OL-08-849Inspection Date: 05/12/2008
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: CO, SHAPAR REALTY
Job Address: 9801 2 AAA-
Miami Shores Village, FL
Project: <NONE>
Contractor:
Permit Type: Occupational License
Inspection Type: Occupational Lic Insp
Work Classification: New
Block:
Phone Number -
Parcel Number 1132060134380
Lot:
Building De artment Comments
OCUPATIONAL LICENSE FOR
LA ROCHE SHOES AND ACCESORIES
(217 NE 98 ST)
Passed 4<ii
Inspector Comments
CC
Failed
Correction
Needed
Re-Inspection
Fee
($75)
No Additional Inspections can be scheduled until
re-inspection fee is paid .
Thursday, May 8, 2008
Page 2 of 2
Miami Shores Village
Building Department
• 10050 N.E.2nd Avenue
P` -, Miami Shores, Florida 33138
° g ' �"� Tel: (305) 795 -2204
OCCUPATIONAL LICENSE _ ..,
Fax: (305) 756 -8972
CO SAFETY INSPECTION
APPLICATION
BY. -__V`_ rmit No. OL Vb'75219
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 N ee:C Shalgot I 04+ Phone # 51, 1 - 02 - G O
Owner's Address 1111 ofd Pi n& Ro.otd
City (7((j Ratv State PL-
Zip �2 a
Business Owners Nameebtl r / LJt POC'le/ Phone # 305-1014 21,a
Business Name La Rc'c4i , Syi,oc .iii A cc e Viral
Address 1--In N.'1 o St . Suite
City Miami Shores State
Florida
Zip 32 l
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 OWNER
Signature
aAt.l,cra Roc-kg./
The foregoiN instrument was acknowledged before me this__ day of� 2��
bY��PJG who is erso
p nally known to me or w o has
produced -V1
Sign:
Print:
NOTARY PUBLI
l!I I I �►•'•�
goro ib rit
My Commission Expires:
Building Officials Approval:
(Rev. 04/18/03)
as identification and who did take an oath.
(b..p4 �� •vim