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REOCC-08-23-2065 9326 NW 2 AveRE -OCCUPANCY APPLICATION Contact Name: Miami Shores Village Building Department 10-050 N.E,2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795,2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 lleana Gagliardi Buyer: Lizette Bemadin Realtor: Cynthia S. Palmer Property Address•9326 NW 2nd Ave City: Miami Shores State: Permit No./1 Oee op,— 23 -- 26b5_ Phone#: 305-710-5417 Seller: lleana Gagliardi Company Name: Berkshire Kathaway Home Services Florida Realty Florida . 33150 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: l!qp& Gagliardi Signature. V• The foregoing i ru4s acknowledged before me this -12L day of A,5e,5L. 20.& , by who is personally known to me or who has produced 124�9 D L As identification and who did takc an oath NOTARY PUBLIC: Sign: Print:. �S-e,2 (C�a-- My Commission Expires: ! i / A Building Officials Apprriv 5waiz Khan PRINCE GEORGE SCaUNry MYC0MMI5510NEXPJR S 11/16/2028 Re-Occ $60.(K) Notary $5.00 Total REV 4-10