REOC-09-10804
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Scheduled Inspection Date: June 29, 2009
Inspector: Bruhn, Norman
Owner: PECACHE, FE
Job Address: 558 NE 94 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor:
c�
Permit Type: Re- Occupancy
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Phone Number (305)751 -7051
Parcel Number 1132060140930
Building Department Comments
RE -OCC
Passed 4ef
Failed
kki
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
OK ALL PERMITS CLOSED.
PLEASE CALL BEFORE GO
FE PECACHE 305.751.7051
June 29, 2009
For Inspections please call: (305)762 -4949
Page 16 of 19
Miami Shores Village
Building Department
RE- OCCUPANCY
APPLICATION
Date (012S-1 0
Contact Name - Pe CC)tC
Buyer Seller X Realtor "
Property Address SS6 N 1(4 £i-ral
5-C 71V
J
JUN 262009
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 75566- 8972Y1
Permit No. k � iO J
Loc ID
Phone #
3o s -t Si '19S 1
Company Name
City Miami Shores
State F1
Zip 2.31 3 '
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 C ` CCicA‘C__:
SignaturA
The foregoing instrument was acknowledged before me this
by
produced
day of IL9JtQ) , 200Q ,
who is personally known to me or who has
as identification and who did take an oath.
Sign:
Print:
My Commission Expires:
NOTARY PUBLIC:
Alididtdoii
IsoretN :141"-
Building Officials Approval:
(Rev. 10/02/03)
Re -Occ. $60.00
Notary $5.0�
CCF $0.��6 <<0
Total V1�3` .