124 NW 95 St- 1 1 cc) .
Ce/05-
,
Passed °i t
Inspector Comments
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Failed el p 1
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rA
Correction
Needed
Re-Inspection
Fee
($75)
No Additional Inspections can be scheduled
re-inspection fee is paid
until
Inspection Date: 07/26/2006
Inspector: Grande, Claudio
Owner: SANTIAGO, TOMAS
Job Address: 124 95 Street NE
Project: <NONE>
Contractor:
Monday, July 24, 2006
Miami Shores Village, FL 33138-
Buildinq De artment Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795-2204 Fax: (305)756-8972
iL 26
Block:
Permit Type: Residential Construction
Inspection Type: Re Occupancy
Work Classification: Re-Occupancy
Phone Number
Parcel Number 1131010330610
Lot:
Page 1 of 2
IFICTEV
JUL 2 4 206
RE- OCCUPANCY
APPLICATION-
Date
(Rev. 10/02/03)
9 -a'-4 200 to
Contact Name
Buyer
Property Address
e Pt A4 1 MCPa
Seller Realtor k Company Name
City Miami Shores State Fl Zip 3 15 O
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 Yncz C . t4& o
Signature a ,,�.fl -a �� °--
0
The foregoing instrument was acknowledged before me this 2a day of, )( � (j , 20 c(, ,
by • IfS S . ..111 ho is personally known to me or who has U
as identification and who did take an oath.
produced O
NOTARY PUBLIC:
Miami Shores Village
Building Department
g p
Sign:
Print:
My Co mission Expires:
Mabel Vargas
Cornnissiaa;'iuD23198
.P; Expires: JuI 13, 2007
-o:
Fle BondedThnu
A tlan +
tic Onndih� C,b., Inc
Building Officials Approval:
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
, Fax: (305) 756 -8972
l r��
- Permit No 2 CO - 1
Loc
Phone# Z0.s `hos - sa.Oa-
Ew
Re -Occ. $60.00
Notary $5.00
CCF $0.60
Total 6 C)r
GL