REOC-16-1346 Miami Shores Village
MAY 18 2016
Building Department
10050 N.E.2nd Avenue,Miami Shores,Florida 33138 �DafU�l"`c
Tel:(305)795.2204 Fax:(305)756.8972
INSPECTION'S PHONE NUMBER:(305)762.4949
RE-OCCUPANCY Permit
APPLICATION
Contact Name: Victor M. De Jesus Melendez phone#:787-236-3548
Buyer: Victor M. De Jesus Melendez Seller: PHH Mortgage Corp.
Realtor: Madeleyne Sutton Company Name: ONE Sotheby's International Realty
Property Address: 150 NW 99th Street
City: Miami Shores State: Florida Zip: 33150
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 Name:Victor M. De sus Melendez
Signature: 0
The foregoing instrument was cknowledged before me this Oc�
day of1"�EX ,2046,by I1/rCAVJ� Oqa itSIJ.S ,Yt%s9'Ide
who is rsonally known to me or who has produced
As identificatio and who did take an oath
NOTARY P
YEE]
tate of FloridaSig liciano FF 082753Pant: 018
My Commission Expires:
Building Officials Approval:
Re-Occ$60.00
Notary$5.00
Total$16�C.)C)
REV 4-10