REOC-4-15-925Permit No. REOC-4-15-925
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Unc: ficate of Re-Occupancy
Address., 78 NE 101 Street
City: Miami Shores
State: FL
Zip:
This certificate verifies that the reference property has been inspected by Miami Shores
Village and has been determined to presently comply with schedule of regulations of
Miami Shores Land and Development Code pertaining solely to the requirement that each
one,-family dwelling is used and: intended to be used for a one-family dwelling purpose
only; however, this certificate does not constitute any representation or warranty as to the
condition of the dwelling or other structures on the premises described herein, or any
aspect of such condition, and interested persons are advised and encouraged to make
their own inspections of the premises in order to determine the condition thereof.
Ulding, Approval:
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)'795-2204 Fax: (305)756-8972
Inspection Number: INSP-23,2913 Permit Number.- REOC-4-15-925
Scheduled Inspection Date: April 21, 2015 Permit Type: Re-Occupancy
Inspector: Rodriquez, Jorqe
Owner: IZQUIERDO, NICOLAS
Job Address: 78 NE 101 Street
Miami Shores, FL
Project: <N ONE.
Contractor: HOME OWNER
Building Department Comments
RE-OCCUPANCY
Inspection Type: Re Occupancy
Work Classification: Re-Occupancy
Phone Number (786)231-5339
Parcel Number 11132060131330,
INSPECTOR COMMENTS False I
April 20, 2015 For Inspections please call: (305)762-4949 Page 46 of 56
Inspector Comments
Passed
NICOLAS IZQUIERDO
786-239-6918
Failed
Correction
Needed
Re-inspection
Fee
No Additional Inspecflons can be scheduled until
re-inspection fee is paid.
April 20, 2015 For Inspections please call: (305)762-4949 Page 46 of 56
RE-OCCUPANCY Permit
APPLICATION
Contact Name: AJ/e e 24 'f 0/ �"
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Phone#:
Realtor: < CompanyNarne:
Property Address: /, ' AJ _ 57--
City: Miami Shores State: Florida Zip:
I hereby certify that I understand that the zoning for this 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 ViHage 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,
APPLICANT'S AFFIDAVIT: I certify that all the foregoing information is accurate.
Applicant Name.
Signature:
The foregj>Wg instrument was acknowledged before me this
day of t` X20 Icy V! 3
who ersonally krua lire *
or who has produced
As identification and who cli�jA qe, p oath
NOTARY PQ LIC:,,.
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Sign:
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Print:
My Commission Expires:
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Building Officials Approval:
REV 4 -10
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