REOC-10-91 r
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
In spection Number: INSP - 133863 Permit Number: RPEOC- 1 -10 -91
Scheduled Inspection Date: January 21, 2010 Permit Type: Re- Occupancy
Inspector: Bruhn, Norman Inspection Type: Re Occupancy
Owner: CUADROS, BRIGITTA Work Classification: Re- Occupancy
Job Address: 226 NW 93 Street
Miami Shores, FL 33150- Phone Number
Parcel Number 1131010331080
Project: <NONE>
Contractor:
Building Department Comments
Inspector Comments
Passe M'�j_ BRIGITTA CUADROS
786- 507 -5727
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re4nspection fee is paid.
January 20, 2010 For Inspections please call: (305)762 -4949 Page 19 of 25
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
RE- OCCUPANCY JAPE 2 0 2010 Fax: (305) 756 -8972
A P P L T CAM 00 w BOG 10
Date
2-0 Y 1 0 Loc ID
Contact Name G avi l a � fi &6P I 14 / Phone 0S � 3SJU
Buyer x Seller Realtor , Company Name
Property Address Z �v
City Miami Shores State Fl Zip
130-t
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.
r
Applicant Name V v, lW ac
Signature --
i
The foregoing was acknowledged
produced v as identification and who did take an oath.
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NOTARY PUBLIC:
Czr
Sign: \\ X\������� j'' %., ✓
_.., ..
Re -Occ. $60.00
w. Print: �� • y x'° %' � ��'
Notary $5.00
My Commission Expires:
CCF $0.60
Total
Building Officials Approval:
(Rev. 10/02/03)
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