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REOC-10-297 F Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 136470 Permit Number: REOC -2 -10 -297 Scheduled Inspection Date: March 01, 2010 Permit Type: Re- Occupancy Inspector: Bruhn, Norman Inspection Type: Re Occupancy Owner: TRS, CITY BANK Work Classification: Re- Occupancy Job Address: 173 NW 99 Street Miami Shores, FL 33138- Phone Number Parcel Number 113101023040 Project: <NONE> Contractor: Building Department Comments Inspector Comments Passe TONY PARDO 305 - 282 -6609 J 305- 271 -9696 Failed eiLl Correction ❑ Needed Re- Inspection ❑ Fee No Additional Inspections can be scheduled until re- inspection fee is paid. February 26, 2010 For Inspections please call: (305)762 -4949 Page 13 of 19 Miami Shores Village Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Q 1 " §� � �� Tel: (305) 795 -2204 RE- OCCUPAN Fax: (305) 756 -8972 BY ............. ... Loc ID Date Z Contact Name / ®� % f �rCsy ® Phone # 3 ©J`'. `` 2 -660 Buyer Seller Realtor Company Name 7 Property Address 3 fu tj Cj 9 S ' ee —/- City Mami Shores State Fl Zip iW9 331S 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: Je6rtify that all the foregoing information is accurate. Applicant Name Signatur The foregoing instrument was acknowledged before me this day of , 20 by :5,)S(, l�CZ D , who is personally known to me or who has produced C _ d as identification and who did take an oath. NOTARY PUBLIC: Sign: � ,� � - �.. `• .,9 Re -Occ. $60.00 Print: Notary $5.00 My Commission Expires: Q : Q.. �4 CCF $0.60 ��'�� ® �9 • �, Total Building Officials Approval: (Rev. 10 /02/03)