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RC-09-2065Inspection Number: INSP - 131672 Scheduled Inspection Date: March 29, 2010 Inspector: Bruhn, Norman Owner: , MIAMI PROPERTY SOLUTIONS Job Address: 190 NE 111 Street Project: <NONE> Miami Shores, FL Contractor: STORMSHIELD HURRICANE PROTECTION SYSTEMS LLC Building Department Comments UPGRADE KITCHEN AND MASTER BATHROOM Passed 04,12:,D7 Failed Correction Needed Re- Inspection Fee March 26, 2010 No Additional Inspections can be scheduled until re- inspection fee is paid. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspector Comments rc For Inspections please call: (305)762 -4949 Permit Number: RC -12 -09 -2065 Permit Type: Residential Construction Inspection Type: Final Work Classification: Kitchen Cabinets Phone Number Parcel Number 1121360040150 Phone: (786)222 -1876 Page 4 of 27 BUILDING PERTVIIT APPLICATION FBC 200 Permit Type: 'UILDIN !' ROOFING. Owner's Name (Fee Simple Titleholder) r I A m® - Pk o feel SO /fi / ,( X 0/15 Phone # 30f - rOO - rt p7 Owner's Address //00r ?P #iiSy /v A iin 4 el' P City /4;4-fin V'44 'i State X Zip 73/3 7 Tenant/Lessee Name Email Job Address (where the work is being done) 'Contact Phone LZ e4 Architect/Engineer's Name (if applicable) 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 E -mail 1,1;1 E 1 G 200 i BY :� ooh ®mmo Permit No. RO M 2 O (12J Master Permit No. Phone # 305- '0 7 - / 90 NE /// / / City Miami Shores Villa e County Miami -Dade Zip 3 7/ 4 1 FOLIO / PARCEL # 8 00 - 0/50 Is Building Historically Designated YES NO I` Flood Zone /1/0 Contractor's Company Name '5 - 1 r dv► 04 Contractor's Address 40 1q0-) 33 .b.O1cQ,41JP1 City -f l' tototkexci. State 1 L Zip 3 1 Qualifier Name L.,0% S t go,r a`" 1 CJ Phone # (Z `8 () ZZZ- (a-1z State Certificate or Registration No. C. t Ci 151 10 1/4.) C) Certificate of Competency No. Phone# (726) zv to -G Phone # Value of Work For this Permit $ (I)) L./► �/ ° Square / Linear Footage Of Work: Type of Work: ❑Addition ❑AAlteration , ❑]New Repair/Replace El Demolition Describe Work: v 0 e l /'' ASe 4 1,Aeid ' itj 1 7� ? Qi9 p I "AJebi) C #hr nP S "� ijpc � %Cs4 `f1- fl/m" .� feem, f f4 111401 d Submittal Fee $ Permit Fee $ fSQ CCF $. Notary $ Training/Education Fee $ • (p L ,r � � Technology Fee $ (4) .41) Scanning $ Radon $ p- (Q ) DPBR $ V- (05 Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ 1C11. ` 1 . 1 D See Reverse side --> 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 indicated. I certify that n work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards 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 be 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 bra chur it be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of co be posted at the job site for the first inspection which occurs seven_ _ days after the building permit is issued i e abs -; c: . F ch posted notice, the inspection will not be approved and anspecti fee will be charged. Signature ' G 7' `4 Sign: Print: 6 APPROVED BY (Revised 07110 /07)(Revised 06/10/2009) Owner or Agent The foregoing instrument was acknowledged before me this / • day of Decev , 20c�/ , by -CU d 11. J LeK- , who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: My Commission Expires: au r C Engineer tor The foregoing instrument was acknowledged before me this day of l'J Cce^^6v, - 20 67 by who is personally known to me or has produced 146022.4 `Q 't ( i ® `As identification and who did take an oath. NOTARY PUBLIC: Cos - ' TL / *ZArC77.Plans Examiner Zoning Clerk checked ea ® MUM matums gr mown ammos morms Mina ae� MOM ormort MB= e, a smomm sorer MIMINOM MEIN 0 m !� Silid ti: �J t L U O o ® o ro L9 E c3 LL. 66j Or. C r_ 11 O v O > U 0 0 This Insl„r.umen1 Prepared By: Name t.@ k it ey Address I t by Ften(Lh_ t Permit No. STATE OF - ft. COUNTY OF • THE UNDERSIGNED hereby gives notice that Improvement will be made to certain real property, and in accordance with Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement. 1. Description of properly: (legal description of property, and street address if available) 110 u It 5AD rs / 33// /f 62 136- 126 0/5 7 2. General description of i rovement: k t -ch eel aria W upc)rade ure y a. Name and address: b. Amount of bond $ c. Phone number. NOTICE OF .COMMENCEM ENT 3. a. Owner information ndrid 'RV S /f//id/ f / � w ,g / /,, p b. Interest in property: a. Name and address: ,774,n; �` ' 7 7' ' / !� A( / /� ' #74 ,./ '. /� c. Name and address of fee simple titleholder (if other than owner): ! ' 0 /" /` 4 - 4 lief 4. Contractor: / a. Name and address: ?Q /I/ Q &it frig Si m ; 17 1 ; (q0 ‘1 AZ .Y,3/. b. Phone number. 7/ 222- .)F 7 . � 6. Lender a. Name and address: b. Phone number: Tax Folio No. 7. Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section 7 13.13(1)(a)7., Florida Statutes: a. Name and address: b. Phone number: 8. In addition to himself, Owner designates the followin Section 8 R era on(s) to receive a copy of the Llenor's Notice as provided in 7.13.13(1)(b), Florida Statutes: a. Name and address: b. Phone number: 9. Expiration date of notice of commencement (the expiration date Is 1 year from the date of recording unless a different date Is specified) WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 713, PART I, SECTION 713.13, FLORIDA STATUTES, AND CAN RESULT IN YOUR PAYING TWICE FOR IMPROVEME, YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE -.:B SI BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR ND$ OR ATTORNEY BEFORE COMMENCING WORK OR RECORDING YOUR NOTICE OF bOMMENCEMENT. The regoing instrumirl yva¢ acknowledged before me this " O /Let (name of parson) as authority, ...e.g. officer, trustee, attorney in fact) for behalf of whom Instrument Was executed). t1_1°°6 C. PATRICIA BETANCOURT y�� MY COMMISSION # DDS58928 *OP ' EXPIRES: June 27, 2010 (407) 308-0108 Florida Notary Savice.aom Signature of Owner or Owner's ,s Officer /Director Partner /Manager ` f Ater Signatory's Title/Office (type of -(name of party on Signs 4 . Notary Public - State of Florida ` Print, Type, or Stamp Commissioned Name of Notary Public Commission Number • Personally Known or Produced.ldentification Veriflcaffon Pursuant to Section 92 625 Florida Statutes Under, penalties of pe4ury, 1 declare that I have read tht) foregoing and that lh stated In it are true to the bust' of my knowtedg and belief. S)gnaturroof Natural Person Signing Above Miami Shores Village Building Department 10050 NE 2 Ave. Miami Shores FL, 33138 To Whom It May Concern: Miami Property Solutions, LLC, authorizes Stormshield Hurricane Protection Systems LLC, to work in the upgrade of the Kitchen and Master Bathroom at 190 NE 111 St., Miami Shores, FL 33161. For any questions on this matter please contact us at 305 - 400 -4842. Thanks in advance for our attention. Miami Property utions LLC Eddie Miller December 21, 2009 gocci-oUps re C ti 2000 Ui A. Settlement Statement U.S. De artmeint of Hoaxing ' and Urban Development AN OMB Approval No. 2502 - 0265 B. Type of Loan 1.Er FHA 2.0 FtnHA 3. 0 Conv. Unins. 4.0 VA 5.0 Conv. ins. C. U• E: This orm is to 6. File Number 371-09p ss 7. Loan Number 8. Mortgage Insurance Case Number rnis ie. give you a statement o actu: settlement costs. - mounts paid to and by the sett ement anent are shown. Items marked "(p.o.e.)" were paid outside the closing; they are shown here for informational purposes and are not included in the totals. D. NAME OF BORROWER: Miami 190 ADDRESS OF BORROWER: U .. Property Solutions LLC NE 111 STREET 1, u a • ■ • '1 • : 0 : • • ADDRESS OF SELLER: e lens an. • ene icianes o t e tate O ' • ert ' . arstco, r., 3611 N 54 AVE HOLLYWOOD FL 33021 ADDRESS OE LENDER: G. PROPERTY 190 NE 111 St LOCATION: Shores, l- 21360040150 Tax f• : 65-00509 OF 1 i ►•t le U :U io • 1. TTL NTD•T : • . 1 • ,'1' 1 : 1 '1` a }' • •jI' . a . i *I ' /I' ! M qDt' Y1` • . 100. GROSS AMOUNT DUE FROM BORROWER 1 1. GRO S AMOUNT DUE TO SELLER 101. Contract sales price 235.000.00 401. Contract sales price 235,000.00 102. Personal property 402. Personal pro 103. Settlement charges to borrower (line 1400) 13,027.10 403. 104. 105. 405. Adjustments for items paid by seller in advance Ad1 i for items paid by setter in advance 106. City /town taxes to 107. County taxes 12/3/2009 to 12/31/2009 406. City /town taxes to ' 200.30 407. County taxes 12!3/2009 to 12/31/2009 200.30 108. A sessments to 109. WASTE 12/3/2009 to 12/31/2009 41 58.37 58.37 409. WASTE 12/3.'2009 to 12/31/2009 110. to 410. to 111. to 411. 10 112. to 42. to 120. GROSS AMOUNT DUE FROM BORROWER • 420. GROSS AMOUNT DUE TO SELLER �► 23 +,255.67 200. AMO S PAID BY OR IN BEHALF OF BORROWER 1 1 - REDUCTIONS IN AMOUNT DUE TO SELLER 201. Deposit or earnest monev 10.000.00 501. Excess d eposit (see instructions) 202. Principal amount of new loan(s) 181.000.00 502. Settlement char to seller(line 1400) 16.143.00 203. Existing loan(s) taken subject to 503. Existin loans) taken subject to 204. 504 P of first mortgag loan 205 505. Pavaff of.second mortgage loan 206. Princi • al amount • f new loan s 506. 207. GARAGE 200.00 517: : R 200.00 208. 508. _209. 50 209a 509a .2096 309b Adjustments tor items unpaid by seller Adjustments for Items unpard by seller 210, Citc /town taxes to 510 City /to taxes to 211. County taxes to 511. County taxes to 212. Assessments to 512, Assessments to 711. to 513. to 214. to 514, to 215 to 515, to 216. to 516. to 217. to 517. to 218. to 518, to 219. to _ . TO A AMOUN • PA BY OR IN BEHALF OF BORROWER. ]P 519. to 16343.00 191,200.00 1. "O 1 1 1 - 0 - 1 AMOUNT DUE SELLER 600. CASH AT SETTLEMENT TO/FROM SELLER 300. CASH AT SETTLEMENT FROM/TO BORROWER .311 . Gross amount • ue • om • orrower the 0 302. Less amounts 'aid b /for borrower line 220 303. CASH tl From 0 To BORROWER S 191,200.00 57,085.77 .1 MSS amount , - to . I _ 1 602. es. reductioi in amount 1 603. CASH RI To 0 From SELLER O. .III 218.915.67 • 'AGE 1 t'mal Display S?*•emratf$63)163 - Laser Generated HUD-I (3 -861 RE.CPA. 118 4305 2 Permit No: 09- 0 )665 Job Name: 2 , 2009 Building Critique Sheet e e Norman Bruhn CBO 305 - 795 -2204 M iami Shores Viiiage 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. Permit No: 09- 2 ®45 Job Name: en fr y , 2009 ELECTRIC Critique Sheet Miami Shores Viiiage Building Department 10050 N.E.2nd Avenue Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Page 1 of 1 Aie e.. _S ,e1.4c / L �d 91`> (-- e 77s r , Y afr/ a b' At t. y 67,2) 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. Mike Devaney 305 - 795 -2204 POOL 7.5ft 10ft r 't 2.51} Living Area First floor CABANA BA BED RM BA ■ 4.5ft oro d 1044 \roan ueffAck, W' aid Total Living Area (Rounded). Non -living Area 2 Car Attached BED RM POOL 6.5ft 42.5ft FAMILY ROOM LIVING ROOM 21ft 618.8 So ft 23.5ft DIN AREA .. ... . • • • AreaCateulationn :.E .' • .. 184sift • •• • • • • • • • • • • • • ••• 23785q& • • • • • • • •• •• • • ••• • • • cLOsET • • • •.. • BATH Rbom BED RM KITCHEN 2 /CAR GARAGE aetctarto; Details 19ft 41.5ft 27.5ft 22.5ft •• ••• 2190.6 Sg ft 2.5 x 0.5 = 1.25 35 x 4 = 140 •• • • •••• •••• •••• 34.5x8 = 276 • • • • • • 6.5 x2 = 13 •• • • ••• • • • •• • 33 x 27.5 = 907.5 • • • • • •• • • •• 18x3 = 54 • • ••• • • • 41,5x19 = 788.5 0.5 x 41.5 x 0.5 = 10375 ••• • • • • • • • • • • • • • •• •• • • • 23x8 27.5 x 22.5 184 = 618.75 •• •. • • • •• 00 • • • • • • • • • • • • • • •.• • • • • • .. . • • • • • • ••• • • • 0 • • • ••• • • •• • • •• • • • • • •' • • • •• • • - • •. • • • • • • • •• • • • • • • • • ••• ••• ••• • • •• •• • • • -.• •••- ••' • • • • • • • •..• • •• • • • • • • 0 • • • . •• • • • • • ••• •• .. ... • • • • • • • • . • • • • •. • • ••• ••• ••• • •• • ••• • • •• • • • • • • • • • • • •• • • • • • • * 4110 • •• • • ••• • • • ••• • • • • ••J • • • • • • • • • • • • • ••• • • • • • • • • • • • • • • •• •• • • • .• •• ••• • • • 000 • • c EEC 6 206q BY:__ •• .. • • • ••• • . . • • . . •. . ••••• • • ... . . . •• • • :�. • •• ' • • • . ': • • • •.,- - -- • • • • ••• .• • •-• • • • • • • • • •• •• • • • •• •• • • • ••• • • • ••• • ; 74j 7 ',/ Miami Shores VIII:, e APPROVED BY DATE ZONING DEPT BLDG DEPT lb., SUBJECT TO COMPLIANCE WITH ALL FEDERAL STATE AND . •UNTY RULES AND REGULATIONS EEC 6 206q BY:__ •• .. • • • ••• • . . • • . . •. . ••••• • • ... . . . •• • • :�. • •• ' • • • . ': • • • •.,- - -- • • • • ••• .• • •-• • • • • • • • • •• •• • • • •• •• • • • ••• • • • ••• • ; 74j 7 ',/ Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 190 111 Street Miami Shores, FL 1121360040150 Block: Lot: MIAMI PROPERTY SOLUTIONS l Owner Information MIAMI PROPERTY SOLUTIONS LLC Fees Due CCF DBPR Surcharge Education Surcharge Permit Fee - Additions/Alterations Radon Surcharge Scanning Fee Technology Fee Total: Amount $4.80 $O.65 $1.60 $180.00 $0.65 $3.00 $6.40 $197.10 Address Valuation: Total Sq Feet: $ 8,000.00 130 Contractor(s) Phone Cell Phone STORMSHIELD HURRICANE PROTEC (786)222 - 1876 Approved: In Review Comments: Date Approved: : In Review Date Denied: Type of Construction: KITCHEN Stories: Front Setback: Left Setback: Bedrooms: Plans Submitted: Certificate Date: Bond Retum : & BATHROOM REMODEL Occupancy: Single Family Exterior: Rear Setback: Right Setback: Bathrooms: Certificate Status: Additional Info: Classification: Residential In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy PROVED Expiration: 07/03/2010 Parcel Number 190 111 Street MIAMI SHORES FL 33161 -7048 Phone Invoice # Total Amt Paid Amt Due RC -12 -09 -36659 $ 197.10 $ 197.10 $ 0.00 Check #: 1138 Applicant January 04, 2010 Date CeII For Inspections please call: (305)762 -4949 Available Inspections: Inspection Type: Drywall Final Framing Insulation January 04, 2010 1 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 190 111 Street Miami Shores, FL 1121360040150 Block: Lot: MIAMI PROPERTY SOLUTIONS l Owner Information MIAMI PROPERTY SOLUTIONS LLC Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $225.00 $3.00 $0.80 $229.60 January 04, 2010 Address 190 111 Street MIAMI SHORES FL 33161 -7048 Contractor(s) Phone CeII Phone MG PLUMBING & SPRINKLER SERVIC (305)525 -9236 Type of Work: PLUMBING Type of Piping: KITCHEN & BATHROOM REMODEL Additional Info: Bond Return : Classification: Residential Parcel Number In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. Authorized Signature: Owner / Applicant / Contractor f Agent Building Department Copy Perrrr Tom: Plulmbi ✓o etiort A 40 /A Gr�Ition AP PROVED Phone Invoice # Total Amt Paid Amt Due PL -12 -09 -36660 $ 229.60 $ 229.60 $ 0.00 Check #: 1138 Applicant Valuation: Total Sq Feet: For Inspections please call: (305)762-4949 Available Inspections: Inspection Type: Top Out Re Pipe Main Drain Heater Water Service Water Main Final Lavatory Underground January 04, 2010 Date Expiration: 06/22/2010 CeII 1 Iw BUILDING PERMIT APPLICATION FBC 20 Permit Type: PLUMBING n Owner's Name (Fee Simple Titleholder) /� l /�] , r' $11 " 2 01 e �( `� 5:/.4 Phone # 30 7� - c/o - Owner's Address / 60 7 f P/I/j 5 kA rl i H Ave l d City /r(a -M, 3eAc- l State ,,CL Zip 33/1 7 Tenant/Lessee Name // Phone # 3 o5 - Email d/r'!i /1 A a72Mf %/1 vPfT44f. C o / Job Address (where the work is being done) 17 0 N /1 Miami Shores Village Building Department City Miami Shores Village, County Miami -Dade FOLIO / PARCEL # 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 Permit No. _ 20(0(D V1 Master Permit No. // -,2/36 - 00V -o /5 Is Building Historically Designated YES NO Flood Zone /V Zip Architect/Engineer's Name (if applicable) Phone # Zip aj/ 6,9 j TZW DEC' 1 6 2009 BY. Contractor's Company Name i 7 I �- � � ��, i � JC Phone # 3 £S 6Z ! 2 36 Contractor's Address , / Z 4s ,i p $o .33/6 / City ' State /f Qualifier Name y Phone # ; 7 L. 2-31;=. State Certificate or Registration No. C Fe- tQ 5 2.4., Certificate of Competency No. I Contact Phone 3 0J — 5 ZJ' de' `Z 3 L E - mail Value of Work For this Permit $ / C ° ® Square / Linear Footta Of Work: Type of Work: ['Addition ['Alteration ['New J Repair/Replace ['Demolition Describe Work: �// �/ / )l R ® k u 4 -1' 4Pn Sin F- 4 3/1Xlidia6Agit R - New (n i /e/ 3A./ X Roast VAn I.-it Tvh 3 *************************************** F * * * * * * * * * * * * * * * *** ** * * * ** * ** * ** Submittal Fee $ / Permit Fee $ 22 ' CCF $ 0 . 0 0 CO /CC $ Notary $ Training/Education Fee $ 0.9 Technology Fee $ a YO Scanning $ 3`00 — Radon $ DPBR $ Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ 429t <00 See Reverse side —* 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 indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards 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 be 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved , a re spection fee will be charged. Signature Owner or P ent The foregoing instrument was acknowledged no before me� this / / r day of 0 eCA•wbv/ , 20 d , by c LA/CV � Jam✓ who is personally known to me or who has produced As identification and who did take an oath. L APP My Commission Exp (Revised 07 /10 /07)(Revised 06/10/2009) � ,� 1 e 7 Al a i I X Signature Contractor The foregoing instrument was acknowledged before me this 1 r da of b LLn^ , 20 C by c) qrne 5 Li. PY CPM who is personally known to me or who has produced 1 L 6-A/ / Ait C1 C 056`120as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: e - My Commission ********************************************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Plans Examiner Zoning Engineer Clerk checked Village of Miami Shores 10050 NE 2nd Ave. Miami Shoran FL 33138 MIAM!S3 SHOULD ANY OF THE ASOYE DBSORENO POLICIES ME CANCELLED BEFORE TEE EXPIRATION GATT' THEREOF, THE MUMS AGURMRWILLENDEAVOR TO NAIL DAYS WRIT EN Wm= TO THE GENTIFE ATE HOLDER NAMED TO THE LIFT, OUT FAILURE TO CO SO SHALL INANE NO OK CATION CALAMITY OF ANY KIND UPON THE INSURER, ITS AssNTS OR LEWES wrarirE$ AutH = RESEN7ATIYE , THE ANY MAY POLICIES. LTR IASR POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH REEF PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES CESCRIBED HEREIN 18 SUBJECT TO AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. FORTHE POLICY ECT TO WHICH THIS AU_ The TERMS, EXCLUSIONS IATE(51MlDDJTYYY) PERIOD INDICATED. NOTWTrHBTANDINO CERTIFICATE MAY BE ISSUED AND CONDITIONS DR OF SUCH ' TYPE OF INSURANCE POuOYIIUNEER DATE FFE UNITS EACH OCCURRENCE 5 GENERAL LABILITY 1 IMMsRCIAL GENERAL LLANLITY cla9 mAOE OCCUR 1 w PRESSES (Ea o S MED EEP (Any ono parson) 5 PERSONAL & AM INJURY 5 - -- 27SRALAGGREGATE Ep 5 GEHLA58REGATEIJMI'T APPLIES PER' POLICY 1 l T& — I LOC PRODUCTS - COMPrOPAGO 5 AUTOMOBILE — — LJABILrry ANY AUTO ALL OWNED AUTOS SCIIEDULEDAUnDS HIRED AUTOS N04.OW NED AUTOS COMM EAGLE UM r 5 BODILY .NJURY (Per Anon) BODILY INJURY (Par skrY) rs PROPERTY ar u 0 AMAL GAMES UASILTTY ANY AUTO AUTO ONLY - EA ACCIDENT 5 D ER THAN EA Aar 5 AUTO ONLY AGG 5 - — DOESS +A LIABILITY EACHOCCURRSNOS 5 OCCUR GLAGI5 MADE I� OEOUCTI LE RETEMION 5 AGGREGATE S S E A WORKERS AND EMPLOYERS' ANY PROPRIETORMARTNERVECUTI OFFICER/MENIBER (MggaqmryInNH) a. SPECIAL S PECIAL AL COMPENSATION UAMLU1Y � � WC 07079196 10/12/09 10/12/10 K TORY TATU- ER • EL EACH ACCIDENT 5100000 y[ Sy,OLIJ0E0? L— PO PROVISIONS 44JVw EL DISEASE -EA EMPLOYEE 10100000 E L INSEAM POLICY LIMIT 8500000 OTHER , I O1, EXCLUSIONSAD DEDBY MSIONS DE54RIPY KAI OP OPERATIONS I LOCATIONS 1w@. E$ 12/14/2009 10:55 FAX 5613611132 FR UCER INSURED Workers Comp. Group g001/001 CERTIFICATE OF LIABILITY INSURANCE ONLY AND CONFERS NO RIGHTS U PON THE CERTIFICATE I � Workers compensation Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P 0 Sox 410 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Baca Raton E 33429 -0410 Phone:561- 392 -3300 Fax :561 361 - 11.32 COVERAGES P 2 98 t Spsinkles Sere 1266 CERTIFICATE HOLDER ACORD 26 (2009101) INSURERS AFFORDING COVERAGE INSURER A: AuquiCap Insurance Co. INSURER B INSU C: INSURER 15 INSURER E CANCELLATION The ACORD name and logo are registered marks of ACORD DATE (MN,[IDMYYYI OP PLII 1 1x/14/09 p F OR A T NAIC # 1988 .2009 AA . CORPORATIdN. All ripht9 reserved. THE ANY MAY POLICIES. L i A POLICIES REQUIREMENT. PERTAIN, OF INSURANCE LISTED BELOW TERM OR CORRIDOR THE INSURANCE AE=FORDEO AGGREGATE Lam SHOWN MAY HAVE BEEN ISSUED TO THE OF ANY CONTRACT OR OTHER BY THE POUCIES DESCRIBED HAVE BEEN REDUCED gY PAM POLICYNDM8�1 - INSURED NAMED ABOVE DOCUMENT WITH HEREIN IS SUDJECT CLA I MS- POLICYEFFfiCTR�E tonR nnroDmrtp FOR THE POLICY RESPECT TO WHICH TO ALL THE TERMS, FOLIGY5 PIRAAT14N Dp ,�.;.., PERIOD INDICAuSD_ NOTINITHSTANOING THIS CERTIFICATE MAY BE ISSUED OR EXCLUSIONS ANp CONDITIONS OF SUCH M TYPE INEURPINCE EM. LIABILITY COMMEPoGALGENERAALu siuTY "-- LIMITS 1 ,34092 9/23/2009 9/23/2010 EACH OCCURRENCE $ 1,000, 000 a 100,000 diSFN , � � r Y _ ,,. .. AL� CLAMS MADE r„a OL CUR M$D ERP (Anyone Person) S 5,000 PERSONAL A ACV INJURY $1,000,000 GENERAL AGGREGATE $2,0100,000 0E41L AGGREGATE UM APPLIES PER: MUM r1 2� n we. PRODUCTS - G PJOP AGG $1,000,000 I3 ALS011 maim* ANT AUTO ALL OWNED AUTOS St HOWLED AUTOS H1RF,0 AUTOS NON.OWNEO AUTOS CA -24753 9/23/2009 9/23/2010 COAIE#INED SINGLE UNIT IEe soLlgeaE $ N / A BODILY INJURY IPerpalaen) $15, 000 BODILY INJURY (ParecaldeM) 530,000 PRR DAMAGE $15,000 '� -- III GARAGE Lummorr ANYALITO AT /14. AUTO ONLY - MAMMY 5 OTHER THAN EA ADC AUTO ONLY; MO $ S EXCESS J IIMERELLA OCCUR [ . j CLAIMS wc DEDUCTIBLE RETENTION 5 N/A _ _ EACH OCCURRENCE $ ■ AGGREGATE $ a $ $ WORP!RB AND $MPLOYER17 A?IV PRQPR15TQ ; Mardat R dnsa SPECIAL COMPENSATION LIABILITY v I N f Nf WC STATU- TS left 1T]RY LRA sa E.L. CAW AOOIDENT 5 !pARTNCR+61tK ArivE NI. DISEASE. EA EMPLOYEE NI. 5 ill NH) to o der PROVISIONS WOW E.L DISEASE . POLICY LIMIT 5 D E B C A P T I 0 N OF O P E R A T I O N S 1 LOCATIONS r V I4 I F5 t EMMEN ODES BY s oiaisktiver I :maim, aim, iNtevi ord RESXDEPPTIAL AND COMMERCIAL. PLUMBING CONTRACTOR ta 12/14/2009 10:38 0 PROCRIDOR - TAY XCl+$10WLLEDGE INBURFyNCE , 9101 -C 9. W. 197.'$!, PLACE FO$1T LAUDERDALE, FL. 33324 INSURED Phone: (954) 382 - 5259 Fax: 954)392 -0090 M. G. PLVN TG 6 SPRINGICLERS SVCS. , INC, b RVIN TROY GORCON 1265 NW 203TE STREET MIAMI, FL 33169 COVERAGES CERTIFICATE HOLDER City of MAW. Shores Flrtrida Policy Number: CA-24753 CERTIFICATE OF LIABILITY INSURANCE PAGE 01/01 Data Entared: 9/21 /2007 DATE (MMiDDNYY1) 12/14/2009 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR TER THE COVERAGE AFFORDED BY THE POLICIES BELOW, INSURERS AFFORDING COVERAGE plEUREROacsrodant COmm$acQi#1 Ininurance, inc. IMBNEM gAeCCXldaft COMMercial MusurE.^C1a, inc. INSURER C: INSURER 0: INSURER E: CANCELLATION MARIA A. DIALS, ADEN ` ; A`' NAIC # BNOULD ANY OF THE ABOVE DESCRIBED POLICIESDE CANCELLED REFIRE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MA1439 DAYS WRITTEN NOME To T$E OttitinVATE HOLDER ( N 5U TO THHU LEFT, EDT FAILURE TO OO 80 SHALL IMPOME NO OBLIGATION OR LIABILITY OP $M ROW UPON THE MONO, ITS AUNTS ON _REEPRESERTATIBES. AUYHOM=REPRRSENTAME KYAL:. ACORD 25 (2009101) 01988-2009 ACRD CORPORATION. Alt rights IesOl yeti. The ACORD name and Ieg o aril registered marks of ACORD roduaad u nl Farms Bess Plus software. rtwr.Fomls3osssram; ImplessNe Publishing 8502011-IStT MIAMI -DADE COUNTY TAX COLLECTOR 140 W. FLAGLER ST. let FLOOR MIAMI, FL 33130 PAYMENT RECEIVED INAMI-DADE COUNTY TAX 60030000317 000045.00 SEE OTHER SIDE 2009 LOCAL BUSINESS TAX RECEIPT 2010 MIAMI -DADE COUNTY - STATE OF FLORIDA - EXPIRES SEPT. 30, 2010 MUST BE DISPLAYED AT PLACE OF BUSINESS PURSUANT TO COUNTY CODE CHAPTER SA - ART. 9 & 10 MG PLUMBING & SPRINKLER SERVICE INC MERVIN GORDON PRES 1265 NW 203 ST MIAMI GERDENS DR FL 33169 li 1111411111111111111111111111 11111 illfltlil�l�litlltll�t19 11HISISNOTABILL DONOTPAY 587193 -5 RENEWAL BUSINESS NAME /LOCATION RECEIPT NO. 612435 -8 MG & SPRINKLER SERVICE STATE* CFCO56920 INC 1265 NW 203 ST 33169 GARDENS OWNER MG PLUMBING 8 SPRINKLER SER INC. Sea Type of Buelnpee WORKER /S TSB 42�,6 MBING CONTRACTOR 1 BUSINESS T AX RECEIPT IT - DOES NOT PERMIT THE HOLDER TO VIOLATE ANY REGULATORY OR DO NOT FORWARD DOES Y IT IDIEMPT THE MOLDER FROM'ANY OTHEI9 PERMIT OR LICENSE REQUIRED BY LAW. THIS 10 NOT A CERTIFICATION OF THE HOLDER'S QUAURCA- FIRST -CLASS .U.S. POSTAGE ; PAID MIAMI, FL j PERMIT NO. 231 Project Address Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 190 111 Street Miami Shores, FL Owner Information MIAMI PROPERTY SOLUTIONS LLC Address Contractor(s) Phone CeII Phone AC ELECTRICAL CONTRACTOR (305)635 -9093 (786)402 -7651 Parcel Number 1121360040150 Block: Lot: 190 111 Street MIAMI SHORES FL 33161 -7048 Phone Type of Work: ELECTRICAL Additional Info: KITCHEN & BATHROOM REMODEL Classification: Residential Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Technology Fee Total: Amount $0.60 $0.20 $225.00 $3.00 $0.80 $229.60 Authorized Signature: Owner / Applicant / Contractor / Agent Building Department Copy January 04, 2010 Total Amt Paid Amt Due Invoice # EL -12 -09 -36693 $ 229.60 $ 229.60 $ 0.00 Check #: 1138 Expiration: 06/22/2010 Applicant 9-209 Residential Iti Alteration ECG MIAMI PROPERTY SOLUTIONS I CeII For Inspections please call: (305)762-4949 Available Inspections: I nspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Underground W. W. In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are required for ELECTRICAL, PLUMBING, MECHANICAL WINDOWS, DOORS, ROOFING and SWIMMING POOL work. OWNERS 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. Futhermore, I authorize the above -named contractor to do the work stated. January 04, 2010 Date 1 FBC 20 FOLIO / PARCEL # f 2134 — ou 1(—o/ 5 0 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 BUILDING Permit No. fI 001 — 2CY t 3 PERMIT APPLICATION Master Permit No.h 2aOS Permit Type: ELECTRICAL p� Owner's Name (Fee Simple Titleholder) j}M( & p.Q y /cal ti Phone # (if) lid o — YQ' 1 Owner's Address (6 6 y -/ dp�le�c y A „ ' City f M Q /9-CA State P1 Zip y 3 a, Tenant/Lesseee y Phone # (2o 5' go �.� 35 o Email 4W iet ;G'�1 S I H veS l o�Zf , Cc7 l�'► Job Address (where the work is being done) MO tit $t City Miami Shores Village County Miami -Dade Zip 3 / 6 / Is Building Historically Designated YES NO t Qualifier Name JOSe Yll: Phone # get95 21921 State Certificate or Registration No. EZ /3 00/3 OS " Certificate of Competency No. Contact Phone E-mail jac Vii/,0 .642-agekt/ 31 e7 Structural Review. $ Total Fee Now Due $ ga l' (OD See Reverse side —> DEC WJECCMEWMTH la 1 8 2009 U BY: aa mo.P � oemo�m Flood Zone /(/o Architect/Engineer's Name (if applicable) Phone # Value of Work For this Permit $ 500.00 Square / Linear Footage Of Work: Type of Work: ❑Addition Alteration New ©/ Repair/Replace ❑Demolition Desciibe Work: Ayd^I/ e net t'2CQ/ C pt.( t ere LJQ /^eta`o ��_s !Z ell e- BL ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Fees * * * * * ** ****: F * * * * * * ** * * * * * * * * ** * * * ** * * * ***** lei/? ,, Submittal Fee $ Permit Fee $ �,/,! 4:79 4:79 CCF $ 0-(0,0 CO /CC $ Notary $ Training/Education Fee $ 0 . a0 Technology Fee $ 0' r Scanning $ .3 . 1.,D Radon $ DPBR $ Bond $ Double Fee $ Violation date: 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 indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards 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 be 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a re- inspection fee will be charged. Signature APPROVED BY (Revised 07 /10 /07)(Revised 06/10/2009) Owner or Agent The foregoing instrument was acknowledged before me this day of f }- , 20 , by b ewE,2 who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: Cevms ` „ Bonded Um Notary Piero Underwritee My Commission Expires: Signature Contractor The forego i g instrument was acknowledged before me this day of j,‘ , 2001 , by D 7c siQt- who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: am/2 My Commission Plans Examiner Zoning Engineer Clerk checked � . -4--..,- r'. SEE OTHER SIDE DO NOT FORWARD A C ELECTRICAL .CONTRACTOR INC . DAYIRA HERNANDEZ PRES 3451 NW 48 ST • MIAMI. FL 33141 ilb t 191t111' t�411f 19 I silt Fri] stile flu th till Al st S ACORLI, CERTIFICATE MONISM (3)63 -4777 AX (05)279 - Gil Garden Avetrani Insurance Group 10689 N. Kendall Dr. Suite 208 Miami, FL 33176 manse A.C. kcal Contra ors, Inc. 3451 NW 48th Street Miami, FL 33142 GENERAL Lunar/ GONINSMCIAL + LIABILITY CLARIS MADE 0 ODOUR L ACISMIEGATE APPUES F FOLLY ELM LOC ANY AUTO OTNIM ALL OWNED AUTOS 15CHISDULED AUYCS IUD AUTOS __. NON OWNED AUTOS MANAGE UABLLITY ANY AUTO EOM 1UMBRELLA UAeu1T OCCUR Q CLAIMS MADE R DEDUCTi$L$ RETENTION $ AND empLoYsTer LumBlTTV 71 PRO �i- i r • AR1N EXCL m grat&SWiLmm CERTIFICATE HOLDER TOO I1 OF LIABILITY INSURAll :E 1 "Th (ABNDBIYYYY) . 12/15/2009 22 CATE 18 " D 1S A MATTER OF INFORMATION ONLY ANO CONFERS NO RI4 at rs UPON THE CERTIFICATE EMEND OR ALTER THIS CERTIFICATE EAAP 0 I DES NOT tDED RYYTHE POUCIES BELOW. ALTER THE E wc 27087 - 2 INSURERS AFFORDING COVED GE ersunerm First Convert s9 Ins. Co. INSURER B INSURER C INSURER INNSUREF; i COVERAGES THE Pt)LIG PERKDIW GAf1a0, NOTWITHSTANDING THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO ma INSURED NAME TO WHICH IC S PERIOD INDICA N E OR M AY RE T iR N, THE TERM OR AFFORDED OF ANY CONTRACT ER HBREI IS SUBJECT HEREIN t5 WTH RESPECT ELTHE HIGH 1 $ t�QNC AND C. Y BE ISSU DF SUCH MAY PERTAIN, THE � NSURANt AFFOR4� sY THE POLICIES DESCRIBE) mums, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED SY PAID cLpIM 8. 04/17/2 NOL VNIKO1 IVDINI3aia DV OP CRIERATIons / LOCATIONs /vE ss OCCLUSIONS AWED BY lam• PROMMOW- 04/17/2010 Miami Shores Village Building Department 10050 NE 2nd Avenue Gil Mi :.,, Share, FL 33138 25( 1 FAX: 305.756.8972 The ACORD nano and logo are ltd tarts 0 1 rraTar�. _, AIMMIIMO RspRESENTATRIB Z M ?MOLE LINT IP P:4') , Rt NLY INJURY IP maelaeM) ACI5 A CO ACOR[I UNITS I ,I =MIME T kt _ t tat e p6 E?6+ gem Pia S 6 5 i (P I =Nam) Al - 'O ONLY • FA ACCIDENT S EAACO 8 At '0ONLYN Age S B )H occURREM+B $ • aREVATB 6 NAIC n $ s DE SONALL & AOV INJURY T GRAL AGGREGATE ic wars • AGO S H . EAOtiACCIDENT 5 100,00z- s _aIS$ASE -GA Dm. p- 9 100■00$ E . olse • POUCY LIMB & SOO.00 CANCELLATION M4OULO ANY woe A$O 5OMBCRI is MUM MI BISVRO YEE EWI CATION usT,s Y,IEREQP,' issw*o IAA B mu. BIDBAYQ TO eiAs. 3 Q.. DAYS== I TU/ TOME TOVets cERTIPCNTIS HOLM $I mere 1. FT. Bur sawmills Daatr SHALL 1 8NOOBIJGATWNOR Net KM waning ersURER.ns 5806 919 20S XV3 90 :10 BOOZ /9T /ZT 12/10/2009 05:15 FAX 305 908 r LtiUER CUN CERTI 2 1CATE OF LIABILITY INSURANCE PRODUCER Government Insurance Ceirj 320 Hialeah Drive Hialeah, FL 33010 Phone (380193-8393 Fax (305)388-193E ElaDRED A.0 ELECTRICAL COMM OTOR, 1NC 3481 ION 43 81 FL 33142 COVERAGES TitE FVLICIES 0 PN4SURANCEST go t 1 i Erato ISSUIED 'r .' Cl — ''TliarlieTAIEIM — NAIIIID ABOVE FO-1 WE POLICID intmcgrlia. rg 'ffwftilerAiioNe ANY REGUIRENENT. TRIM OR CONDITION I F.ANY COMIRACT OR omea COCHMENT mai REsPECT TO WHICH THIS CERIFICATE MAY SE ISSUED UR NIAY PeILTAIN THE INSURANCE APPORms IY THE POLICIES DESCRIBED WEIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDMONS OF SUCH i, _ POIAIES. !moms; LEM Show* rtqA1 lAVE MEN REDUCED EY PAO CLOW iamb Arm i taURANC . _._ FOXY MAWR PaLic _ayipstmc a L F4 TIU LIMITS I R 001111/ERCIAL GENERAL MASS. Y eaNisid.usearry EACH =HMO.= 1,000&30 FEEN1115-0991_ MECO A D , • 100 CLANS MADE CI ODOUR 0 MED EXP (Any ow pawn) ' PAO ..— - PERSONAL &ADV WARY . 1 00 IMO GENERAL AGGREGATE 1,000.000' , GEWCAZREGATE LLEIT a ... 1 440111.1C1 - 7F — CONi/OP AGTE 1 1,01ipxo • ..•• . ..... , ...I. ....0.2 =•• •■•■•■,■,..... •■...• ••■■• ■ , El Parr (3 FRoacT cz,.. UTMDE0 ANY AUTO • • I AOSDLIA SILITY 0 Ali. OWNED Auros 0 . C".I SCHEDULED AUTOS ICI HIRED AUTOS IQ Nolo owlet: Amos I GARAGE LIABILITY 0 CI ANY AUTO ' P ... ID I 1 2 EXCESSARARRELLA LIAMILRY i 0 OCCUR 0 CLAWS WOE i i C3 1 !CI mucriaLE 1.. I 0 Ranwriom $ i i fiwricseametworike-- , , ANY PROPRIETOR / PARTNER / EXEcumE . . EMPLOYERW LIAELLITY • . OFFICER / MEMEER EXCLUDED? 1 i : If yes, desalts under .1 ArgASPAGAYLNg3fletv i I ' 1 ' . thificNiiiithicie aPERATIOiiichiroriS ATE teuisiint-riiiioneetramietaiiini !ELECTRIC/AN I I ' I • • • PAC6828$30 I • . coniPICATE HO-Linat I 11 1! , ACORD " -- a • • - - • - • . • - Warn' Shama Wogs Butidir 13epartment 10050 N.E. 2nd AWRING NUMMI Shares, Fl 33139 INSURER F; 03117/09 •••••••••••-- •-■■•■••■••••■■. • •• •■•••■ •no • ••■•••••••••■••,sso ■•-•••• •-•••-nn.•• •• p . 1 firAT706117divir" 12/11509 mIS CIMIFICATE13 ISSUED AS A MATTER OF N NIFORMATIO . Vaame•••■■■• ONLY AM CONFESS NO RIGHTS UPON THE CERTIFICATE HOLOER_TINS CERTFICA'TE DOES NOT AMEND, EXTEND OR THE INSURERS AXORDING COVERAGE atamo; PENN-AMERICA INSURWICk eei nuamptak moot a: 03117/10 7211...• ••••••711■■••.... Om/kV INJURY BODILY INJURY (Per accident) PROPERTY DAMAGE _ AUTO ONLY - EA ACCIDENT OTHER THAN sfia.k, AUTO ONLY EACH OCCURRENCE AGGREGATE EACH ACCIDENT EL. DJSEASE - EA EMPLOYE ai :PlaE. 13 / 4 • 55 PaIL U11 iiPE‘NAL PROVISIONS - - •■■,........•••••• •.......,111111•••••••■•••■••• COMBINED ENGLE war . irto.E.: • .1./I■mlia,„., - ■••••••■&••...... CAIRN:14010N ......–__.----....._ .... _ ... ._......... — ....._ _._ . . .._ . SHOULD ANY( F THE MOVE DESCRIBED POLICIES IFIE CANCELLED BEFORE THE ExpiRATioND Ter ThEltEcat THE WHINE ROURER WILL ENCEAVOR 'TO MAIL 10 DAYS Iwurran NONCE TOMS CERTIFICATE ROWER ?IAMB TO TFRWFT, NUT FAILURE TO DOS° SNAIL WPM NO OMIGATION OR LIARRHY ay ANN KIND LPON THE NEMER, ITS ANTS oR RIEFonEnfINTATIVOS- AUTI4BRIZED " -- I - -.--".". . -..- - "" - ' ... ' . - ... • .. ' "" fiablifitl alliFoRkiiiihriiiii - Scheduled Inspection Date: March 24, 2010 Inspector: Devaney, Michael Owner: , MIAMI PROPERTY SOLUTIONS Job Address: 190 NE 111 Street Project: <NONE> Miami Shores, FL Contractor: AC ELECTRICAL CONTRACTOR Building Department Comments March 23, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 e ft-A0(06 Inspection Number: INSP- 131960 Permit Number: EL -12 -09 -2093 For Inspections please call: (305)762 -4949 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1121360040150 Phone: (305)635 -9093 ELECTRICAL WORK FOR KITCHEN AND BATHROOM REMODEL Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments Page 5 of 20 Inspection Number: INSP - 131681 Scheduled Inspection Date: March 24, 2010 Inspector: Hernandez, Rafael Owner: Job A IAMI PROPER dress: 190 NE 111 Street Project: <NONE> Contractor: MG PLUMBING & SPRINKLER SERVICE Building Department Comments PLUMBING WORK FOR KITCHEN AND BATHROOM REMODEL Passed Failed Correction Needed Re- Inspection Fee March 23, 2010 No Additional Inspections can be scheduled until re- inspection fee is paid. Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 OLUTIONS Inspector Comments, For Inspections please call: (305)762 -4949 Phone Number Permit Number: PL -12 -09 -2066 Permit Type: Plumbing - Residential Inspection Type: Final Work Classification: Addition /Alteration Parcel Number 1121360040150 3 / ' At-W /4 ' 2 ' Phone: (305)525 -9236 Page 4 of 20