RE-OCC-04-20-701 800 NE 95 STRit MIAMI SHORES VILLAGE
.TIli� �ii.f III" Building Department
` _Yw 10050 N.E. 2nd Ave, Miami Shores, Florida 33138
�ORION
Tel: 305-795-2204 Fax: 305-756-8972
Certificate of Re -Occupancy
Address: 800 NE 95TH ST
City: Miami Shores
State: FL
Zip: 33138
Permit No. REOCC-04-20-701
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 VillagervED
Building Department APk( 02 A1.2o
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY,
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
RE -OCCUPANCY Permit No. t=e�� - C)I -2(D-10I
APPLICATION
Contact Name: JGb1T F- P44W1 N Phone#: 30S -(p0 %-87r9
Buyer: ti,e __C� -- __ Seller: � f� P K. �II- Oe- -qk
Realtor: AlavfO �Q� //k"O Company Name: S
Property Address: f 0Q � U, &&/►#Xr
City:
Miami Shores
State: Florida Zip: 33/3 P
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 instrument was acknowledged before me this
day Of 20toby SCn
who is personally known to me or who has produced
As identifi at
ion and who did tak an oath
NOTARY PUBLIC:
Sign:
Print:
My Commission Expi s ARLENISSILVERA
MY COMMISSION # GG 950477
s r'91 EXPIRES: March 6, 2024
Bondod Building Officials Alp �' 0rd Re-Occ $60.00
Notary $5.00
Total $
REV 4-10