REOC-10-990Inspection Number: INSP- 144749 Permit Number: REOC -5 -10 -990
Scheduled Inspection Date: June 01, 2010
Inspector: Bruhn, Norman
Owner: SAVITS, MONICA
Job Address: 1360 NE 103 Street
Miami Shores, FL
Project <NONE>
Contractor: HOME OWNER
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Permit Type: Re- Occupancy
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Phone Number
Parcel Number 1132050300070
Passed
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
PLEASE CALL
MARCO BONANNI
1360 NE 103 ST
786 - 543 -7821
ec
May 28, 2010
For Inspections please call: (305)762 - 4949
Page 22 of 22
R
(Rev. 10/02/03)
RE- OCCUPANCY
APPLICATION
Date 0 5 a 2 , 0 1
Contact Name M AR CO O '' tO N, M Phone # 6 ' 51131-821
Buyer 1 oir fR a ellerl Q tM 6th Realtor B U v Company Name
Property Address /13 Co t-3 STnr
City Miami Shores State F1
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 11 17 , 20 10 ,
by r1 1'[ t 11 t , who is personally known to me or who has
produced l TA-Lt
P
My Commission Expires:
Building Officials Approval:
Miami Shores Village
Building Department
MARC° 4k Iii tic
UBLIC:
i
; Ian S James
a My Commission DD860180
'4"op4° Expires 04 /03/2013
O
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
Permit No. 'ROC- 5 D
Loc ID
Zip ;3 -z2 21.,
6 as identification and who did take an oath.
Sign: Re -Occ. $60.00
Notary $5.00
CCF $0.60
Total