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RC-10-18Inspection Number: INSP - 150373 Permit Number: RC- 1 -10 -18 Scheduled Inspection Date: August 25, 2010 Inspector: Bruhn, Norman Owner: POZNER, MARCIA Job Address: 9013 NE 4 Avenue Road Project: <NONE> Miami Shores, FL Contractor: HH CONSTRCTION GROUP INC Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 REPLACED KITCHEN CABINET DISHWASHER & GARBAGE DISPOSAL Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP- 132660. No access. NB August 24, 2010 For Inspections please call: (305)762 -4949 Permit Type: Residential Construction Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132060460070 Phone: (954)868 -5637 Page 21 of 26 Permit Type: FOLIO / PARCEL # BUILDING PERMIT APPLICATION .1)(1 FBC 20 T 1 4 c - o, Owner's Name (Fee Simple Titleholder) Phone # Owner's Address 3 ,OEc4 " Pig/e.g. 1)02.... City A JV ») State ?' Zip Tenant/Lessee Name /,E1 Email Z"4,, ! )s4 e, 110 e, City Miami Shores Village Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Job Address (where the work is being done) 9 0 3 /o6 County Miami -Dade Is Building Historically Designated YES NO Contractor's Company Name PH CONLMO r 6440, Contractor's Address 373 Pia co 3 4'E City t4 7 -4/-tat SOAtA1 &S State *L / 6 AlE /J 'q Qualifier Name State Certificate or Registration No. C(,c. /5/ 091 ci ti) g6 g-S63 7 Contact Phone Architect/Engineer's Name (if applicable) Value of Work For this Permit $ Type of Work: ❑Addition Describe Work: 120G c 6 DAlteration Submittal Fee $ Permit Fee $ S cot E -mail /J Maste Permit No. cal/ Phone # /V /14 4v 4L Phone # Zip Phone # Permit No zip 33 Certificate of Competency No. NRC tOSTO[.r2oAJG.4200, .. ' Nov coN1 Phone # Square / Linear Footage Of Work: ❑New / Repair/Replace Kz r/1Eov c`gl.r " 575 gi (076 Flood Zone See Reverse side Notary $ Training/Education Fee $ D4,0 Scanning $3' 00 Radon $ ©" l ofl DPBR $ O• Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ 1 trn 00 rumnywn FE 252Q1Qi L ' ": .�•.... (u') 8563 7 33t667 (95868 -set.77 /do ❑ Demolition • •****** * * * ** * * * * ** * ** * * * * * * * * * * * * * * ** Fees*•********•***** * * * * * * * ** * * * * * * * * * * * *•* ** * * * * ** CO /CC $ Technology Fee $ 40 Bond $ Bonding Company's Name (if applicable) Bonding Company's Address City State Zip Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Application is hereby made to obtain a permit to do the work and installations as ittPlbaipd. I'certifyharwork or installation has commenced prior to the issuance of a permit and that all work will be perforaed to matt the standard.' of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a re- inspection fee will be charged. Signature CY) aVem, Owner or Agent The fo egoing instrument was acknowledged before me this ab day tL , 201O,by who is 1 s personally known to me or who has produced 1) d 1Y1/4 NOTARY PUBLIC: Sign: Print: My Commissio * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY top il\ / t i i • Expires: ADEN A �' GIN Notary Public STATE OF TEXAS (Revised 07 /10 /07)(Revised 06/10/2009) As identification and who did take an oath. _. __ Plans 'N) xaminer Engineer Signature The oregomg instrument was ac owledge before me this 4-5 day of FCLG , 20 0 , by 1-10 Co who is personally known to me or who has produced P.--- I o as identification and who did take an oath. NOTARY PUBLIC: ��p \111111 if r� /r� Priers /s • Trot: si p iles: LP/De 6�• l5o 40 -. ' r t1r1 1rtti�i� '' * * * * * * * * * * * * * *, * ** *** * * * *it ** Zoning Clerk checked NOTICE OF COMMENCEMENT A RECORDED COPY MUST BE POSTED ON THE JOB SITE AT TIME OF FIRST INSPECTION PERMIT NO. RC "•/ /O..' /R TAX fOUO NO. 1 132,o60 yrod o70 STATE OF FLORIDA: COUNTY OF MIAMI -DADE: THE UNDERSIGNED hereby gives notice that Improvements will be made to certain real property, and In accordance with Chapter 713, Florida Statutes, the following information is provided hi this Notice of Commencement. 1 111111. 11111111111111111111111111111111111111 CFN 2010R0416576 OR Bk 27326 Ps 3958; (fns) RECORDED 06/21 /2010 12 :36:44 HARVEY RUVIN. CLERK OF COURT MIAMI -DADE COMM FLORIDA LAST PAGE 1. Legal description of property and street/address: '101 q•/EiJU �i0�4D NtZ04M2 `FNoQE'$ 1 c- 33132- 3183 2. Description of improvement ve.,.. `TCIIEEN 14.41Mt■E 3. Owner(s) name and address: 3 r3 PE -N Interest in property: Name and address of fee simple titleholder. 4. Contractor's name and address: NN. COJIST4i k..1 XoAJ 6400P / 37S rq 'A! r4Yef•IOG MzAMX, 5144x4 6s j I C,. 23/4 5. Surety: (Payment bond required by owner from contractor, if any) Name and address: AJ / Amount of bond $ 6. Lender's name and address: 7. Persons within the state of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 713.13(1)(a)7., Florida Statutes, Name and address: 8. In addition to himself, Owners designates the following persons) to receive a copy of the Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes. Name and address: 9. Expiration date of this Notice of Commencement: (the expiration date is 1 year from the date of recording unless a different date is = ified) Signature of Owner Print Owner's Name 61r R.$ e Sworn to and subscribed before me this Print Notary's Name My commission expires: STATE OF F' �NTV OF DADE i H £BYCERT/Mitttthis is a 6 , origitej this cg aL � the �1g� A.D. �4�SV ®s` Ptb 20 `�r ».... - Wad sea. CLERK ofUral <r COLOtyCARA D.C. ^7NA � - II(( Prepared by ill/ 6o 12A AJPE`Z- day of _\,,n,! , 20 I' Q '70 ,...p\Nor C_ODC\CA" c r) \ ,T STZ,442._ r• ok.A (LATONi.), e o ....„ 4 c--A--Or A r rt,,N7 C-C3 ? 33\ 300 p (—Ism crip-40. , . . WILEY ADAM THURMON Notary Public STATE OF TEXAS My Comm. Exp. March 27, 2013 04 - /o lA age Y � Av i Otis z_.., =d Pik) 6_64 4 -i Cvi4(3 `162 as ff p ICk r /S -�� 1 t4 1 o,c.0 k-pIJ °I Ait--e 4"-P A (4 4 ,) 4 -6-7-?-)3 CIVE 3 Pi ., 4 2- ` `\\\ P � ,. \e t ii S asc A___ j€s: P 0 4 li; 6/ • �� 91 S. ,N. Com yP UB1. / /i . r FL ��` 01/04/2010 09:50 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES Z1001 TRANSMISSION OK * * * * * * * * * * * * * * * * * * * ** * ** TX REPORT * ** * * * * * * * * * * * * * * * * * * * ** TX /RX NO 4486 RECIPIENT ADDRESS DESTINATION ID ST. TIME 01/04 09:49 TIME USE 00'47 PAGES SENT 3 RESULT OK SHORES VILLAS CONDOMINIUM ASSOCIATION, INC. A Corporation Non -for Profit 8901 N.E. 2 Ave, Miami Shores, Fl 33138 January 25, 2010 Miami Shores Village 10050 N.E. 2 Ave Miami Shores, Fl 33138 Dear Sirs: This is to inform you that the owner of unit 9013 NE 4 ave Rd. has been approved to install new kitchen cabinets. Thank -you for your attention to this matter. Sincerely, o Olarte esident of . e Association F E B 7, 5 201 Permit No: 10- / Job Name 2009 C -t ,� i, /d/' o 5 / ..t iL' c2j, - / COGt� 2 e.�- ICJ /dt /C� /f 01 42 % lid AA- -, "Nee a4e Norman Bruhn CBO 305 - 795 -2204 Building Critique Sheet M iami Shores Vmage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Plan review is not complete, when all items above are corrected, we will do a complete plan review. If any sheets are voided, remove them from the plans and replace with new revised sheets and include one set of voided sheets in the re- submittal drawings. May 04 10 04:34p AGIO C� PRODUCER Pinnacle Insurance Group InC. 2525 S.W. 27th Ave, Suite 100 Miami, FL 33133 Phone (305) 854 -9898 INSURED HH Construction Group. Inc. 375 Falcon Ave Miami Springs, FL 33166 COVERAGES THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDI. POLICY EFFECTIVE POLICY EXPIRATION LTR INSRO TYPE OF INSURANCE POLICY NUMBER RATLINE/RD/TM DATE (MMJD . LIMITS GENERAL LIABILITY ❑/ COMm RCIAL GENERAL LIABILITY fW CLAIMS MADE ❑ OCCUR n 11 $1000 per claim ❑ . GEM AGGREGATE LIMIT APPLIES PER: ❑ POLICY G PROJECT I LOC AUTOMOBILE LIABILITY ❑ ANY AUTO U ALL OWNED AUTOS ❑ ❑ SCHEDULED AUTOS HIREOAuT05 ❑ NON OWNED AUTOS GARAGE LEABBIUTY ❑ 0 ANY AUTO 0 CERTIFICATE F EXCESS t UMBRELLA LIABILITY 11 OCCUR 0 CLAIMS MACE ❑ DEDUCTIBLE ❑ RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE Y/N OFFICER / MEMBER EXCLUDED? (Mandatory In NH) � a g Oeealbe undor SPE PROVISIONS below OTHER CERTIFICATE HOLDER Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores, FL 33138 [Fax:(305)756 -8972 ACORD 25 (2009101) QF p.1 DATE (MNNODrYY) 05104/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER TH COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURER A: Accident Insurance Company Fax (305) 854 - 9899 AGL88073 O LIABILITY INSURANCE INSURER D; INSURER C: INSURER D: INSURER E: 04/13/2010 EACH OCCURRENCE DAMAGE T'O RENTED 04/13/2011 PREMISES (Ea occurrence) MED EXP (Any one person) DESCRIPTION OF OPERATIONS l LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS General Contractor CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED • TI4E LEFT, BUT FAILURE TO 00 SO SHALL IMPOgg NO OBLIGATION OR A • = OF ANY KIND UPON THE INSURER, ITS A,GEN OR REP ENTATIVES AUTHORIZED REP SE Marcia C. Alvarez , ! .:. -2009 ACORD CORP • - TION. All rights re The ACORD name and logo are registered marks LITY 1 PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per sodden PROPERTY DAMAGE (Per accident) AUTO ONLY • EA ACCIDENT OTHER THAN EA A AUTO ONLY: EACH OCCURRENCE AGGREGATE AGG 1,000,000 100,000 5,000 1,000,000 2,000.000 2,000,000 TORY gas ❑D ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT ed. RD Miami Shores Village Building Department 10050 NE 2nd Ave Miami Shores, FL 33138 Fax:(305)756 -8972 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR EPRES ATIVES. AUTHORIZED REPRESS / Marcia C. Alvarez �/. r THE POLICIES OF INSURANCE LISTED HAVE BEEN ANY REQUIREMENT, TERM OR CONDITION OF ANY MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH BEEN REDUCED BY PAID CLAIMS. LTR I INSRD NERD TYPE OF INSURANCE POLICY NUMBER POLICY (TE M POUCY DATE ( MIDDNYYDYNj LIMITS A ❑ GENERAL LIABILITY AGL82632 04/13/2009 EACH OCCURRENCE 1,000,000 04/13/2010 PREMISE (Ea occurrence) 100,000 n COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) 5,000 IN 0 CLAIMS MADE OCCUR PERSONAL & ADV INJURY 1,000,000 • $1000 per claim GENERAL AGGREGATE 2,000,000 ❑ PRODUCTS - COMP/OP AGG 2,000,000 GEM_ AGGREGATE LIMIT APPLIES PER: ❑ POLICY • PROJECT • LOC ❑ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) • ANY AUTO ❑ ALL OWNED AUTOS BODILY INJURY (Per person) . SCHEDULED AUTOS • HIRED AUTOS BODILY INJURY (Per accident) • NON OWNED AUTOS • PROPERTY DAMAGE (Per accident) ❑ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC • • ANY AUTO AUTO ONLY: AGG • EXCESS !UMBRELLA LIABILITY EACH OCCURRENCE AGGREGATE • OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE • RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABIUTY ANY PROPRIETOR / PARTNER / EXECUTIVE Y IN OFFICER / MEMBER EXCLUDED? (Mandatory In NH) K describe under SPE PROVISIONS below ❑ WC STATU- ❑ OTH- TORY LIMITS ER E.L. EACH ACCIDENT E.L DISEASE - EA EMPLOYEE E.L. DISEASE - POUCY LIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS General Contractor ACS �L7R PRODUCER Pinnacle Insurance Group Inc. 2525 S.W. 27th Ave, Suite 100 Miami, FL 33133 Phone (305) 854-9898 CERTI, .LATE OF LIABILITY INSLAANCE Fax (305) 854-9899 INSURED HH Construction Group, Inc. 375 Falcon Ave Miami Springs, FL 33166 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A: Accident Insurance Company INSURER B: INSURER C: INSURER D: INSURER E: DATE (MMIDD/YY) 02/18/10 NAIC # COVERAGES CANCELLATION ACORD 25 (2009 /01) CIF v ryaw�vuaP...vrcv'.vnrvnn� ivy. ru...y.w • The ACORD name and logo are registered marks ' ACORD Scheduled Inspection Date: August 18, 2010 Inspector: Devaney, Michael Owner: POZNER, MARCIA Job Address: 9013 NE 4 Avenue Road Project: <NONE> August 17, 2010 Miami. Shores, FL Contractor: RAY WILLIAM ELECTRIC , INC Building Department Comments Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Phone Number Inspection Number: INSP- 132680 Permit Number: EL- 1 -10 -20 For Inspections please call: (305)762 -4949 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Parcel Number 1132060460070 Phone: (305)582 -6142 Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 2 of 14 • • • ECEIVED JAN 06 200 • • •• • • • • • • • • • • • • •• • • ?;• �;. • • • • ••' 4 5 ai ?-1'-¢/ "(Veil '7 a )71 - ?/ c ,o, - 27 __(-1/6.71 ✓/' - - /Wii at 4 /,yam/ ei 1,7-4/7441 7d Y 640 i T relthiva -� , f r � /.lIt.7y7 4.14 --a,dy7 - /'' s-a�r a y S r4- W V I W i 1 3 tf