REOCC-04-24-1067r
Miami Shores Village
Building Departm0nt
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 1
Tel: (305) 795.2204 Fax: (305) 756.8972 J
INSPECTION'S PHONE NUMBER: (30S) 762.4949
RE -OCCUPANCY Permit No. I Eue ()q-
APPLICATION
Contact Name: Mario Pacheco Phone#: 305-342-9908
Buyer: Todd Schefflin Seller: Jovany Bandomo
Realtor: Mario Pacheco Company Name:
Property Address: 9314 NW 2 PL
EXP realty
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
Signature:
The foregoing i rumkint was acknowledged before me this
day ofko6l, w2 by Mot in ;kbm
who is personally known to me or who has produced
UCCOSe- As identification and who did take an oath
NOTA UBLIC:
Sign: o1I` • M
Print: 4pr l Avg xan.l EoveiverveiG
My Commission Es - - -
Building Officials
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�a yERISELLABIGAILECHEVERAIA
j ? Notary Public• State of PbrW
'CowCotnmlfsion 1 HH 479104
'..an ,% ry Comm. Explrts Jan 10. 2028
Bonded throu/h National Notary Ann.
Re-Occ $60.00
Notary
Total $ �0.°�
REV 4-10