REOCC-09-24-2501Miami Shores Vikage
RE -OCCUPANCY
APPLICATION
Contact Name: Isael Prieto
Building Departrrent
10050 N.E.2nd Avenue, Miami Shores, Flo :da 33138
Tel: (305) 795.2204 Fax: (305) 756.E2'-')72
INSPECTION'S PHONE NUMBER: (305) "'62.4949
Permit W-, � 0C Dq_zq -Z��b 1
Phone#: 786-570-0455
Buyer: Darian Betancourt Seller: 201i 2 IH BORROVdER LP _
Realtor: Isael Prieto Company Nam(- Able CRE
Property Address: 124 NE 110 St
City: Miami Shores State: Florida _ _"—Zip: 33161 _
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 AFOAVIT: I certify e o information is accurate.
Applicant N,im
Signatu
C�e�d
The foregoing instrument was acknowledged before me this
day of4r—, 20a-q, by
who is personally known to me or as produced QrV --r�
7ARO
s ide ification and wh did take an oath
NOTC: ;;Ni+'ii�•� MIGUELABINADER
iiTT �Ps Notary Public - State of Florida
Sign: Ia`, Commission # HH 521096
Print: ! k;!G% ky9ry r _ao
My Commission Expires: � Jip— d-6
Building Officials
46
REV 4-10
SEP 2 5 2024
Re-Occ S60.00
Notary $S.00
Total
24