Re-Occupancy Application REOCC-01-23-216�osNORes MIAMI SHORES VILLAGE
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Building Department
- 10050 N.E. 2nd Ave, Miami Shores, Florida 33138
F10R/Dp
Tel: 305-795-2204 Fax: 305-756-8972
Certificate of Re -Occupancy
Address:
395 NW 111TH TER
City:
Miami Shores
State:
FL
Zip:
33168
JAN
BY:
Permit No. REOCC-01-23-216
This certificate verifies that the reference property has been inspected by Miami Shores Village and has
been determined to presently comply with schedule of regulations of Miami Shores Land and
Development Code pertaining solely to the requirement that each one -family dwelling is used and
intended to be used for a one -family dwelling purpose only; however, this certificate does not constitute
any representation or warranty as to the condition of the dwelling or other structures on the premises
described herein, or any aspect of such condition, and interested persons are advised and encouraged to
make their own inspections of the premises in order to determine the condition thereof.
Please avoid unnecessary expenses.
As per section 6-4 of Miami Shores Village Code of Ordinances and section 105.1 of the 2020 Florida Building
Code, Permits are required for New, Alteration, Modification and Renovations. Please visit our web site or contact
the Miami Shores Building Department at 305-795-2204 for requirements before you start a project. Buildings and
structures located in a flood hazard areas may be subject to higher standards.
Building Approval:
Sew
r% C0-c
RE -OCCUPANCY
APPLICATION
Contact Name:
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) 762.4949
Y. 4J:J� - IV +AID
Ji- N
BY:
Permit No.
i
Buyer: Seller:
Realtor: Elia Isidron
Company Name: Keystone Realty Enterprises Inc.
Property Address:
tty: 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 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:ii"
Signature:
The fore oing instrument was cknowledged before me this 241
day of 7`f , 2027, by Xu 4_ a, f r►�f
who is personally known to me or who has produced
As id cation and wIt did take a�' joath
NOTARY PUBLIC: / / ��t
Sign:
Print-.
My Commission Expires:
Building Officials Approval:
REV 4-10
ARLENIS SILVERA
_W 0,9MISSION # GG 950477
EXPIRES: March 6, 2024
Bonded Thru Notary Puhso unne..M.e.
Re-Occ $60.00
Notary 0
Total
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