REOCC-05-23-1118Miami 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: Scott D. Alexander
Buyer: Florian Jouin
Realtor: Sandra Orlinsky
Property Address:100 NE 92 Street
City: Miami Shores State:
Permit No. M�(% _2_3 - ( ( I?) -
Phone#: 954-232-9021
Seller: Scott D. Alexander and Brenda Kravec
Company Name: Luxe Realty Group
Florida
.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: bcot L1. MxaMqr
Signature:Zf
The foregoing instrument was acknowledged before me this 2
day of May 20 _, by Scott D. Alexander
who is personally known to me or who has produced
�—'N As identification and who did take an oath
NOT
Sign
Print:
My Commission Expires:
Building Officials Approval:
titer ■ CAROLYN CINTRON
' Notary Public . State of Florida
Commission N HH 212800
aFry My Comm. Expires Feb 13, 2026
Bonded through National Notary Assn.
Re-Occ $60.00
Notary $5.00
CD
Total $ �-
REV 4-10