OL-06-1799 Inspection Worksheet JUL
� 2006
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
IMP
Inspection Date: 07/11/2006 Permit Type: Occupational License
Inspector: Grande, Claudio Inspection Type: OCCUPATIONAL LIC INSP
Owner: CORP, FIRST STATES MGMT Work Classification: New
Job Address: 9545 2 Avenue NE
Miami Shores Village, FL 33138- Phone Number (813)229 -8545
Parcel Number 1132060133920
Project: RETAIL
Block: Lot:
Contractor:
Building Department comments
Inspector Comments
Passed
Failed
Correction
Needed
Re- Inspection
Fee.
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid .
Tuesday, July 11, 2006 Page 2 of 2
Inspection Worksheet
Miami Shores Village
V. 10050 N.E. 2nd Avenue Miami Shores, FL
'AR
Phone: (306)795-2204 Fax: (305)756 -8972
Inspection Date: 07/10/2006 Permit Type: Occupational License
Inspector: Grande, Claudio Inspection Type: OCCUPATIONAL LIC INSP
Owner: CORP, FIRST STATES MGMT Work Classification: New
Job Address: 9545 2 Avenue NE
Miami Shores Village, FL 33138- Phone Number (813)229-8646
Parcel Number 1132060133920
Project: RETAIL
Block: Lot:
Contractor:
Building Department Comments
305-490-9945
Inspector Comments
Passed &Z b
Failed i(vul
Correction / 6-t
Needed
Re-inspection
Fee
($75)
No Additional Inspections can be scheduled until
re-inspection fee is paid
Thursday, July 6, 2006 Page 2 of 2
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
OCCUPATIONAL LICENSE Fag (305) 756 -8972
CO SAFETY INSPECTIO r Permit No. OLd(P' 1 �"1 Iq ,
APPLICATION
JUL ®6 200
Per Village Ordinance 14 -32, the purpose ofgbTat - n certificate of Occupancy/ Safety Inspections is
to ensure your safety and to ensure that previous tenants have not changed the original structure in
violation of Fire Safety and the Florida Building Code.
I
Building Owner's Name 6"ee- 4 �/ � \1 � 1ne�S Phone # -
Owner's Address �7 2 � � � c �� � ly CL 3313
City State Zip
So 2 -&C-XQ
Business Owners Name Phone # - �a5 4 f- f �L
Business Name
Address Suite
City Miami Shores State Florida Zip
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will
be done in compliance with all applicable laws regulating construction and zoning.
BUSINESS O
Signature
The foregoing instrument was acknowledged before me this (0 day of �� ��- , 20
by who is personally known tome or who has
produced as identification and who did take an oath.
OTARY PUBLIC:
o , t i, G;
Mabel Varga
_Commission #DD23193
. Q - Expires: Jul 13,200
Sign: F oQ° Bonded Yhru
A rlanric Bonding Co Inc.
Print: n5
My Co ission Expires:
Building Officials Approval:
(Rev. 04/18/03)