llZ9§ , 20 &), by _r� L- C A-7A who is personally known to me or who has produccd_ � �1,,J(,J'L identification and who did take an oath NOTAR UB ARLENIS SILVERA Sign: ;* .: 1' COAtAAISSiQH.#_(dG.95� Print: EXPIRES: Merch B, 2024 My Commission Expires: Building Officials Approval: Re-Occ $60.00 Notary $5.00 Total $ REV 4-10