REOCC-06-23-1447RE -OCCUPANCY
APPLICATION
Contact Name:
Buyer: Cuili Deng
Realtor:
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
Nelson Gonzalez
Permit No.j
Phone#: 305-674-4040
Seller: Coral Coastal LLC
Company Name:
Property Address:1184 NE 91 Terrace
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: Nelson Gonzalez
Signature:
The foregoing instrument w . ged befot-e me this 6
w e
day of June 20-2, by Nelson Gonzalez
Who is personally known to m or who has produced
As identification and who did take an oath
NOTARY PUBLIC:
Sign:
Print:
Pat Bravo
My Commission Expires:
a 7
Building Officials Approval: �>?
REV 4-10
't►Av PATBRA4o
_� Notary Public - State or Florida
�' Commission N GG 93M,
wha►n�'` Ay Comm. Expires Nov 18, 2023
Bonded through National Notary Assn.
Re-Occ $60.00
Notary$§-.�90 --41—
Total$ �Q,00