REOC-10-162f
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 134671 Permit Number: REOC -2 -10 -162
Scheduled Inspection Date: February 03, 2010
Inspector: Bruhn, Norman
Owner: BRAZIS, LILLIAN & ALBERT
Job Address: 330 NE 97 Street
Miami Shores, FL 33138-
Project: <NONE>
Contractor:
Permit Type: Re- Occupancy
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Phone Number
Parcel Number 1132060135850
Building Department Comments
Passed
Wc)._J r�
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
PLEASE CALL:
EMILIO VEGA
786- 287 -4288
305 -694 -3818
February 02, 2010
For Inspections please call: (305)762 -4949
Page 17 of 22
Miami Shores Village
RE- OCCUPANCY
APPLICATION
53r75.7771.7
rEB02210
Building Department BY: .:.........,
.10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
. Permit No. geoc
'LocTh •
Bate (644-
Contact Name EYYIg 13 / Phone # —ISA° 2 —LVZ,MOVIOlottC ,
Company Name
.1(02_
Buyer Seller
Property Address
Realtor
3 1476 S -
City Miami Shores State
Fl
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.
--ay's■Vo \ck
The foregoing instrument was acknowledged before me this 02141.1 day of 1.O/1 U , 20 16
by C.. c•A•;i l)to , who is personally known to me or who has
produced VLierv,010, Or e/r5 L- c e
Sign:
Print:
NOTARY PUBLIC:
as identification and who did take an oath.
Notary Public State of Florida
Joanna Moreno
y+�, • My Commission DD900938
�`or offr Expires 06/21/2013
T CA.VlikO■
My Comniission Expires: 2 7.0(3
Building Officials Approval:
Rev. 10/02/03)
Re -Occ. $60.00
Notary $5.00
CCF $0.60
Total