REOCC-04-20-765�ORES MIAMI SHORES VILLAGE
Iwo 111 ,. 1 Building Department
10050 N.E. 2nd Ave, Miami Shores, Florida 33138
0RibPTel: 305-795-2204 Fax: 305-756-8972
Permit No. REOCC-04-20-765
Certificate of Re -Occupancy
Address: 10804 NW 2ND AVE
City: Miami Shores
State: FL
Zip: 33168
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
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Miami Shores Village
Building Department
10050 N.E.2nd Avenue, A9iami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.9972
INSPECTION'S PHONE NUMBER: (305) 762.4949
RE-OCCUPANCYPermit No
APPLICATION
Contact Name: Angela M.Henao _ _Phon(*: 3057932495 Buyer: _—
Luis F. Cadena Seller: Angela M. Henao & Carlos Torres
. _ _ _._
Realtor: Juan Zuluaga C'ompanv Name: Graber Group
Property Address;10804 NW 2nd Avenue
City. Miami Shores _ State: Florida _ _.Zip: 33188
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.
ApplicantName:A la K H ao
Signature:
The foregoing inst ent was acknowledged before me this 4
day of April , 20 1�1, by
who is personally known to me or who has produced
As identification and who did take an oath
NOTARY-PUBW.
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Print:
My Commisssi6n Expires: 5-- 4- 9 rO Z D
Building Officials Approval:
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Re-Occ $60.00
Notary $5.00
Total $
REV 4710