REOCC-10-24-2742RE -OCCUPANCY
APPLICATION
Contact Name: Julian Ho
Buyer:
Miami 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) 762A949
in and Jennifer Gomez
Permit No. kEOCe _j()_0q _ 2it(Z
(310)993-4101
Seller: Julian Holguin and Jennifer Gomez
Realtor: Rafael Corrales Company Name: Redfin
Property Address:1059 NE 98th 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: Jennifer Gomez
Signature: CZ2
The foregoing instrument was aln'oowledged before a this 16
day of October 20� by �c4n - -&—
who is personally known to me or who has produced kvj- `aftt,
TO As identification and who did take an oath
NOTARY P
Sign: _
Print: n� i
"� "" Adrian Hidaa go
My Commission Expires: Z!A" SAL Comm MHO 64580
Expires: Nov.17, 2024
Building Officials Approvals" 0F` nded Thru Aaron Notary
tllul- l
REV 4-10
OCT 2,3 Z024
Re-Occ $60.00
Notary $3e6®
Total $ 6, 0 - CO