REOCC-23-1292Miami 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 Permit No. IA3
APPLICATION
Contact Name: Patricia Burton Phone#: 305-934-1684
Buyer: Levar Livingston
Realtor: Myriam K. Louis
Property Address: 534 N.W. 113th Street
Seller: Patricia Burton
Company Name: Daniel Whitebook Real Estate
City: Miami Shores State: Florida Zip: 33168
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
Signature:
jcia Burton
The foregoing instrument was acknowledged before me this 17th
day of May , 20 _, by Patricia Burton
who is;r, •�S2 1pa iy known to me or who has produced
As identi ation and who did take an oath
NOTARY_CY14
Sign: �J*
Print: �''� ► '
My Commission Expires:
Building Officials ApproNal: QI)I"�[?�
REV 4-10
pry MYRIAM K. LOUIS
1 Notary Public • State of Florida
• Commission 2 GG 972307
My Comm, Expires Mar 27, 2024
Bonded through National Notary Assn,
Re-Occ $60.00
Notary $5.00
Total $ 65.00