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REOCC-08-23-2064 9338 NW 2 AveMiami 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 ICE -OCCUPANCY APPLIC'ArTION Contact Name: Michael Antkowiak Buyer: Alfonso Miranda Londono Realtor: Sam Chute Property Address:9338 NW 2nd Avenue Permit No. ��-�•'-�3- / Phone#:832 483 5244 Seller: Michael Antkowiak & Dalvane Pires Company Name: Redfin City: Miami Shores State: Florida Zip: 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: Michael Antkowiak Signature: The foregoing ins rument was acknowledged before me this t day of Ash_, 20 Z-7 , by iNl (Gd A(t who is personally known to me or who has produced tv,ti As identification and who did take an oath NOTARY PUBLIC: �� Sign: Print: My Commission Expires: Building Officials A REV 4-10 * MY COMMISSION # GG 950477 EXPIRES: March 6, 2024 BIided Thal Notary Public Undenxdters Re-Occ $60.00 Notary $5.00 Total $