REOC-10-1135RE- OCCUPANCY
APPLICATION •
Contact Name: � //� 6
NOTA
Sign:
Print:
My Commission Expires:
REV 4 -10
Sig
T forego' g ins . e z as acknowledged before me this
da y o nature: tf , 2010 , by �f 0 1 . t Fi
w ho personally known o me or who has produced
Building Officials Approval:
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
Buyer: efr/L -i//f 7-'r i Seller: ‘i S/ !QC-
Realtor: t•' 4 — 6.4t 1 "(6.- Jed tom Company Name: &WW 74 Gietif P7vp te,
Property Address: /t A /e(
City: Miami Shores State: Florida Zip: 33/3e
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.
As identification and who did take an oath
11` aMIVU1E
JUN 222010
Permit No. eie -)135
/
Phone#: 37}x= .371 x /
ANTHONY J. DIGIORE
MY COMMISSION # DD969566
EXPIRES March 14, 2014
( 407} 398.018 P c$daN°te !eiVk °
Re -Occ $60.00
Not 5OH
Total $ 400
Inspection Number: INSP- 146601 Permit Number: REOC -6 -10 -1135
Scheduled Inspection Date: June 23, 2010
Inspector: Bruhn, Norman
Owner: LEVINSON, GARY
Job Address: 186 NE 108 Street
Project: <NONE>
Contractor:
Building Department Comments
RE -OCC
Passed, }, 6. 6)
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
June 22, 2010
Miami Shores, FL 33161-
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspector Comments
GRATHINA LEVINSON
305.975.1357
ec.___
For Inspections please call: (305)762 -4949
Permit Type: Re- Occupancy
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Phone Number
Parcel Number 1121360090010
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