REOCC-06-24-1681Contact Name -
Buyer: _
Realtor:
Property
Miami Shores Village - BUILDING DEPARTMENT
10050 NE 2 Ave Miami Shores, FL 33138
305-795-2204 www_ ms�
RE -OCCUPANCY APPLICATION
l� Permit No. REOCC- d�¢ - l(o�l
1�QU� 6 .Phone: z$6,37,E
seller:
Company Name:
City: Miami shores „State: Florida
Zip:
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 familyto 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. in addition, I acknowledge the requirement
for a swimming pool barrier to be in place and in compliance with code requirements at the time the pool was
constructed, repair and or re -surface.
APPLICANT'S AFFIDAVIT: I certify that all the foregoing Information is accurate.
Applicant
Signature:
The foregoingin Iumentwas acknowledged before -mg this
day
who I ersona y know ho has produced
.� As Identification and who did take an oath.
My Commissich
Building
(REV
MY COMMISSION # HH 109171
EXPIRES; June 17,2028
Bonded Thm NotM Pubk Unlenrdim
ZENTEHBD
Applico^tioi,
RE-Occ: $60.00
Notary, -%ea
Total: &O' CYO
Rage 1 of 1
JUN ' 2024
BY: