REOC-10-880 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 143982 Permit Number: REOC -5 -10 -880
Scheduled Inspection Date: May 24, 2010 Permit Type: Re- Occupancy
Inspector: Bruhn, Norman
Inspection Type: Re Occupancy
Owner: CHURCH, MIAMI SHORES CHRISTIAN Work Classification: Re- Occupancy
Job Address: 144 NE 101 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1132060131990
Project: <NONE>
Contractor:
Building Department Comments
Inspector Comments
Passe CREATED AS REINSPECTION FOR INSP - 143741.305- 904 -4803
PATRICK DUFFY
Tenant refused access NB
Failed ❑ PLEASE CALL
PATRICK DUFFY
305 - 904 -4803
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
May 21, 2010 For Inspections please call: (305)762 -4949 Page 23 of 39
Miami Shores Village
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
RE- OCCUPANCY Permit No im- OC - 5 -1 0 - 89
APPLICATION
Contact Name: Ppr c v_ a p``, Phone#: a' wy — slt*
Buyer: .aJ Soli ry �b Seller: HIA
Realtor: Nr= try ll �-F-�� Company Name:
��1� �� —�
Property Address: � �
City: Miami Shores State: Florida Zip: 3:St3
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.
Applicant Name: N-r a4 c.4.-- I
Signature• ,
The foregoing instrument was acknowledged before AUS PS
day of tj�t , 20 Lg , by "cpc L• f ,
who (;p ersonally known fa me or who has produced
As identification and who did take an oath
NOTARY PUB C: a � ONA E, AIM
* * MY CORtPAISSION # D0 718397
Sign: a Q EXPIRES: January 19, 2012
//yy 4 0 ft
Print: ow,4
My Commission Expires AA-1. x- -10 ®
Building Officials Approval:
Re -Occ $60.00
Total ,
REV 4 -10