REOC-10-443 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305 )795 -2204 Fax: (305)756 -8972
Inspection Number: I NSP- 138321 Permit Number: REOC -3 -10 -443
Scheduled Inspection Date: March 22, 2010 Permit Type: Re- Occupancy
Inspector: Bruhn, Norman Inspection Type: Re Occupancy
Owner: LANIO, PEDRO Work Classification: Re- Occupancy
Job Address: 118 NE 102 Street
Miami Shores, FL Phone Number
Parcel Number 113206013189
Project: <NONE>
Contractor:
Building Department Comments
1 1 � — I
Inspector Comments
Passe PLEASE CALL PATRICK DUFFY
w'� t0 305 - 904 -4803
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
March 19, 2010 For Inspections please call: (305)762 -4949 Page 11 of 26
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.
Date___4 i g b Loc ID
Contact Name Phone # 3 ` O 4 1 F®
Buyer Seller Realtor_ Company Name �aC
Property Address ( ( '� Q F ( C) 5 t
City Miami Shores State Fl Zip 33 (
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
Signature
The foregoing instrument was acknowledged before me this day of ' h 4 ' 20 "
A
by , who is personally known to me or who has
produced as identification and who did take an oath.
NOTARY PUBLIC:
Sign: ' c Re -Occ. $60.00
Print: Notary 4"0
•. LOIS E LINDLEY ~i. a
My Commission Expires: "= MY COMMISSION # DD838034 CCF $0#6e 1 ;0 F* EXPIRES December 15, 2012
(407) 398 -0153 Flondallotary5erwce40m Total r-
Building Officials Approval:
Rev. 10/02/03)