RC-07-1903Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 09/13/2007
Inspector: Grande, Claudio
Owner: DAVIES, JOHN
Job Address: 1041 94 Street NE
Permit Type: Residential Construction
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Miami Shores Village, FL
Project: <NONE>
Contractor:
Block:
Phone Number
Parcel Number 1132050120080
Lot:
Building Department Comments
Monday, September 10, 2007
Page 2 of 2
Inspector Comments
PLEASE CALL
JOHN DAVIES 305.450.2162
Passed
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid .
Monday, September 10, 2007
Page 2 of 2
Parcel Owner Report
Parcel Number: 1132050120080
1041 94 ST
Miami Shores Village FL
Tax ID: 1132050120080
Owner Information
JOHN DAVIES
Phone:
ROXANE DAVIES
Phone:
Current Owner: Yes
Current Owner: Yes
Related Permits
Imported Permit
Imported Permit
Residential Construction
Permit Number
BP2002 -490
EL2005 -275
RC -9 -07 -1903
Application Date Expiration Date Status
03/11/2002 01/29/2003 CLOSED
08/08/2005 02/04/2006 CLOSED
09/10/2007 03/11/2008 APPLIED
Monday, September 10, 2007 Page 1 of 1
1111Gi1111 011U1 ili:1.g:
RE-OCCUPANCY
APPLICAT -I
Date Q-- DZ
Building Department
MIZMETIM
SEP ip
B Y:
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
Loc ID
Contact Name t44 v�5
cirttew— cilZo r+a
Buyer Seller
,ems Realtor ?/Y o
ne Company Name .05 • 4502 t(0 2,reM
_
)Q \ (J Property
cleo
Phone # 3 ®s- ii' —1J-0 /
Address
City Miami Shores
State F1
Zip 33 (-3
1 hereby certify that 1 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. 1 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 Na
Signature
The oregoing ii t ment was acknowledged before me this ) 0 day of
by UOIANA , V4` 61 S , who is personall Y known to me or who has
produced Qg. 2"% as identification and who did take an oath.
NOTARY PUBLIC:
,200,
Sign:
Print:
My Commission Expires:
Building Officials Approval:
(Rev. 10/02/03)
Re -Occ. $60.00
Notary $5.00
CCF $0.60
Total jigfk •