RC-07-2273TOD
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 11/14/2007
Inspector: Grande, Claudio
Owner: MALDONADO, FRANCISCO
Job Address: 1001 96 Street NE
Miami Shores Village, FL
Project: <NONE>
Contractor:
Permit Type: Residential Construction
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Block:
Phone Number (305)756 -1064
Parcel Number 1132060143740
Lot:
Building Department Comments
Tuesday, November 13, 2007
Page 1 of 2
Passed
Il
Inspector Comments
CREATED AS REINSPECTION FOR INSP - 66745. CALL] JIM AT
305 - 302 -4795
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Tuesday, November 13, 2007
Page 1 of 2
Miami Shores Village
Building Department
RE— OCCUPANCY
APPLICATION
Date //
Contact Name
Buyer
Property Address
City
?_
,,q D66 6DJ1=N4
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
Permit No.
Loc ID
KC, 1- ZZ,1.,3
Phone #
Seller
/00/
-9-ec, 28/339-0
Realtor (7 Company Name / 14,/ R .
Miami Shores State
7
Fl
Zip '33/ 3Z
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.
g.c34
Applicant Name
(\ignature
The foregoing instrument was acknowledged before
by J?djty►rat C , who is
produced
NOTARY PUBLIC:
Sign:
Print: /04"
ethis day of AtV , 20
own to me or who has
as identification and who did take an oath.
My Commission Expires:
Building Officials Appr
Rsv. 10/02/03)
NOV 062O7
CC
MIAMI SHORES VILLAGE
Re -Occ. $60.00
Notary $5.00
CCF $0 60
Total \
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