REOCC-05-20-909ORES MIAMI SHORES VILLAGE
Building Department
=Y� 10050 N.E. 2nd Ave, Miami Shores, Florida 33138
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Tel: 305-795-2204 Fax: 305-756-8972
Permit No. REOCC-05-20-909
Certificate of Re -Occupancy
Address. 499 NE 102ND ST
City: Miami Shores
State: FL
Zip: 33138
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
REGF_,IVF_',D
MA o 5 : ��, Miami Shares 'Village
Building Department
BY: 10050 AI EIM Avenue
Miami Shores, Florida 33138
�T �(T Tel: (305) 795-2204
RE —OCCUPANCY Fax: (303)756-8972
APPLICATION Permit No._��C- Off, 20 _ '�TIC
67
z..oc lod
Date -3-D� t7
Contact Name 1 Phone # r ��
Buyer Seller Realtor �% Company Name
Property Address _ LJ-9i" +J 0
City Miami Shores State Fl Zip ��?I Z
I hereby certify that I understand that the zoning of the 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 Mianii 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.
OWNERIS AFFIDAVIT: I certify that ail the foregoing information is accurate
Applicant Name
Signarure
The foregoing instrument was acknowledged before me this -3 � day of 7tp . t 20
by who i ersanally kna o me or who has
produced as identification and who did take an oath.
NOTARY PUBLIC:
Sign:- :.. <_ x" :� T
Print: �.o z✓c, �:� st
My Commission Expires: 1
Building Officials Approval:
Rev, 10!02103)
E
LISA CHRISTINA FLORES
Notary Public - State of Florida
Commission A GG 286706
My Comm. Expires Jan 28, 2023
ded through National Notary Assn.
Re-Occ. $60.00
Notary $5:ft
CCF 3"Q__
Total 4