REOCC-06-20-1201R`�# MIAMI SHORES VILLAGE
Xill Building Department
10050 N.E. 2nd Ave, Miami Shores, Florida 33138
Tel: 305-795-2204 Fax: 305-756-8972
Permit No. REOCC-06-20-1201
Certificate of Re -Occupancy
Address: 10414 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
�Si,,c�c� .mac✓� .,�✓'� � � ' �
RE -OCCUPANCY
APPLICATION
Contact Name:
Buyer:,, GAn 5>w�
Realtor: 44e l t"�v
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
Permit No.
06/11 /2020
RE-OCC-06-20-1201
C 1 Ph,,,#.- 3cf5 - 3321 Y82
99er. H 21 ✓ k Q-� !�Xf f i 'N c#--µ
Company Name: "i A lam • Y e I' 'C
Property Address: A 0"I �j r4 0 qA 1-1, 4 M ! A V 'E - - -
City: Miami Shores State: Florida zip: 3 3 l S 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.
APPUCANT'S AFFIDAVIT: I awtirfy that afl the foregoing information is arcuate.
Applicant [dame: 4el",LS P P ,JC [< .moo 1'e
Signature:
The foregoing instrument was acknowledged before me this . _s
day of L2021by fle i 1'1to+ AYE GkfYi � j��.
who is personally known tome or who has prvduc3edi0c"
O As identification and who did take an oath
NOTARY P LIC'
Sign:
Print: { 2,
My Commission Expires: 1 () �0 %z_aZ.3
Building Officials Approval:
REV 4-10
F Notary Public 5tata of FWida
Lilian Alvaraz
+� My Comm*&!w GG 342329
£xpims 06MBr2023
Re-Occ $60.00
Notary $5.00
Total S