Re-Occupancy Application REOCC-02-23-350Miami Shores Village
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
N Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
TANCY
TION
Permit No. P-E; 0 CC' 02— Z 3' 3 5�V
Contact Name: Amanda Levasser phone#:7862132544
Amanda and Danny Levasser Seller: Comerica
Realtor: n/a
Company Name: n(a
Property Address-490-NE 94th 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: Amanda Levasser
Signature: x 94rA4L4
The foregoing instrument was acknowledged before me this T
clay of �20Z3, by �0.✓l dta.- Lf,%&L SS9S
Who is p nsatally •nown to me or who has produced
As identification and who did take an oath
NOT
Sign:
Print:
My Commission Expires:
Building Officials
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Re-Occ $60.00
Notary $5.00
Total $65.00
REV 4-10