RC-07-583 Inspection Worksheet
ixto Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
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Inspection Date: 0312712007 Permit Type: Residential Construction
Inspector: Grande, Claudio Inspection Type: Re Occupancy
Owner: SWARTZ, EMERY Work Classification: Re- Occupancy
Job Address: 1045 97 Street NE
Miami Shores Village, FL Phone Number (305)758 -9030
Parcel Number 1132050170100
Project: <NONE>
Block: Lot:
Contractor:
Building Department Comments
RE- OCC
MAR 2 8 2007
Inspector Comments
Passed BETWEEN 11 -12
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid .
Monday, March 26, 2007 Page 2 of 2
® Miami Shores Village
Building Department
10050 N.E.2nd Avenue
�� � Miami Shores, Florida. 33138
Tel: (305) 795 -2204
RE- OCCUPANCY MAR 2 6 2007 F 305) 756
APPLICATION BY: Permit No. 40 .�
�`VG1U�t
' Loc ID
Date
Contact Name C �� P` S� Phone # 3 ®S (��7 ( 4
Buyer Seller Realtor _ Com pany Name ( Qi� ed
Property Address 0 ) C�_
r
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 AFFIDAVIT: I certify that all the foregoing information is accurate.
Applicant Name
Signature
The foregoing instrument was acknowledged before me this Z6 day of 144 20 07 ,
by T&9C7Q ?L? KISS o , who is personally known to me or who has
produced . 'T/wfu � l,.(L _ r) as identification and who did take an oath.
NOTARY PUBLIC:
Sign: Re -Occ. $60.00
Print: Al eq k��q Notary $5.00 l'
My Commission Expires: CCF $0.60
Total 6 5.66
Building Officials Approval:
(Rev. 10/02103)
�� � 7-
e ;d
Invoice
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Bill To
EMERY SWARTZ Invoice Number: RC-3 -07 -27962
1045 NE 97 ST Invoice Date: March 26, 2007
MIAMI SHORES, FL 33138 -2555 Permit Number: RC-3 -07-583
Return to:
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
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Date Fee Name Fee Type Fee Amount
03/26/2007 Notary Fee Fixed $5.00
03/26/2007 Re- Occupancy Fee Fixed $60.00
03/26/2007 Re- Occupancy CCF Fee Fixed $0.60
Total Fees Due: $65.60
Payments
Date Pay Type Check Number Amount Paid Change
03/26/2007 Check 2540 $65.60 $0.00
Total Paid: $65.60
Total Due: $0.00
Monday, March 26, 2007