10080 N MIAMI AVEORES MIAMI SHORES VILLAGE
Building Department
_ =tea r� 10050 N.E. 2nd Ave, Miami Shores, Florida 33138
oin� Tel: 305-795-2204 Fax: 305-756-8972
Permit No. REOCC-04-20-835
Certificate of Re -Occupancy
Address: 10080 N MIAMI AVE
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
" o'
J
y�6
L
Miami Shores Village
Building Department `
11.1050 N,E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 156 8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
RE -OCCUPANCY Permit N. q�C 0
APPLICATION
Contact Name: —Phone#:7& 721 27
Buyer:!� #s Dn.. - !! S
Realtor: RancIP11 SOMQSOn -Company Name:
City:
Miami Shores
State: _ Horida
zip: 33161
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 fie -Occupancy
that may be issued by Miami Shares 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 orl 1 --
Signature• �- -----
The foregoing instrument was acknowledgs�dd before me this
day of20 za , by
who is personally known to me or who has produced Jem,
-r rOnS- As identificat� and w did take an oath
NOTARY Pub [
Sign: � ...
Print: O 0
My Commission Expires -
Building Officials Approval:
EGO
i; tIORAGAL
t. W 00MMIBSIUN # Gt3 387W
pPIPa: May 4, 2023
$W" jay NOWY PUW Wd8lWiWs
Re-Occ $60.00
Notary $5.00_
Total
RFV 4-16