REOC-10-739 Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 141878 Permit Number: REOC -4 -10 -739
Scheduled Inspection Date: May 03, 2010 Permit Type: Re- Occupancy
Inspector: Bruhn, Norman Inspection Type: Re Occupancy
Owner: TOMA, TAMARA Work Classification: -Re- Occupancy
Job Address: 280 NE 107 Street
Miami Shores, FL Phone Number (300)575 -7806
Parcel Number 112231013046
Project: <NONE>
Contractor:
Building Department Comments
Inspector Comments
Passed PLEASE CALL BEFORE GO
ESTHER AMADOR 305.742.7225
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
April 30, 2010 For Inspections please call: (305)762 -4949 Page 20 of 29
MIAMI SHORES VILLAGE
Building Department
10050 NE 2 Ave, Miami Shores Fl, 33138
Tel: 305 - 795 -2204- Fax: 305 - 756 -8972
Permit No. REOC -4 -10 -739
Certificate of Re- Occupancy
Address: 280 NE 107 Street
City: Miami Shores Village
State: Florida
Zip: 33138
This certificate verifies that the reference property has been inspected by Miami Shores
Village and has been determined to presently comply with schedule of regulations of
Miami Shores Land and Development Code pertaining solely to the requirement that
each one - family dwelling is used and intended to be used for a one - family dwelling
purpose only; however, this certificate does not constitute any representation or
warranty as to the condition of the dwelling or other structures on the premises
described herein, or any aspect of such condition, and interested persons are advised
and encouraged to make their own inspections of the premises in order to determine the
condition thereof.
Building Officials Approval:
CBO
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
+� Tel: (305) 795 -2204 f
RE- OCCUPANCY Fax: (305) 756 -8972
APPLICATION Permit No.
' Loc ID
Date
9 1 S:W _ 16 r Qf ,4-- S%. Phone # 36! 7 �Z --1 � �.� Contact Name �t
Buyer Seller Realtor Company Name (lIle/ bi'(&O ddij
Property Address Ag M� 40q
I �
City Miami Shores State Fl
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 j
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 TkMffi
I
Signature t
rud
The foregoing instrument as ackno ledged before me this as day of 20 10
b r g-e&. a ry-�&. , w e or who has
produced as identification and who did take an oath.
NOTARY PUBLIC:
Sign: LISA LYDA Re -Occ. $60.00
Print:
' Expires August 30, 2011 Notary $5.00
X867019
My Commission Expires:4llorj - !0 zo l l CCF $0.60
Total
Building Officials Approval:
(Rev. 10/02/03)