REOC-10-604 'P
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 140268 Permit Number: REOC -4-10 -604
Scheduled Inspection Date: April 12, 2010 Permit Type: Re- Occupancy
Inspector: Bruhn, Norman Inspection Type: Re Occupancy
Owner: FARMER, JEFFREY Work Classification: Re- Occupancy
Job Address: 153 NW 100 Terrace
Miami Shores, FL 33150- Phone Number 305 - 754 -6070
Parcel Number 1131010230220
Project: <NONE>
Contractor:
Building Department Comments
Inspector Comments
Passed PLEASE CALL BEFORE GO
JIM PETERS 305.302.4795
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
April 09, 2010 For Inspections please call: (305)762 -4949 Page 13 of 18
Miami Shores Village APR 0 8 zo10
Building Department BY.-
10050 N.E. 2nd Avenue
Miami Shores, Florida 33138
v ta1.r Tel: (305) 795 -2204
RE — OCCUPANCY Fax: (305) 756 -8972
PLICATION .Permit No. 10
Hate O 1 b L ° c �' .
Contact Name i V � Phone* o �.
Buyer Seller Realtor Company Name ,
Property Address (� p
City Miami Shores State Fl
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 N fiiami 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 A + +iI?AVIT: I certify that all the foregoing information is accurate.
Applicant N
I OA On2n�Z�
Signature
o
The regoin ment was acknowledged before me this day of 20
by �� who is personall known to me or who has
produced as identification and who did take an oath.
70
NOTARY PUBLIC:
Sign: '`°'°�� ®� Re -Occ. $60.00
Print: Q�ti �`' Notary $5.00
My Comniission Expires:
Total
Building Officials Approval :
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