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REOCC-08-24-2263Contact Name: Miami Shores Village - BUILDING DEPARTMENT 10050 NE 2 Ave Miami Shores, FL 33138 305-795-2204 www.msvfl.gov RE -OCCUPANCY APPLICATION Permit No. REOCC- 2-`4' 2-2_kP_3 P1 one�:2'61�) / ©4`_42 C'�? Buyer: Seller: � �rA--7E L .�' c--W,�- -:T V. �; � I � Realtor: �A��r c_E� i.-��j' CompanyName: Property Address: 2�, r� J City: Miami Shores State: Florida Zip: 13d 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. Applicant Name: Signature: Thhe foregoing instrumen day of who is rson0yk=wn NOTARY PUB Sign: Print: --A My Commission Expires: was acknowledgecrbVore me this As identification and who did take an oath. Building officials Approva - (e of k Hu .- �nro'J8h ,ational 7 es Mar 6' 2028 Notary Assn. RE-Occ: $60.00 Notary: $5.00 Total: tiff 1