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RC-11-2346 (2)Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 184530 Permit Number: RC -12 -11 -2346 Scheduled Inspection Date: February 05, 2013 Inspector: Bruhn, Norman Owner: Job Address: 253 NE 92 Street Miami Shores, FL 33138- Project: <NONE> Contractor: GMB CONSTRUCTION INC Permit Type: Residential Construction Inspection Type: Final Building Work Classification: Alteration Phone Number (305)466 -2990 Parcel Number 1132060133560 Phone: (305)967 -3640 Building Department Comments 3 BATHROOM & KITCHEN REMODEL Infractio Passed Comments INSPECTOR COMMENTS False 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- 184390. Sidewalk must be repaired. Mech and electrical inspections required. window in garage must be inspected including shutters. NB February 04, 2013 For Inspections please call: (305)762 -4949 Page 22 of 30 DEC -18 -2012 04:37P FROM: TO:3I57568972 P.2 '`'� " CERTIFICATE OF LIABILITY INSURANCE f °ATE {MM. ° °'"'''"' 11/30/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. HOLDER. THIS BY THE POLICIES AUTHORIZED IMPORTANT: If the certlflcate holder la an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION 1S WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In Ilau of such endorsement(s). PRODUCER Casualty Systeme 3331 SW 107 Ave Miami FL 33165 CONTACT Juan Hernandez NAM PHONE F (305)551 -0590 x (30 08 I IA / FAC, N4L 5)551 -57 pSS;juanQcaeualtyeyatema.cam INSURERIBI AFFORDING COVERAGE NAIL Y INSURERA :Colony Insurance Company EACH OCCURRENCE INSURED A & J Roofing Corp. 7947 NW 64 St Miami FL 33166 rnveo A r - -- _ __—._. — - -- - -- -- -- -- INSURER B : S 100,000 INSURER C : I CLAIMS -MADE © OCCUR INSURERD: $ 5,000 INSURER E : INSURER P ; S 1,000,000 • mcviorVre raunnoCK: THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW 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. LIMITS SHOWN MAY HAVE BEEN REDU CEO BY PAID CLAIMS. INSR LTR TYPE ADOLSUER' INRR,Min POLICY NUMBER 0890768 -a ' POILJ�CYEEFF j(4NTDOIYYYYI 11/20/201211/20 POL�ICYEXP (MM /DDIYYYYI /2013 UMITS A GENERAL X UABIUTV COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 PREMISES Ee occurrence) S 100,000 I CLAIMS -MADE © OCCUR MEDEXP (Any onapereon) $ 5,000 PERSONAL AADVINJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GENLAGGREGATE MIT APPLIES PER: TO POLICY I L_JECa7 ( 1 LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ AUTOMOBILE — UABILITY C pMBIIWEsO SINGLE LIMIT s ANY AUTO AUTOOWN ED MIRED AUTOS ., SCHEDULED NONOWNED AUTOS BODILY INJURY (Per person) $ BODILY INJURY (Per accident) S PROPERTY DAMAGE (Per BCCidantl $ $ UMBRELLA LIAB EXCESSLIAB OCCUR CLAIMS-MADE EACH OCCURRENCE S AGGREGATE $ DED 1 1 RETENT ON $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Yr N OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes desclbeunder DESCRIPTION OF OPERATIONS below N /A , TORY LAMI7S I ER E.L. EACH ACCIDENT $ E.L. DISEASE • EA EMPLOYEE S E,L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES (Attach ACORD 101, Additional RsmarltsScho* a, 11 more space Is required) CgRrIrletATF um ncn ANCELLATION City of Miami Shores Building Dept. 10050 NE 2nd Ave. Miami Shores, FL 33138 ACORD 25 (2010/05) INS02E onlnnSi (11 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE Juan Hernandez /YOYI 01986 -2010 ACORD CORPORATION. All rights reserved. Tho Ar:rl1 f nom* oriel Inns aro ranIatararl marks of Alf1R11