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RO05-103Type Insp'n Inspection Date MIAMI SHORES VILLAGE BUIL!?ING DEPARTMENT 305- 795 -2204 Build' g Inspection Request Date—.3 ate Permit No. Name Address Company Phone # e 5/II Correction c- �c ;" Re- Insp'n Fee ❑ 0 O± /O, �. W t.T qi /V 6 9, . (Rev. 04/24/03) Address Miami Shores Village Building Officials Approval: Building Department Certificate of Re- Occupancy The following residence is issued a Certificate of Re-Occupancy /1St. Permit No. NOOs —/ 03 Date 0//0 City Miami Shores State Florida Zip This certificate verifies that the referenced property has been inspected by Miami Shores Village and has been determined to presently comply with the schedule of regulations of the Miami Shores Land and Development Code pertaining solely to the requirement that each one - family dwelling is used and intended to 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 inspection of the premises in order to determine the condition thereof. 10050 N.E.2nd Avenue Miami - Snores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 (Rev. 1 0/02/03) • Building Department RE- OCCUPANCY APPLICATION Date -5/°/5 Contact Name Buyer j Seller Property Address City Miami Shores Applicant Name Signature Building Officials Approval: Miami Shores Village ri i W'C Phone # V,erb 9 )7_15/72- Realtor 6 ( 4)Lko a 7y ,✓c 9/ s� OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate. fLLtLr Pr p Htw My Commission Expires: GinnyH. Gonell �_• Commission #DD323870 Expires: May 26, 2008 - ,- 94 ` o ". BondedThru 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795 -2204 Fax: (305) 756 -8972 _Permit No. 0O31 l3 Loc ID Company Name State Fl Zip 33/ 3 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. The foregoing instrument was acknowledged before zne thi 0 day of / / l , 20 ©5 , by / / % o is personally known to • r who has produced as identification and who did take an oath. NOTARY PUBLIC: Re -Occ. $60.00 / Notary $0.60 CCF Total