Re-Occupancy Application REOCC-04-23-975i � ,-,
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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
RE -OCCUPANCY
APPLICATION
Contact Name: Mariel Baigorria
Permit No.
305-790-8432
Buyer: Alberto Velarde Gutierrez, Marisol Campillo Seller. Vasco P B Lopes Da Silva, Maria Jose Rubio
Realtor: Mariel Baigorria
Property Address: 909 NE 99 St
Company Name: United Real Estate- Miami
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: Mcnezej gwofi4gil
Signature:
The foregoing instrument was ackpopledged before me this
day of L0 Z, by ek eC�GD0�a
who is erp sonally known to me who has produced
As identfilf
cati%` nd ` 'o did take an oath
NOTARY PUBLIC: n I An ?
Sign: Y
f. ,'; HEOMMARTINEZ
Print: '• '•� MY COMMISSION# HH 323276
My Commission Expires: `'?+ EXPIRES: oolobw 16, 2026
Building Officials
Re-Occ $60.00
/�- Notary $5.00
Total $
REV 4-10