REOC-10-868 Inspection History
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
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Project: <NONE>
Owner: THOMAS GOYETTE
Phone: (305)754 -0498
Job Address: 158 94 Street Parcel: 1131010330790
Miami Shores, FL Block: Lot:
Scheduled Insp # Inspection Tvpe Inspection Status Inspector Date Completed
05/18/2010 INSP- 143516 Re Occupancy APPROVED Norman Bruhn 5118/2010
PLEASE CALL
ALAN BEARDSLEE
305 - 218 -7200
Tuesday, May 25, 2010 Page 1 of 1
Miami Shores village ° G' V R 9 W 3 0
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Buildin D MAY 1 7 2010
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 BY: ..4a...,A.......
Tel: (305) 795.2204 Fag: (305) 756.8972
INSPECTION'S PHONE NUMBER: (3057 762.4949
RE- OCCUPANCY Permit No.1 c.0(--A0 — W S
APPLICATION
Contact Name: , s 1 4nP1 ' J et Phone#: at _7 Z C< )
Buyer 0 1 Seller:
Realtor: �� L �v A � L Company Name: 2_zoq
Property Address: S &.t u6 S �-
City: Miami Shores State: Florida Zip: 33 1
I hereby certify that I understand that the zoning for this 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.
APPLICANT'S AFFIDAVIT: I certify that all the foregoing information is accurate.
Applicant Name: A _ L lv�
Signature:
The foregoing instrument was acknowledged before me this
day of � , 20\_C>, by
who is personally known to me or who has produced
As identification and who did take an oath
NOTARY BLIQ
Sign: u►u / / /�� /i
Print:
My Commission Expires:
ID
Building Officials Approval:
IDA ....
Re -Occ $60.00
Notary 5.00
Total $
REV 4 -10