OL-07-1612Inspection Date: 08/02/2007
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: 172 96 Street NE
Miami Shores, FL 33138-
Project: <NONE>
Contractor:
Permit Type: Occupational License
Inspection Type: Occupational Lic Insp
Work Classification: New
Block:
Phone Number
Parcel Number 1132060132630
Lot:
Building Department Comments
OCCUPATIONAL LIC CO SAFETY INSPEC
RAY PEREZ AND ASSOC. PA
FOR
AUG 0a 21
b
Inspector Comments
CALL RAY PEREZ AT 305-758-1136
Passed
Failed
Correction
Needed
Re- Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re- inspection fee is paid .
Wednesday, August 1, 2007
Page 1 of 2
Miami Shores Village
Building Department
OCCUPATIONAL LICENS
CO SAFETY INSPECTION
APPLICATION
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795 -2204
.-k/ , itrmit Fax: (305) 756 -8972
AUG 0 R 2001 No. ek. . `At
BY:
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.
Building Owner's Name h49 ( a /7Erciededvr; Phone # VZ7-6y1"-1ss y
Owner's Address // 9S3 / ,/E 2.44 4Je
City / A.1et f% ,eJ State rl p -csiem Zip r r/
Business Owners Name AIL L Phone # _Tar Art- as (o
Business Name ,P y ,4a. .(1,,4 p j a. /tJ , ,O,4
Address /7Z ,v C 9U, S Pe-/ Suite
City Miami Shores State Florida Zip 33/38
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 e •er R
Signature ,� G %�� iTh
The foregoing instrument was acknowledged before me this
_0_7_, by
day of 4 , 20
who is personally known to m ho has
produced as identification and who did take an oath.
NOTARY PUBLIC:
Sign:
Print:
My Commission Expires: 69/ / ?/2D //
JUAN CARLOS FIGUEROA
0P , Comm# DD0686003
�rt�� 6/17%2011
rxr�t~+it
4j PF if Florida NOtaIyAssn., Inc
AMA 01 PAID
ISO°
Building Officials Approval: Carte'
(Rev. 04/18/03)
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-8 -07 -29342
Invoice Date: August 01, 2007
Permit Number: OL-8 -07 -1612
...................
Date
08/01/2007
Fee Name
Occupational Fee
Fee Type
Fee Amount
Fixed
$75.00
Total Fees Due:
$75.00
Payments
Date Pay Type Check Number Amount Paid Change
08/01/2007 Credit Card $75.00 $0.00
Total Paid:
$75.00
Total Due: $0.00
Wednesday, August 1, 2007