REOC-09-816Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 4204 Fax: (305)756 -8972
Scheduled Inspection Date: May 14, 2009
Inspector: Bruhn, Norman
Owner: AAGAARD, STEPHANIE
Job Address: 502 NE 94 Street
Miami Shores, FL
Project: <NONE>
Contractor:
Permit Type: Re- Occupancy
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Phone Number (305)331 -2910
P Number 1132060140970
Building Department Comments
Passed ,iii.:^iereivp
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
PLEASE CALL BEFORE GO
MORTEN AAGAARD 305.582.9199
RE- OCCUPANCY
APPLICATION
Date D /3 0
lv iami snores village
Building Department
IMCMEIVICI
MAY 13 2009
orc >eKl A49,D
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
Permit No_e E .. _�
Loc ID
Contact ame / / Phone # j 05 SS2 9/Ff
Seller // Realtor Company Name
Buyer
Property Address
City Miami Shores
soz NE qy
State Fl
Zip 33/35
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 °X I-6t/ 49?1lW
Signature
The foregoi g instrument was acknowledged before me this I o day o CIA « 2(09_,
by y �tC:t Q(W+ who is ersonall known y wn to me or who has
produced �� -0 (Qi ' "O(')J identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
GAS S•. 0`eA
My Commission Expires:
Building Officials Approval:
(Rev. 10/02/03)
Re -Occ. $60.00
Notary $5.00
CCF $0.60
Total (6.(60