Re-Occupancy Application REOCC-02-23-522��•_": uni�.. ' 3:•-•.tiMr i = .. �i..=c...wUri
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RE -OCCUPANCY
APPLICATION
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
Permit No
BY:
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Contact Name: Alicia Diaz Phone#..305-79.6-7129
Buyer: Enlon, LLC
Realtor: Jack Coden
Seller: Aletha Hardiman
Company Name: Keller Williams Eagle Realty
Property Address:107 Ne 103 St, Miami Shores, FI 33138
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.
App
Sign
The
day
w o is personally known to me or who has produced—UJ3"
As identification and who did take an oath
Sign: 1 I W V it f
Print: M fI
My Commission Expires:
Building Officials
REV 4-10
MERUNECHERY
MY COMMISSION # HH 2522o6
EXPIRES: Apol12,2026
Re-Occ $60.00
Notary $5.00
Total $ IVS7• 0-7)