REOC-10-910 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP 144060 Permit Number: REOC -5 -10 - 910
Scheduled Inspection Date: May 24, 2010 Permit Type: Re- Occupancy
Inspector: Bruhn, Norman Inspection Type: Re Occupancy
Owner: MENDER, VERA Work Classification: Re- Occupancy
Job Address: 249 NW 91 Street
Miami Shores, FL 33150- Phone Number
Parcel Number 1131010331330
Project: <NONE>
Contractor:
Building Department Comments
Inspector Comments
Passed PLEASE CALL
r PETER CHADWICK
305 -632 -9579
Failed et�
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
May 21, 2010 For Inspections please call: (305)762 -4949 Page 26 of 39
Miami Shores Village a m a m g y
Building Department MAY 2 0 2010
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 ]BY: �......
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (3057 762.4949
RE- OCCUPANCY PermitNo. Io —'�I b
APPLICATION
Contact Name: 4 �i ��/1/ C Ana Ana G Phone#: 3 S G 52 q 9
Buyer: 1�nn p Seller: VeY3 R'6
Realtor: /�eZ 6e(nd kk Company Name: /(eLl-&- aor �'O'
Property Address: �? * /V t.] 9 / 5 � _ S 11
City: Miami Shores State: Florida
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. l 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: 4X dr
Signature:
The foregoing instrument was acknowledged before me this
day of , 200, by ?(Ok ..
who is personally known tome or who has produce
As identification and who did take an oath
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires:
Building Officials Approval:
Re-Occ $60.00
Notary $5.00
Total $ (p 5
REV 4 -10 r �QA c�)