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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