10 NE 97 STsHRE MIAMI SHORES VILLAGE
Building Department
ES 1 10050 N.E. 2nd Ave, Miami Shores, Florida 33138
Mt
Tel: 305-795-2204 Fax: 305-756-8972
Permit No. REOCC-07-20-1445
Certificate of Re -Occupancy
Address: 10 NE 97TH 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
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RE -OCCUPANCY
APPLICATION
Contact Name:
R-ECEIVEn
Miami Shores Village A 0 9 Zo,,
Building Department BY:_ _
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.13972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Permit No.
C.
Buyer: k ul v n e_ . `� Gi en Seller:
Realtor: , __ Company Name: 1 j�-c:c c.: (- i r + f �� �2 ��
e
Property
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City: Miami Shores State: Florida Zip:
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: 1 certify that all the foregoing information is accurate.
Applicant
Signature:
The foregoing instrument was acknowledged before me this J
day of I202�LQ by
;1
wh it personally known t -mF or who has produced
As identification and who did take an oath
NOTARY PUBLIC:
Sign: . ` Notary POpik SWO W Fk Wo
Angelico DuVa
Print: C: .a._ ` MY Commission or,183830
a �Xoles OaFW2022
My Commission Expires:
Building Officials Approval:
Re-Occ $60.00
Notary $5.00
Total $ .
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