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REOC-10-668 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 141086 Permit Number: REOC -4 -10 -668 Scheduled Inspection Date: April 22, 2010 Permit Type: Re- Occupancy Inspector: ioledy" v Inspection Type: Re Occupancy Owner: PANN, JAMES Work Classification: Re- Occupancy Job Address: 9153 NW 1 Avenue Miami Shores, FL Phone Number Parcel Number 113101016008 Project: <NONE> Contractor: Building Department Comments RE -OCC Inspector Comments Passed PLEASE CALL BEFORE GO JAMES PANN 305.495.9355 Failed Correction Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. April 21, 2010 For Inspections please call: (305)762 -4949 Page 16 of 25 Miami Shores Village ARC 2 1 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 Permit No. APPLICATION Contact Name: Phone#: 25 / 55 Buyer: Seller: S ,9iy «J Realtor: f parry Name: Property Address: l �� /�/ l� / X 1/ City: Miami Shores State: Florida Zip: 3 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 I certify that all the foregoing information is accurate. Applicant Name: Signature: The fotfgoina instrument w a owledged be me this day of ,20�,b WIWI wht sonall i kno to me or who has produced identificatio and who did take an oath N C Sign: Print: My Commission Expires: A Building Officials Approval:_ A ©cam Re -Occ $60.00 Notary $5.00 Total REV 4 -10