REOC-10-855 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: I NSP- 143388 Permit Number: REOC -5 -10 -855
Scheduled Inspection Date: May 17, 2010 Permit Type: Re- Occupancy
Inspector: Bruhn, Norman Inspection Type: Re Occupancy
Owner: WEBBER, JAMES Work Classification: Re- Occupancy
Job Address: 68 NW 97 Street
Miami Shores, FL 33150 -
Phone Number (786)281 -1825
Parcel Number 113101033034
Project: <NONE>
Contractor:
Building Department Comments
Inspector Comments
Passed PLEASE CALL JAMES WEBBER AT
786 - 281 -1825
Failed cc---
Correction ❑
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
May 14, 2010 For Inspections please call: (305)762 -4949 Page 30 of 32
Miami Shores Village 0 TR E W 3
Building D IMAY g p 1 4 2010
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 ��: <.......�....� -.
INSPECTION'S PHONE NUMBER: (305) 762.4949
RE- OCCUPANCY Permit No.
APPLICATION
Contact Name: 1 AAA 5S ) Phone#. (°' L —
Buyer: JOS61 W Seller: ia_m�s W A..") e_ 6
/ A
Realtor: a A � � �� Company Name: _1 ` 14-+— l [ c� S
Property Address: U S N W Q S' 1
City: Miami Shores State: Florida Zip:
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• W a) e- J Lo*- 9
Signature:
The foregoing instrument as acknowledged before me this 14
day of -�� , 20 Q , by Sg2� M YL �'�"i�rj (L(Z_
who is personally known to me or who has produced
As identification and who did take an oath
NOT LI
Sign:
Print:
My Commission Expires:
Building Officials Approval:_
Re -Occ $60.00
Notary $5.00
Total $
REV 4 -10