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RC-07-2342Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Date: 11/20/2007 Inspector: Grande, Claudio Owner: TAYLOR, MICHAEL Job Address: 916 96 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 305/751 -3693 Parcel Number 1132060143020 Lot: Building Department Comments Monday, November 19, 2007 Page 1 of 2 J � Passed Inspector Comments CALL JIM AT 305 - 302 -4795. MLD Failed Correction Needed Re- Inspection Fee ($75) No Additional Inspections can be scheduled re- inspection fee is paid . until Monday, November 19, 2007 Page 1 of 2 Miami Shores Village Building Department RE- OCCUPANCY APPLICATION Contact Name Buyer Seller Realtor 'i Company Name W Property Address 10050 N E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 7564972 Permit No. it, 1 °' Loc ID • Phone City Miami Shores State Fl Zip 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 Signatur fLohlvitor ecb (A(2) The foregoing instrument was acknowledged before me this I( day of Ahi , 20 di , by iii 104. wh rsonally known me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: Building Officials Approval: Rev. 10/02/03) CKL424 MIAMI SHORES VILLAGE Re -Occ. $60.00 /,/ Notary $5.00 1- CCF $0.60 Total ;��