REOC-10-461 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 138494 Permit Number: REOC -3- 10-461
Scheduled Inspection Date: March 22, 2010 Permit Type: Re- Occupancy
Inspector: Bruhn, Norman Inspection Type: Re Occupancy
Owner: JOHNSON, MICHAEL Work Classification: Re- Occupancy
Job Address: 445 NE 94 Street
Miami Shores, FL Phone Number
Parcel Number 113206014052
Project: <NONE>
Contractor:
Building Department Comments
RE OCC
Inspector Comments
Passed PLEASE CALL BEFORE GO
MICHAEL JOHNSON 305.499.8581
Failed On_
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 19, 2010 For Inspections please call: (305)762 -4949 Page 18 of 26
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
7� L�
Tel: (305) 795 -2204
RE t
- OCCUPANCY o �? �tY1 Fax: (30 756 -8972
APPLICATION 9 2010 V Permit No.
MAC 1 Loc m
Date
'p p ... 13 5 7
Contact Name 1 G'�° 5�f�1 .+....� Phone # ��
Buyer Selle Realtor Company Name
Property Address L j c,( S J s
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. 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 AFFID I certify that all the foregoing information is accurate.
Applicant Na �+
Signature ----
The foregoing instrument was acknowledged before me this day of -- , 20
by �AA Ci��`�. ::S .,o Vms. r� who is personally known tome or who has
produced °'C.. d�1t1 � S LACa✓v_�-C as identification and who did take an oath.
NOTARY PUBLIC ° 6%! y .. , a
® ° ®;� e.�e " ,Frey S. Hersh
A Commission #DD551365 1
Kf JULY 08 2010
® ® ° ' ® e Re -Occ. $60.00
Sign: Y.com
y � C � i
Print: � » C' & 4J 1-I' Notary $5.00
My Commission Expires: �� I 0 CCF $0.60
` Total
Building Officials Approval:
(Rev. 10102103)
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