REOC-10-399 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
i nspection Number: INSP- 137741 Permit Number: REOC -3 -10 -399
Inspection Date: March 12, 2010 Permit Type: Re- Occupancy
Inspector. Bruhn, Norman
Inspection Type: Re Occupancy
Owner. HOWARD, ANDY Work Classification: Re- Occupancy
Job Address: 448 NE 96 Street
Miami Shores, FL 33138 -0000 Phone Number (305)799 -7095
Parcel Number 1132060140575
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
Inspector Comments
Passed PLEASE CALL ALEX PEREZ
�.- 305 - 965 -5738
Failed
Correction ❑
Needed
Re- Inspection El
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid
For Inspections please call: (305)762 -4949
March 12, 2010 Page 1 of 1
Miami Shores Village �A� g � 201
Building Department
100501 . ii &.........
Miami Shores, Florida 33138
Tel: (305) 795 -2204
RE— OCCUPANCY Fax: (305) 756 -8972
APPLICATION Permit No. eoc 1 0 :50
Lac ID
Date 10 20 / a
��� 0 & - 5 -3r1 ALXX
Contact Name e_e - �YfhN Dgp �E F_ --& Phone # 305 - 5 - P pZ 6 e,
Buyer Seller Realtor ✓ / Company Name /ANC A3'rneS? 1--'q OF ,F
Property Address L/ L/g nJE I&
City Miami Shores State F1 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 A &c P e/ 2 E?- �E,q cTo,e- FaQ &VAJ02, SUiV7R11S7
Signature
The foregoing instrument was acknowledged before me this 10 -1 ' 4 day of HAR d# , 20 10
by A154MAJ0 G . Te' FRE? , who is personally known to me or who has
produced -z> /-r eecsg_: as identification and who did take an oath.
NOTARY PUBLIC:
Sign: Re -Occ. $60.00
Print: Notary $5.00
My Commission Expires: CCF $0.60
Total ' ®�
Building Officials Approval:
(Rev. 10/02103)
MERCEDES KWADO '
1 L .
*, .*. MY COMMISSION A OD 925617
. EXPIRES Septemter 16, 2013
a„ 4 Sonded Tin Notary Pu* Underwriters