REOCC-08-24-2007Miami 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: (30S) 762.4949
RE -OCCUPANCY APPLICATION
Permit No. � � � cc— oe 2"-1^ 20C
Contact Name: Ayaniris Noya Phone#: 305.582.0263
Buyer: Vikramjit Singh & Karishma Chopra Seller: Ayaniris Noya & Brian Fuentes
Realtor: Nailan Rodriguez Company Name: New Way Realty Group
Property Address: 580 NE 106 St
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. 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.
ApplicantName*
�jY I Gt �-e S
Signature:
The foregoing' strument was acknowledged before me this
day Of .f1t1�'_tr4s� 20?i� by 1�3i eAv-i i'itL' I�-- ,
who is personally known tome or who has produced
L_ � r- ✓ti S { As identification and who did take an oath
NOTARY PUBLIC:
• .��*9;�.pGe;• WENDY RODRIGUEZ
Sign v �Z(? J ��° Notary Public State of Florida RE-Occ: $60.00
Commission # HH 528689
G� V2 C' v �t '? of F°°e My Comm. Expires May 19, 2028
Print:
Bonded through National Notary Assn. Notary: $5.00
My Commission Expires: Total: �L'0.00
Building Officials Approval: _AA:�'__ ,