REOC-10-1082Inspection Number: INSP- 146059 Permit Number: REOC -6 -10 -1082
Scheduled Inspection Date: June 15, 2010
Inspector: Bruhn, Norman
Owner: DONAHUE, THEODORE
Job Address: 1208 NE 98 Street
Project: <NONE>
Contractor:
Miami Shores, FL 33138-
Building Department Comments
June 14, 2010
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 Type: Re- Occupancy
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Phone Number
Parcel Number 1132050090360
RE- OCCUPANCY
PaesasiWo ��
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
PLEASE CALL
INES GARCIA
305 - 206 -9366
C`G
Page 24 of 25
RE- OCCUPANCY
APPLICATION
Contact Name: ) nGS 44 ci US ^ c' VZ4 o&, 6
Phone #: 3 DS - • •.1 3 6,
Buyer: �
uye : r Seller t'G.I � 4 M 1 avl2g it V €
Realtor: I n eS -1 P. U S --.6 t2f 2 Company Name: 1 G- C. - Poo pe `�7'S
Property Address 1 7 0 S
City: Miami Shores State: 1 Florida Zip: 53 1 SP)
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.
s... >Si
pplicant Name:
Signature:
The foregoing instrument was . ct before me this —`
day of
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
Miami Shores Village
20 al, by / ii)`tS (A c'
who is personally known to me or who has produced
I t I "i4Vwth
As identification and wi
NOTARY PUBLIC: Alb
Sign:
Print: q •
My Commission Expires: ° �, ®..p..� 0��.�
� i01 "1111111111
S TAT E CI` �
Building Officials Approval:
REV 4 -10
V)) SEC
Permit No. Koc,10°'1
Re -Occ $60.00
Notary $5.00
Total $ ,