REOCC-05-23-1318Miami 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: Lawrence Branchetti
Buyer: Corrine Barak
Realtor: Corrine Barak
Property Address: 185 NE 106 Street,
City: Miami Shores
Permit No. QLoM -C6' 2,3 -1-3iG
Phone#: (305) 758-5081
Seller: Lawrence Branchetti
Company Name: The Barak Group
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: awrence
Signature:'"''
The foregoing inst]'ument was acknowledged before me this 9-3
day of f .. 202�, by I _au, C eyle-a
who is personally known to me or who has produced
X>(-►1r..e41:r LL['L As identification and who did take an oath
NOTARY PUBLIC:
Sign:
Print: l v t -e_v\ v\_e_
My Commission Expires: i 311 2-4 z �' :,ram + ,�•`
Building Officials Approval: M?5
r it
Vivienne Yao
comm.0 222410
Expires: Jan. 31, 2026
Notary Public - State of Florida
Re-Occ $60.00
Notary $5.00
Total $ (9 S • 60
REV 4-10