REOCC-04-20-718°Rs�f{�� MIAMI SHORES VILLAGE
up �; i�,: „ Building Department
10050 N.E. 2nd Ave, Miami Shores, Florida 33138
�CaRsv� Tel: 305-795-2204 Fax: 305-756-8972
Permit No. REOCC-04-20-718
Certificate of Re -Occupancy
Address: 118 NW 102ND ST
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:
RECEIVED
Miami Shores Village
Building Department
10050 N.E.2.nd Avenue, Miami Shores, Florida 13138
Tel: (305) 7952204 Fax: (305) 756-8972
INSPECTTON T'S PHON TE' N'r'UMBER- (3,05) 762.4949
RE -OCCUPANCY
APPLICATION
Contact Name: Deborah E. Rubinson or Ulysses Gibson
Buyer
Kristina Joyce Fielder
Realtor: Ulysses Gibson
Property Address:118 NW 102nd Street
API 0 6 2020
f
BY:
Permit No. 4 2G J
Phone#: 305-336-448 _job
-..
Seller: Deborah E. Robinson
(:ornpany Name: The R.E. Resource Grp Inc.
City: Miami Shores State: Flori{ia.
Zip: 33150
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 tine family to reside therein. 1 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, Deborah E. Robinson
Signature: ! l�Jt'1i1t u.� 1'
The fore ❑ing,i ta1tmel7m
nz was acknowledged �rfore e this
dny of ,'20W., by ems! 1 hpLW_7
�n is pw�sanaUi knotivn to n3 r wiio has produced
As identit'icazion and who did take an oath
NOTARY' LIC: ?
Sign. .� -- iE'Z�Ii,J
Print:
My Cmmnuscion Expires: rvv i✓ Z- l /Z c�, 2-/
Kuilding Officials Approval:
REV 4-10
JEHOMFUM -AN
I�.-� -� . Noery i'ut7ilC — ��.reUf Fluri�n
f Cwrurrisserv� R W 162-%3
,.. `Ay clever 5*0.%, r«• ,• ri a,
Re-Occ $60.00
Notary'-
Total $ 60 ' r