REOC-10-479 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 138716 Permit Number: REOC -3- 10-479
Scheduled Inspection Date: March 24, 2010 Permit Type: Re- Occupancy
Inspector: Bruhn, Norman Inspection Type: Re Occupancy
Owner: HAMILTON, KATHRYN Work Classification: Re- Occupancy
Job Address: 117 NW 101 Street
Miami Shores, FL 33150- Phone Number
Parcel Number 1131010220150
Project: <NONE>
Contractor:
Building Department Comments
OT
-- HR.Z
e S
Inspector Comments
Passed PLEASE CALL BEFORE GO
KATHRYN HAMILTON 305.371.3788
NOEL REMY 786.486.0990
Failed
Correction
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Mardi 23, 2010 For Inspections please call: (305)762 -4949 Page 15 of 20
Nl iami Sho res Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
�;+
0 Tel: (305) 795 -2204
RE-- OCCUPANCY Fax: (305) 756 -8972
AT-��JON—_V v rMit N
Date 3)t "t �t0 BY :.. ....• ........
Loc ED
Contact Name �G� n Phone# 305 371 3
Buyer Seller Realtor Company Name
Property Address H NW 1 O 1 SiTee -
City Miami Shores State Fl Zip 331.56
I hereby certify that I understand that the zoning of the property is for single- family residential use and
that it is ilnlawful 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 NameKp: hl rl H7v Y) 1 IJ3,y) \&tit 1
Signatu �
The foregoing instrument was acknowledged before me this 1 ° 1 4 � h day of Nlo-r&h 20 U
by HXMi Itry) , who i personally known >e or who has
produced as identification and who did take an oath.
NOTARY PUBLIC: �,•a1'�'��.- Eneida Lopez
_ o ;
. Commission # DD647762
Si n �`Ex
Expires July 28, 2010
g °,'" 896.1010 Re -Occ. $60.00
r
Print: )-,4 Notary $5.00
My Commission Expires: -Zr, '-ZO/ CCF $0.60
•��
Building Officials Approval: Total
(Rev. 10102/03)