RC-08-394Inspection Date: 03106/2008
Inspector: Grande, Claudio
Owner: BANKER, COLDWELL
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
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
RE OCC FOR MR PERICLES PAYOTI
.
LI.
�
Passed
Inspector Comments
CLALL Mr GREGORIOM AT 954- 682 -9440
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Wednesday, March 5, 2008
Page 1 of 2
lvtic11111 31.1.01 CS v mage
Building Department
10050 N,E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
RE-OCCUPANCY . Fax: (305) 756 -8972
APPLICATION- ` Nn
P xm i 0
�t
/ MAN 5 2008 Loc ID
Date 6/0
Contact Name rte/ C- LE: 5 f El r ierip1014 Phone# %) - t12-- I 4" 0
Buyer 1, Seller Realtor Company Name
Property Address O 1UC 7h fk-
City Miami Shores State Fl Zip 3 -1 S 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 f E7Z/CCF3 q
Signature
The foregoing instrument was acknowledged before me this 5 day of At , 20 es ,
by "Panda S7 1 yy6 i , who is personally known to me or who has
produced fi Iiw(s l i _ L 42,A60 as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
■INE
liwzr
1U'1
4 0t7' % MONICA LISSETH DIAZ
MY COMMISSION # DD 483995
Wit
_ ... ..
My Commission Expires:
Building Officials Approval:
(Re. 10 /02/03)
it EX ° I ES:October20,2009
Aom9odThru Notary Public Undewriters
t52O
SK \ALUNGE
Re -Occ. $60.00 Z
Notary $5.00 Y
CCF $0.60 • ,/
Total C�'a 4 0