REOC-10-697 Miami Shores Village Wmry
APR
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138 P ... PA
Tel: (305) 795.2204 Fax: (305) 756.8972 �..Oe46«
INSPECTION'S PHONE NUMBER: (305) 762.4949
RE- OCCUPANCY Permit No. RCOC 1 04 9
APPLICATION
Contact Name: t V ;, ,e, Phone#: 79i - , 2 - 7,
Buyer: _cd"') �S p-, ^ , - N Seller:
Realtor: V eji -e.;- Company Name:
Property Address: 131 N if 9 -
City: Miami Shores State: Florida Zip: _33 LU
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• r e, t � e-n
Signature:
The foregoing instrument was acknowledged before me this 2- 2-
day of /�,� , 20 L, by
who is personally known to me or who has produced t .,. S
I f U - 1 VA-- As identification and who did take an oath """` ANT Y ASKKOW Z
MY coWSSION # DD696613
NOTARY BLIC: � s EXpME& o oz 2011
Sign: '- soas.'o'cnxY
N OD.
Print: A &/t
My Commission Expires:
Building Officials Approval:
Re -Occ $60.00
Notary $5.00
Total $
REV 4 -10
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 141352 Permit Number: REOC -4 -10 -697
Scheduled Inspection Date: April 26, 2010 Permit Type: Re- Occupancy
Inspector: Bruhn, Norman Inspection Type: Re Occupancy
Owner: AITKEN, KRISTY MOORE Work Classification: Re- Occupancy
Job Address: 131 NE 97 Street
Miami Shores, FL Phone Number
Parcel Number 113206013247
Project: <NONE>
Contractor:
Building Department Comments
Inspector Comments
Passed PLEASE CALL FRED VIENER
786- 2 23r 34 -3753
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
April 23, 2010 For Inspections please call: (305)762 -4949 Page 21 of 27