RC06-2303i nspection Number: INSP -26356
Inspection Date: 09/11/2006
Inspector: Grande, Claudio
Owner: BERRY, MARY
Job Address: 464 91 Street NE
Project: <NONE>
Contractor:
Friday, September 8, 2006
Miami Shores Village, FL
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
2 MI
Block:
Permit Number: RC -9-06 -2303
Permit Type: Residential Construction
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Phone Number (305)754 -5783
Parcel Number 1132060190030
Lot:
Page 1 of 2
Passed g
�IQ 0
Inspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
i nspection Number: INSP -26356
Inspection Date: 09/11/2006
Inspector: Grande, Claudio
Owner: BERRY, MARY
Job Address: 464 91 Street NE
Project: <NONE>
Contractor:
Friday, September 8, 2006
Miami Shores Village, FL
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
2 MI
Block:
Permit Number: RC -9-06 -2303
Permit Type: Residential Construction
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Phone Number (305)754 -5783
Parcel Number 1132060190030
Lot:
Page 1 of 2
Rev. 10/02/03)
RE- OCCUPANCY
APPLICATION
Date
City Miami Shores
Sign:
Print:
My Com
`ssion Expires:
Building Officials Approval:
Miami Shores Village
Building Department
State Fl
•r I■• F:;• ;i
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate.
Applicant Name � � -' &a,74_/-0
Signatur
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
Permit No. ,IJ
Loc ID
Contact Name �' � ` �� � � �' � Phone # 6 ca ct 3 «<S
Buyer Seller Realtor Company Name c// Q/
Property Address
Zip
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 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.
The foregoing instrument was acknowledged before me this day of Se= 17 , 20C
by , who is personally known to me or who has
produced as identification and who did take an oath.
TARY PUBLIC:
%2qq
Re -Occ. $60.00
Notary $5.00
CCF $0.60
Total (0.5z2/0