RC-08-348Miami Shores Village
Building Department
RE-OCCUPANCY
APPLICATION
B Y:.,
Date r
/'? e�
Contact Name Sc 67 o G'l
.10050 N E,2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
Permit No. I 6 '
Loan 303 v°61.-
o.
Phone #
Buyer Seller Realtor
Property Address 4/ 9 0 N E 1& - Se
City Miami Shores State _ FI
Company Name
Zip 33
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
7
Signature t -
The fo egoing inst en wags acknowledged before me this
by✓ �l
day of
, who is personally known to me or who has
produced ''O k O4 }I,9_, as identification and who did take an oath.
NOTARY PUBLIC:
2c0
6G? 1 atif
Sign: �i ..d►. �►__� ►,,� �U `a Z �ti�''��° Print: ��Illi0 [��l r�`� .:�`��~ g~ °4`'0 •
My Commission Expires:
Building Officials Approval:
Rev. 10/02/03)
Re -Occ. $60.00
Notary $5.00 V
CCF $0.60
Total (4-60
Inspection Date: 03/03/2008
Inspector: Grande, Claudio
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Owner: BANKER, COLDWELL
Job Address: 490 96 Street NE
Miami Shores, FL 33138-
Project: <NONE>
Contractor:
Permit Type: Residential Construction
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Block:
Phone Number
Parcel Number 1132060140550
Lot:
Building Department Comments
Thursday, February 28, 2008
Page 1 of 2
Passed
Inspector Comments .
PLEASE CALL
SCOTT DIFFENDERFER 305.458.3334 yyup,
/2e-(7&L 64 (&
46
049$ 14-- 1 °C.(
Z:-
fr C� d
,
frL
Failed l
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Thursday, February 28, 2008
Page 1 of 2
MIAMI SHORES VILLAGE
Building Department
10050 NE 2 Ave, Miami Shores Fl, 33138
Tel: 305- 795 -2204• Fax: 305 -756 -8972
Permit No. RC -2 -08 -348
Certificate of Re- Occupancy
Address: 490 NE 96 Street
City: Miami Shores Village
State: Florida
Zip: 33138
This certificate verifies that the reference property has been inspected by Miami
Shores Village and has been determined to presently comply with schedule of
regulations of Miami Shores Land and Development Code pertaining solely to the
requirement that each one - family dwelling is used and intended to be used for a one -
family dwelling purpose only; however, this certificate does not constitute any
representation or warranty as to the condition of the dwelling or other structures on
the premises described herein, or any aspect of such condition, and interested
persons are advised and encouraged to make their own inspections of the premises
in order to determine the condition thereof.
Builsjng Offici A
C a udio Grande. CBO