RC-08-1075Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 06/11/2008
Inspector: Rodriguez, Jorge
Owner: JOHNSON, STEVEN
Job Address: 145 95 Street NE
Miami Shores Village, FL 33138-
Project: <NONE>
Contractor:
Permit Type: Residential Construction
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Block:
Phone Number
Parcel Number 1132060132740
Lot:
Building Department Comments
Tuesday, June 10, 2008
Page 2 of 2
Passed
Inspector Comments
CC
PLEASE CALL BEFORE GO: 6_ i (_
EMILIO VEGA 305.6943818
i -t
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Tuesday, June 10, 2008
Page 2 of 2
Miami Shores Village
Building Department
RE- OCCUPANCY
APPLICATION
12LX
Contact Name L-rYI I I1
Buyer
Property Address
Seller
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
Permit No.
LocID
OS 1015.
Phone # S R-331
Realtor \ Company Name
IL iJE
City Miami Shores State
Fl
zip 1.
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 Name4 -fl 1 1 O
Mature
The foregoing instrument was acknowledged before me this �.U, day of V ewi._ , 20 C4
by Cott
produced cvr%ierc(6 - as identification and who did take an oath.
NOTARY PUBLIC:
, who is personally known to me or who has
Sign:
Print: It 4-01 C t)
My Commission Expires:
° Notary Public State of Florida
Joanna Sosa -Diaz
y ommission
Of n. #� Expires 06 /19/2009
o !
•
15
Building Officials Approval:
Rev. 10 /02/03)
REG C07 061
111►
Re -Occ. $60.00 \
Notary $5.00
CCF $0.60\
Total
$60.60