REOC-10-869 T
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 143520 Permit Number: REOC -5 -10 -869
Scheduled Inspection Date: May 18, 2010 Permit Type: Re- Occupancy
Inspector: Bruhn, Norman Inspection Type: Re Occupancy
Owner: CAREY, RODNEY Work Classification: Re- Occupancy
Job Address: 145 NE 110 Street
Miami Shores, FL 33161- Phone Number
Parcel Number 112136004019
Project: <NONE>
Contractor:
Building Department Comments
Inspector Comments
Passed'& PLEASE CALL
RODERICK KEMP
954 - 756 -3463
Failed
Correction ❑
Needed
Re- Inspection ❑
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
May 17, 2010 For Inspections please call: (305)762 -4949 Page 13 of 18
Miami Shores Village
Building Department
D � � J� y� � � � 10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
RE- OCCUPANCY
M A Y P� 1 Fax: (305) 756 -8972
APPLI ATION BY Permit No ` �U G
..
Date t
Contact Name O L' P 't Phone # �s�" ��o ' •�
Buyer Seller Realtor Company Name Rc4j
Property Address t 4 1 S 1 Jar C-M
City Miami Shores State Fl zip 3 3 l
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
i
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.
i
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate.
Applicant Name '2 . Ctre
Signature 1!
F
The foregoing instrument was acknowledged before me this I day of 20 1 o
by '_olnnQy Cct.r!n , who is personally known to me or who has
produced I wet � d4 ake an oath.
61 E. HAGAN
TARY PUBLIC: COMM. # 179301$ NuifRY PUBLIC - CAUFORNIA SAN DIEGO COUNTY n
MM. EXPIRES MARCH 7, 2012
Sign: Re -Occ. $60.00 j
Print: JL LA Notary $5.00
My Commission Expires: 1-7 (2 1 7-- CCF $0.60
Total
Building Officials Approval:
(Rev. 10/02/03)