REOCC-06-20-1178ORES MIAMI SHORES VILLAGE
-Tow Building Department
?'ES yw 10050 N.E. 2nd Ave, Miami Shores, Florida 33138
1Tel: 305-795-2204 Fax: 305-756-8972
Permit No. REOCC-06-20-1178
Certificate of Re -Occupancy
Address: 575 GRAND CONC
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
Miami Shores Village
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
RE -OCCUPANCY
APPLICATION
Contact Name: Joanna Tesser
Buyer: Raul Arevalo and Bradley Schmidt
Realtor: Joanna Tesser
Property Address:575 Grand Concourse
DECEIVED
JUN 10 2020
BY:
_Ca��D��
Permit No. keccc- b l0 - 2 D -1 I_tS
Phone#: 305-968-6558
Seller: Donald and Susan Budenz
Company Name: Douglas Elliman
City: Miami Shores State: Florida Zip: 33138
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: Donald L. Budenz
Signature, C_
The Foregpiag instrument was acknowledRe4d before me th'''
day of , 20 � by
who is persona]] known to me or who has prod��ujjced
As.iclGntihc ation and wirffdid take an oath
ARY
Sign:
My Commission Expires:
Building Officials
REV 4-10
Ndwy F bbC Sete of Florida
*40
Jerome Hurtak
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Re-Occ $60.00
Notary $5.00
Total $ 4 `,-,