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ELC-10-962Inspection Number: INSP - 144579 Permit Number: ELC -5 -10 -962 Scheduled Inspection Date: June 15, 2010 Inspector: Devaney, Michael Owner: Job Address: 9526 NE 2 Avenue Project: <NONE> Contractor: ADT SECURITY SERVICES, INC Building Department Comments BURGLAR ALARM INSTALLATION SUITE 103 Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments FOR UNIT #101 45 — June 14, 2010 Miami Shores, FL 33138 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 For Inspections please call: (305)762 -4949 Permit Type: Electrical - Commercial Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132060132630 Phone: (786)331 -3967 Page 15 of 25 Inspection Type: Final Meter Box Alteration Relocation Fire Alarm Service Change Underground W. W. Protect Address 9526 NE 2 Avenue Miami Shores, FL 33138 1132060132630 Block: Lot: MIAMI SHORES MEDICAL CENT Owner Information Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138 -0000 Phone: (305)795 -2204 MIAMI SHORES MEDICAL CENTER INC 9526 NE 2 AVE MIAMI SHORES FL 33138 -2750 1 Contractor(s) ADT SECURITY SERVICES, INC Phone (786)331 -3967 CeII Phone Type of Work: ELECTRICAL Additional Info: BURGLAR ALARM Classification: Commercial Scanning: 1 Fees Due CCF Education Surcharge Permit Fee - Additions/Alterations Scanning Fee Submittal Fee Submittal Reversal Fee Technology Fee Total: Amount $0.80 $0.20 $100.00 $3.00 $50.00 ($50.00) $0.80 $104.60 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 June 03, 2010 Address Parcel Number Phone Pay Date Pay Type Invoice # ELC -5 -10 -38015 06/03/2010 Check #: 5613 $ 54.60 $ 50.00 05/27/2010 Check #: 5601 $ 50.00 $ 0.00 Amt Paid Amt Due Date Expiration: 11/29 /2010 Applicant Cell Valuation: Total Sq Feet: $ 1,000.00 0 1 Available Inspections: June 03, 2010 1 Miami Shores Village BUILDING PERMIT APPLICATION FBC 20 s Permit Type: ELECTRICAL �, / i Owner's Name (Fee Simple Titleholder) 2 ,, � e 4i i LI C Phone # 8 S 7 ' 6 - / / 7 Owner's Address Pt) a e` o l 33/73 y! City State I"(_ Zip ,? 5 °3 Y Tenant/Lessee Name ( r VI tnkt) f NClaiel S jela3 1144 Pho # ;SOS 1 - C- 7 6- (p Email &10 �Q 1--� � Jc Job Address (where the work is being done) q s ° Ai E p k V SA /6 3 City Miami ores Village !•- FOLIO / PARCE Is Building Histor y Designated YES Contractor's Company Name Value of Work For this Permit $ Type of Work: DAddition Describe Work: Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 331 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305 County NO Contact Phone 6 —z 7 � Architect/Engineer's Name (if applicable) / 3S ❑Alteration E -mail Miami -Dade State Certificate or Re Re 'stred o. �d ua�� Z Contractor's Address / b 7� City � /� //�z� State Q❑alifier Name bedh 14-e/4 14-e/4 State Certificate istratioo. € Z Notary $ Training/Education Fee $ D Scanning $ 3.00 Radon $ DPBR $ LOC Permit No.d / 0 Master Permit No. zip 3 3/ 3' Flood Zone Phone # &11 2 6- -.5// S k ilo - � t (0» Zip r Phone # (�j- j 15 Certificate of Competency No. Phone # Square / Linear Footage Of Work: ❑New ❑ Repair/Replace CCF $ ❑ Demolition ******** * ** * * *** * * * * * * *** * *** * * * * * * * * ** F * * ** * * * * * * * * * * *** * * * * ** * * * * * * ** Submittal Fee $ -. SD* op Permit Fee $ �� OP 01) D (f1iC__J CO /CC $ Technology Fee $ O'c Bond $ Double Fee $ Violation date: Structural Review. $ Total Fee Now Due $ ��- 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 a achment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which •ccurs seven (7) days after the building permit is issued. In the absence of such po ted notice, the inspection will not be approve % and a re -' spection fee will be charged. Signature � : Signature wner or Agent Contractor i► o r 4 The foregoing instrument was acknowledged before me this of 6 The foregoin instrument was acknowledged befbfe me day of , 20 (O , by 7" GQ GeO N / day of who is personally known to me 9r who has produced personally identification and who did t • , e. ; ! . a NOTARY PUBLIC: Sign: Print: IERALDINE LILLIAN FAILLA RAY COMMISSION 8 DD696627 EXPIRES: July 18, 2011 ARY 81.14 . V • Co. My Commission Expires: * * * * * * * * * * * * * * * * * * * *. APPROVED BY ( "k/y4.) Examiner (Revised 07 /10 /07)(Revised 06/10/2009) to *** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** Engineer ,20 / ,by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: 0T ruB CPA OPTLORIDA My Commission Expire ; �� Alba Aguila Commission #DD682830 ,/ Expires: JULY 26, 2011 BONDED THRU ATLANTIC BONDING CO., INC. Zoning Clerk checked www.sunbiz.org -.Department of State Home Previous on List No Events No Name History Detail by Entity Name Florida Limited Liability Company LEOCAVA LLC Filing Information Document Number L02000029124 FEI /EIN Number 020651120 Date Filed 10/31/2002 State FL Status ACTIVE Effective Date 11/01/2002 Principal Address 9534 NE 2 AVE MIAMI SHORES FL 33138 Mailing Address PO BOX 381703 MIAMI FL 33238 Registered Agent Name & Address LEONI, TODD 7100 BISCAYNE BLVD 206 MIAMI FL 33138 US Manager /Member Detail Name & Address Title MGRM LEONI, TODD M MR 7100 BISCAYNE BLVD SUITE 206 MIAMI FL 33138 US Title MGR Contact Us CAVA, RICHARD H 1865 BRICKELL AVE MIAMI FL 33129 US E Filing Services Next on List Return To List Document Searches Forms Page 1 of 2 H Entity Na Su http: / /www.sunbiz.org/ scripts /cordet.exe ?action= DETFIL &inq doc number=L020000291... 5/26/2010 www.sunbiz.org -.Department of State Page 2 of 2 Annual Reports Report Year Filed Date 2008 01/18/2008 2009 01/22/2009 2010 02/04/2010 Document Images 02/04/2010 — ANNUAL REPORT 01/22/2009 — ANNUAL REPORT 01/18/2008 — ANNUAL REPORT 02/14/2007 — ANNUAL REPORT 01/06/2006 — ANNUAL REPORT 01/04/2005 — ANNUAL REPORT 02/06/2004 — ANNUAL REPORT 02/20/2003 — ANNUAL REPORT Previous on List No Events No Name History View image in PDF format Vi+ View image in PDF format View image in PDF format View image in PDF format View im ig+ View image in PDF format View image in PDF format 11/01/2002 — Florida Limited Liability View image in PDF format Note: This is not official record. 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