REOC-09-1846 :
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 128966 Permit Number: REOC -11 -09 -1846
Scheduled Inspection Date: November 10, 2009 Permit Type: Re- Occupancy
Inspector: Bruhn, Norman Inspection Type: Re Occupancy
Owner: SOSTRE, MICHAEL Work Classification: Re- Occupancy
Job Address: 117 NW 101 Street
Miami Shores, FL 33150- Phone Number
Parcel Number 113101022015
Project: <NONE>
Contractor:
Building Department Comments
Inspector Comments
Passed 786- 281 -1965
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
November 09, 2009 For Inspections please call: (305)762 -4949 Page 23 of 29
Miami Shores Village
Building Department
.10050 N E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
RE- OCCUPANCY Fax: (305) 756 -8972
APPLICATION Permit No. 1Q E 6C " 1>1 — 120 ( r
NOV 0 9 2009
Loc ID
Date t � � � o
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Contact Name y>�l �"�— Phone
Buyer Seller Realtor Company Name
Prope Address \ \D IQ C 0 � 0 \ SF
City Miami Shores State Fl Zip
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.
Applicant Name ;V' 43E_�
Signature
The foregoing instrument was acknowledged before me this q l day of U \f 20 oq
by WkWl Q - SO -fie , who is personally known to me or who has
produced - l 40 L S 0 2- U as identification and who did take an oath.
NOTARY PUBLIC:
Si � f I • Re -Occ. $60.00 z7e
Print: Notary $5.00 /
My Commission Expires: �td� e�a CCF $0.60
Total �
Building Officials Approval:
Rev. 10/02/03)