Re-Occupancy Application REOCC-02-23-446Miami Shores Village
�23 Building Department
1 y 10050 N.E.2nd Avenue, Mia ni Shores, Florida 33138
7� Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
RE -OCCUPANCY
APPLICATION
Contact Name: RoberE Bourne
Buyer:
Realtor: Robert J. Bourne
Property
Seller:
Name: RBRE
We
786-281-8376
City: 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.
ApplicantNaAre--f�0bert J. Bourne
Signature:
Theflorepenjinsmanentwas acknowl ged efore me this
y 3 day of P me
who is wn o who has produced_
As identification and who did take an oath
Sign:
My
Bonded Thor
Building Officials
REV 4-10
110N # HH 109171
June 17, 2025
Re-Occ $60.00
Notary 1
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