REOC-10-577 i
1
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: I NSP- 139843 Permit Number: REOC -4 -10 -577
Scheduled Inspection Date: April 07, 2010 Permit Type Re Occupancy
Inspector: Bruhn, Norman Inspection Type: Re Occupancy
Owner: DOCAL, ABELARDO Work Classification: Re- Occupancy
Job Address: 410 NE 94 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060140360
Project: <NONE>
Contractor:
Building Department Comments
Inspector Comments
Passed PLEASE CALL BEFORE GO
JIM PETERS 305.302.4795
�f✓
Failed
Correction
Needed ❑
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
April 06, 2010 For Inspections please call: (305)762 -4949 Page 15 of 16
M iami Shares Village
Building Department
.10050 N E.2nd Avenue
Miami Shores, Florida 33138
1�7�
Tel: (305) 795 -2204
R E -OCCUPANCY Fax: (305) 756 -8972
JPLICATION ..Permit No.
Date 4 bCe
t6 Loc ED
Contact Name R � # p ` S'�
Buyer Seller Realtor Company Name v4
4
Property Address .44o satF, 4 �5T —,
City Miami Shores State Fl 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. T 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..
OW'NER'S A + +ID IT: I certify that all the foregoing information is accurate.
Applicant Name L
Signature
The foregoin ment was acknowledged before me this day of t o, , 20
by who is personally known to me or who has
produced
r
p as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
_ A Re -Occ. $60.00
Print:"'
Notary $5.00
My Commission Expires: CCF P-fU
_ To tal
Building Officials Approval:
of
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