RC-08-139Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Date: 01/28/2008
Inspector: Grande, Claudio
Owner:
Job Address: 537 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 1132060171570
Lot:
Building Department Comments
2 ,
P,A 1 9 791
Passed
,
Inspector Comments
CALL JIM AT 305 - 302 -4795
The approval of this Re- occupancy does not constitute an approval of the
Code violations previously identified on this property. Violations are still
active and pending to be resolved. 1/28/08 CG
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid.
until
Tuesday, January 29, 2008
Page 1 of 2
Miami Shores Village
RE- OCCUPANCY
APPLICATION
Date 1/ 3 D`K
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
Permit No. R.- 0(8
Loc ID
Contact Name tri4 Phone #
Buyer Seller Realtor Company Name
Property Address 5-3 7 ' /' "/ 62 v'`` �1---
City Miami Shores State Fl Zip -3 '3 ) .a q
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 8'3
Signature
The foregoing instrument was acknowledged before me this n day of G(h
by '4 6T 1 Au , who ^ wn to me or who has
produced as identification and who did take an oath.
NOTARY PUBLIC:
, 200e
Sign:
Print:
My Comniission Expires:
Building Officials Approval:
Rev. 10/02/03)
JAN 2 3 2008
MU \?V u SHORES VILLAGE
Re -Occ. $60.00
Notary $5.00 i
CCF $0.60-7
Total (1957:2L)