OCCUPANCY11 -12 AS PER CLAUDIO GRANDE
` iqa
Passed
d
I nspector Comments
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Inspection Date: 09/11/2006
Inspector: Grande, Claudio
Owner: HOMES, LLC, OM
Job Address: 525 92 SI j1E
Project: <NONE>
Contractor:
Miami Shores Village, FL
Building Department Comments
Thursday, September 7, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Residential Construction
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Phone Number (305)758 -0775
Parcel Number 1132060141130
Lot:
Page 2 of 2
(Rev. 10/02/03)
Jai S i 0 5 E
BY: ' JUL
e°oa°eeo
RE— OCCUPANCY
APP—
Date Z0 O
Contact Name h
Buyer
Property Address
Sign:
Seller
City Miami Shores
Miami Shores Village
Building Department
sz5 72_
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.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate.
Applicant Name Le 7-.J
Signature
Print:
My Commission
cA
fres:
Realtor Company Name e_J ( C2-- Li II 1 &„4,i
State Fl
Zip f3
— �'_ermit 11to (ZiCrr
Loc ID
Phone# 6S 4 `tqa s
The foregoing instrument was acknowledged before me this 5 day of Sep 0 " , 20
by , who is personally known to me or who has
produced as identification and who did take an oath.
NOT PUBLIC:
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Building Officials Approval:
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
Re -Occ. $60.00
Notary $5.00
CCF $0.60t—
Total 6 c
• — � - - swk S e c u r i t y e n h a n c e d d o c u m e n t . S e e S a c k for
2290
RJ BOURNE P.A 07-04
786 -281 -8376
285 N.E. 100TH ST.
MIAMI SHORES, FL 33138 -2418
DATE Yd � � ,� t
M i ,y �` OF � ,. 1.. (tU1,�` �'�
BankofAmerica
ACH R/1' 083100277
FOR
it
11'00 2 29011' '.0630000471: 00549
a.=LT_S.
63 -4/630 FL
1375
DOLLARS 8 i =gym