REOCC-06-24-1566Miami 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 Permit No !Fcolz - bfo -Z
APPLICATION
Contact Name: Tracy Mohr Pttone#:(305) 281-8869
Buyer: Ignacio Agate and Morgan Freret Seller: New Ventures Inc
Realtor: Liz Hogan Company Name: Compass
Property Address: 1181 NE 97th Street
City: Miami Shores State: Florida Zip. 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: Ignacio Agote
Signature:
The foregoing instrument was acknowledged before me this
day of ,:rOAP 20,149, by A&,W ZO 04(007 � .
who is personally known to me or who has produced Ni D f—
identification and who did take an oath
NOTARY PU
1
RONAID E HOFMANN
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Notary Public - State of New York
Sign;
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No. 01H00018356
Print: /A'f�1D E,
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Qualified In Querns County
My Commission Exptres Dec 10, 2027
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My Commission Expires:
Building Officials Approval:
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Re-OCc $60.00
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REV 4-10