REOC-5-17-1344Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 283128 Permit Number: REOC -5 -17 -1344
Inspection Date: May 25, 2017 Permit Type: Re- Occupancy
Inspector: Naranjo, Ismael Inspection Type: Re Occupancy
Owner: PATINO, ULISES Work Classification: Re- Occupancy
Job Address: 78 NE 101 Street
Miami Shores, FL Phone Number (305)900 -2012
Parcel Number 1132060131330
Project: <NONE>
Contractor: HOME OWNER
Building Department Comments
REOC I Nnfractio Passed comments
INSPECTOR COMMENTS False
For Inspections please call: (305)762 -4949
June 05, 2017 Page 1 of 1
Miami Shores Village .:.
Building Department N� �. � �r
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949
RE-OCCUPANCY Permit No. 9�f 1
City: Miami Sli r s State: Florida Zip: �1
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
Applicant
Signature:
foregoing information is accurate.
The foregoing instrument ryas ac h wl4dged efore me this
day of 20 .x by ..�_ - .���.:�....�1
who is personapnown to me or who has produced
t)IT�' f " BAs identifi ": -W o -d!' an oath
NOTA. IILI ...
Sign. —t-4(
Print:
My Commission
Building Officials Approval:
REV 4 -10
YANADYPRIEfO
MY COMMISSION 0 FF 214031
EXPIRES: March 25, 2019
Bonded Thor Notary Public Underwr ers
Re -Occ $60.QO
Notary $5.00
Total $ 6,5 •4—
I' IA II SHORES VILLAGE
Building Department
10050 NE 2 Ave, Miami Shores Fl, 33138
Tel: 305 - 795 -2204• Fax: 305 -756 -8972
Permit No. REOC -5 -17 -1344
Certificate ot' Re- ccu anc r
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.