833 NE 96 St (10)BETWEEN 11 -12
Passed
4
U �
/ Inspector Comments
l�
Failed
Correction
Needed
Re- Inspection
Fee
($
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
•
Inspection Date: 12/14/2006
Inspector: Grande, Claudio
Owner: KNOX, PATSY
Job Address: 833 96 Street NE
Project: <NONE>
Contractor:
Miami Shores Village, FL 33138-
Building Department Comments
Wednesday, December 13, 2006
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Block:
Permit Type: Residential Construction
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Phone Number
Parcel Number 1132060142800
Lot:
Page 2 of 2
Rev. 10/02/03)
Miami Shores Village
Building Department
lammmul
RE- OCCUPANCY
APPLICATION B Y: _ .OVA Permit
Loc
Dateg
Contact Name (27/5'74/2 C 1?4/-.50d7 Phone # 176'6 2 & /J-2-
Buyer Seller Realtor 1
- Company Name �er cc.)////
Property Address S33 0 1..)6' 26 :51.
Zip 331
City Miami Shores
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
Applicant Name
Signature
produced
My Commission Expires:
r PQ
'A
' tor t% °"'
(407) 398 -0153
State Fl
the foregoing information is accurate.
The foregoing instrument was acknowledged before me this f 3 day of .D e G
by V) s +t vlc. ree +C-C Sq'who is personally known to me or who has
NOTARY PUBLIC:
Si gn: "4-7C,u.--- /�-- --
Print: DSCL1 2 S'
OSCAR RESEK
MY COMMISSION 8 DD502208
EXPIRES: Dec. 27,2009
Florida Notary SeMce.com
as identification and who did take an oath.
Building Officials Approval:
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
No. Rt u.7Mb
, 20 0 12
Re -Occ. $60.00 I/
Notary $5.00
CCF $0.60 k
Total (),/(,�