REOC-10-1233Inspection Number: INSP- 147994 Permit Number: REOC -7 -10 -1233
Scheduled Inspection Date: July 09, 2010
Inspector: Bruhn, Norman
Owner: ANDERSON, ALBERT & KRISTINE
Job Address: 1217 NE 100 Street
Project: <NONE>
Contractor:
July 08, 2010
Miami Shores, FL
Building Department Comments
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 1132050090631
RE -OCC
Passe
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
PLEASE CALL
EMILIO VEGA 786.287.4288
OK,
Page 8 of 11
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BY:
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
Permit No. '' e A )25
Loc ID
b 4 31 8
Contact Name 1 0 \ q Phone # 1 o
Buyer Seller ealtor Company Name Y 1€( t10 1 01MS -'C-l1
Property Address (2 `DO E*' 2
City Miami Shores State Fl Zip 33 C
RE- OCCUPANCY
APPLICATION
Date
Rev. 10/02/03)
Miami Shores Village
Building Department
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 all the foregoing information is accurate.
il 1
Applicant Name
The foregoin trument was acknowledged before me this day of , 20
by
produced as identification and who did take an oath.
who is personally known to me or who has
Polite - 111 KIUCK
� COMM. Erprr Stare 2 - -Occ. $60.00
Sign: /I /� � � • OD New
�e
otary $5.00
Print:
My Commission Expires: CCF $0.60
Total
Building Officials Approval: