REOCC-04-20-750°R'. MIAMI SHORES VILLAGE
�iii i a�ipieii Building Department
` Nr N 10050 N.E. 2nd Ave, Miami Shores, Florida 33138
f�ORIV Tel: 305-795-2204 Fax: 305-756-8972
Certificate of Re -Occupancy
Address: 383 NE 97TH ST
City: Miami Shores
State: FL
Zip: 33138
Permit No. REOCC-04-20-750
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
RE -OCCUPANCY
APPLICATION
Miami Shores pillage
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
TE C EI VED
AF' 10 2020
BY:
Permit No.
(J _G) -2L -_� 5b
Contact Name: VMC_P_r)+ Tn'L6i l CA- . Phone##:'�Q5; - a - 51,71 f
Buyer: Seller: D Gxr v D i. o L Ca �LJ
Realtor: C_eyl T -:17WIO V.+'G. i C, Company Name: &C4 O(A
aWCJ.I �
Property Address: 3 83 N, 9 7t' s�ee-4 7
City:
Miami Shores
State: Florida Zip: 22 0
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.
11
Applicant Name: y-:y1 / 'y 1 6�_ do
Signature:
The foregoing in rument was acknowledged before me phis 16
day o i 20,21L by
who is personally known to me or Sc has produced
As identification and who did take an oath
N A �U LIC:
Sign:
Print: �
My Commission Expires:
Building Officials Approval:,
REV 4-10
t Y, t. • NANCYGOLDRING
my cQmmtSSION # GG 059069
EXPIRES: February 15, 202f
OF FL� BpgdBC{ TAru 8u.goi %,Cle ry Swv$C7s
Re-Occ $60.00
Notary $5.00
Total $