REOC-10-957Inspection Number: INSP- 144549
Scheduled Inspection Date: June 01, 2010
Inspector: Bruhn, Norman
Owner: BURKE, CHARLES
Job Address: 1279 NE 97 Street
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
PLEASE CALL BEFORE GO
HEATHER ZIBELLI 305.458.1296
dc-
May 28, 2010
Miami Shores, FL 33138 -2559
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
For Inspections please call: (305)762 -4949
Permit Number: REOC -5 -10 -957
Permit Type: Re- Occupancy
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Phone Number
Parcel Number 1132050090440
Page 19 of 22
RE- OCCUPANCY
APPLICATION
Applicant Name:
The foreg
day of
who is personal
Building Officials Approval:
REV 4 -10
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APPLICANT'S AFFIDAVIT: I certify that all the foregoing information is accurate.
(- 2(.( 2 -S
Signature: TIAJ
ng instrument was actnow1 �ged before thi
, 1V 2 ,
y known to me or who has produced
As identification and who did take an oath
NOT PUB
Sign:
Print:
My Commission Expires:
Miami Shores Village agaVZ
Building De °
g partment lip 2 6 9-M
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Permit No. I2
- VLZI3ca.1 Phone#: 2
Contact Name:
Buyer: -- S - v (Z- Seller: r N L D ow tJ C
Realtor: Company Name: 1 � �L ,/ L L Li 1
Property Address: k7.-7 NE 9? '+
City: Miami Shores State: Florida
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.
Zip:
Re -Occ $60.00
Notary $5.00
Total $ (LS -CO