REOC-10-1220Scheduled Inspection Date: July 07, 2010
Inspector: Bruhn, Norman
Owner: OSOLASE, MARLA
Job Address: 10101 NW MIAMI Court
Project: <NONE>
Contractor:
Miami Shores, FL
Building Department Comments
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INSP- 147867 Permit Number: REOC -7 -10 -1220
re -occ
Failed
Correction
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
Inspector Comments
please call before go
Angelina Perez 305.651.5502
July 06, 2010
For Inspections please call: (305)762 -4949
Permit Type: Re- Occupancy
Inspection Type: Re Occupancy
Work Classification: Re- Occupancy
Phone Number
Parcel Number 1131010210080
Page 23 of 26
RE- OCCUPANCY
APPLICATION
C vu.r 19
Contact Name: Q C *e''NIL \f‘ kern 0 c-S Po CL(- J Phone # ios - (S S I —SS
Buyer: 1 . ,S� 0 01 s ` 4°I � , .n U Seller: e.. Cut t 1. �r 1 ? e �i Le.,„ Mt/A--
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Realtor: C 0901 ()C tom- _Q C 1 Company Name: -- 6 , 2 (4-Un (, ' n ° 1 Le Ct-If (./
Property Address: \ () (.) N V'J Witawtt C
City: Miami Shores State: Florida
Signature:
Sign:
Print:
Miami Shores Village
Building Department
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:
The foregoing instrument was acknowledged efore me this
day of 1 , 20 0 by QnTL;nk. ?
who is personally known to me or who has produced
NOTARY P LIC:
l
My Commission Expires:
As identification and who did take an oath
Sus E TtE 001)50
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Building Officials Approval:
REV 4 -10
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JUL 0 6 3010
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10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE NUMBER: (305) 762.4949 l!��,,���� � �/�
Permit No.gEO J 10
Re-Occ $60.00
Notary $5.00
Total $