REOC-10-830 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 143030 Permit Number: REOC -5 -10 -830
Scheduled Inspection Date: May 13, 2010 Permit Type: Re- Occupancy
Inspector: Bruhn, Norman Inspection Type: Re Occupancy
Owner: KIRBY, MICHAEL Work Classification: Re- Occupancy
Job Address: 10565 NE 2 Court
Miami Shores, FL
Phone Number (305)751 -7467
Parcel Number 1122310130590
Project: <NONE>
Contractor:
Building Department Comments
Inspector Comments
Passe SS PLEASE CALL
._/ DON MILLER
305- 776 -7863
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
May 12, 2010 For Inspections please call: (305)762 -4949 Page 16 of 25
Miami Shores Village MAY 1 1. "010
Building artMent ��:......
.10050 NX.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
R E -OC CUPAN CY Fax: (305) 756 -8972
]PLICATION : Permit N®. wO G 10 63b
Date _54j_ '2. &,xC
Contact Na w e, 1 ® Phan # 3 CNS - "� �° -_7 ,
Buyer Seller Realtor Company Name L1 Deg,►
Property Address 1 p t S
City Miami Shores State Fl Zip 25
I hereby certify that I understand that the zoning of the 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 NEami 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:
OV ER'S AFFIDAVIT: I certify that all the foregoing information is accurate.
Applicant Nam _ •� �1.Q
Signature I ���.��
The foregoing instrument was acknowledged before me this / I day of 84 _ 20 10
by ®� I'�,����; who is onall kno me or who has
produced as identification and who did take an oath.
NOTARY PUBLIC:
Sign: J Re -Occ. $60.00
Print:
lhilpe • aw ar ft Notary $5.00
in 24
My Commission Expires: ®�r,�y�/ 3 �'' C I 00SW CCF $0.60
Total
Building Officials Approval:
v. 10/02103)
WWA Von*