OL-07-1293Inspection Date: 06/21/2007
Inspector: Grande, Claudio
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FL
Phone: (305)795 -2204 Fax: (305)756 -8972
Owner: RICHARD CAVA, TODD LEON!
Job Address: 174 96 Street NE
Miami Shores, FL 33138-
Project: <NONE>
Contractor:
Permit Type: Occupational License
Inspection Type: Occupational Lic Insp
Work Classification: New
C1,
Block:
Phone Number
Parcel Number 1132060132630
Lot:
Building Department Comments
occ Ile for Life America Lender LLC °
JUN 21 91
Inspector Comments
CALL 786- 285 -2882
OR 305- 466 -4114
Passed
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled
re- inspection fee is paid .
until
Wednesday, June 20, 2007
Page 2 of 2
Miami Shores Village
Building Department
OCCUPATIONAL LICENSE D M0ECgV�
CO SAFETY INSPECTION JUN 2 0 2001 rmit No. OL� 1L°[
APPLICATION BY .20 MiliVaail
Per Village Ordinance 14 -32, the purpose of obtaining a 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.
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
Fax: (305) 756 -8972
Building Owner's Name Oil Zee941 Phone # 3 6S-- -- ?-r-i- (3 6
Owner's Address 9S 3 q Alm 2" f Ave
City it-Ka-a; S4 a ie 1 State FC--
Zip 33(3?
Business Owners Name ,b fkti t/ (CJ,,�'Iat d Phone # (30S:- *6- VP/
Business Name 4i ,4 e..tes� GQ'dP, GGC - 2sa�
4 2�a�2
Address / ?c/ NE 961-4 e
City Miami Shores State Florida Zip 3 ? 1 3 $
Suite ,--
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 0
Signature
The foregoing instrument was acknowledged
,by j2ani / CG »'1 bu✓
produced
Sign:
My Commission Expires:
NO _ - -- PUBLIC
before me this c90 day of Uh L , 20
who is personate known to me or who has
as identification and who did take an oath.
!; p RAMON PEREZ
, �� ' Notary Public • Mak, of Florida
. ice. �+. „ . Mar13,2108 `®
1-" A Commission • 00272525
Pan
.;N ktP2-
kk)
Building Officials Approval:
(Rev. 04/18/03)
Total Due: $0.00 I
Invoice
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Phone: (305)795 -2204 Fax: (305)756 -8972
Bill To
TODD LEONI RICHARD CAVA
LEOCAVA LLC
PO BOX 381703
MIAMI, FL 33238-
Return to:
Miami Shores Village
10050 N.E. 2nd Avenue
Miami Shores, FL 33138 -0000
Invoice Number: OL -6-07 -28900
Invoice Date: June 20, 2007
Permit Number: OL-6 -07 -1293
Date
Fee Name
06/20/2007 Occupational Fee
Payments
Fee Type
Fee Amount
Fixed
$75.00
Total Fees Due:
$75.00
Date Pay Type Check Number Amount Paid Change
06/20/2007 Check 1941 $75.00 $0.00
Total Paid:
$75.00
Wednesday, June 20, 2007