REOC-6-16-1709Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 261330
Scheduled Inspection Date: June 21, 2016
Inspector: Naranjo, Ismael
Owner: KIMBERLY KRAUSE, JACK EFROMSON
Job Address: 290 NE 100 Street
Miami Shores, FL
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
RE- OCCUPANCY
Permit Number: REOC -6 -16 -1709
Permit Type: Re- Occupancy
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Phone Number
Parcel Number
INSPECTOR COMMENTS False
1132060134440
June 20, 2016 For Inspections please call: (305)762 -4949 Page 25 of 27
MIAMI SNORES VILLAGE
Building Department
10050 NE 2 Ave, Miami Shores Fl, 33138
Tel: 305 - 795 -2204• Fax: 305 -756 -8972
Permit No. REOC -6 -16 -1709
Certificate o ' Re- Occupancy
Address: 290 NE 100 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.
Building Approval: 4 L, 1.
7
Miami, hores Village ...
Building Department JUN . 0 2016'
10050Te1E(305 X95 2204 Fax: (305) 756.8972 33138 ^��_,.
INSPECTION'S PHONE NUMBER: (305) 762.4949
RE-OCCUPANCY PermitN�
AILICATION
Contact Name: it/ 16 N!� Imo- r0_1A- ° r v Yo w� S o y1. pjjo"c#: 3 c9 S - q 1 - l o
Buyer:. 7� (1 �' Z Seller•�i ✓K a-c �a c.� �-�re n�-s
Realtor: Id + 1 w t�ii. — .. - ...f.`< nl any Name:._. !. i _..W i i t.. W' _A
Property A' ... �.� ..� � �Y�r"� .�,.� _.._..
City: _ Miami Shores ewe _. _ 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 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.
APPLICANT'S AFFIDAVIT: I certify that all the foregoing information is accurate.
Applicant 1"~l: rue: • M MU1
Signature:
The foregoing instrument was acknowledged before me this
day of .... - 20 ._r by .m_.: _�....... _
�NN........
who is personally known to me or who has produced ""-
As identification and who did take an oath
NOTARY
Sign:
Print:
My Commission Expires:
Building Officials Approval:
REV 4 -10
V,Wf P('4 Motary Public State of Florida
Sindia Alvarez
My Commission FF 156750
"e 1,,6 Expires 09/03/2018
Re-Occ $60.00 .................._
Notary $5.00
Total$ ...... _ ........ ........_.................._...