REOCC-08-23-1979 173 NW 107 STMiami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795,2204 Fax: (305) 756.8972
INSPECTION'S PRONE NUMBER: (305) 762.4949
RE -OCCUPANCY
APPLICATION
Contact Name: Esther Pierre
Buyer: R&M Investments Property Group
Realtor: Esther Pierre
Property Address:173 NW 107 Street
City: Miami Shores
RECEIVED
AUG 0 ® 2023
BY:
Permit No. PEDCZ - UQ' —Z3 - 1 q7q
Phone#: J? O5 M 373E
Seller: Jarrett & Jarrell Jenkins
Company Name: EXP Realty, LLC
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:
'�
The foregoing instrument WVas acknowledged before me this I b
day of 1''y .20 L3 , by
who is personally known to me or who has produced
D{' Y e 3 As identification and who did take an oath
NOTARY PUBLIC:
Sign: l 1 �— � L
Print: t (► v ► -e_Yl V--e
My Commission Expires:
Building Officials Approval:
ti.�+�Y`p���•.,, VivienneYao
- Comm.AH 222410
Expires: Jan. 31, 2026
aF`;,�.' Notary Public • state of Florida
Re-Occ $60.00
Total $ (00.0
REV 4-10