REOC-10-1119RE-OCCUPANCY
APPLICATION
CATION
b
Date / 0
Contact Name J L � Phone # 3 0 ('Q?- 1 7 / ”..r
Buyer •
Property Address
City Miami Shores
Seller
NOTARY PUBLIC:
Miami Shores Village
Building Department
Sign: �
Print:
My Commission Expires:
.10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
Permit No. 7 C, (C t <19
•LocID •
JUN
BY:
R altos Company Name 7L/11 r
St tP F1 Zip
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 all the foregoing information is accurate.
The foregoing instrument was acknowledged before me this day of , 20 t C�
by I r n - K- , who is personally known to me or who has
produced as identification and who did take an oath.
y \1eS ' >
r \
61
Building Officials Approval:
v. 10/02/03)
Re -Occ. $60.00
Notary $5.00
CCF $0.60
Total
/
Contractor:
Scheduled Inspection Date: June 22, 2010
Inspector: Bruhn, Norman
Owner: WESENSTEN, JOHN
Job Address: 1210 NE 100 Street
Miami Shores, FL
Project: <NONE>
Building Department Comments
June 21, 2010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 146438 Permit Number: REOC -6 -10 -1119
For Inspections please call: (305)762 -4949
Permit Type: Re- Occupancy
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Phone Number (305)757 -1457
Parcel Number 1132050090070
RE- OCCUPANCY
Passed J 44 1 ( 7;1
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
PLEASE CALL
JIM PETERS
305 - 302 -4795
Cc---
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