EL-10-99 j33� i alrff ' ° �
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Miami Shores Village
10050 N.E. 2nd Avenue y��
n
Miami Shores, FL 33138-0000 f`
Phone: (305)795 -2204
3:3
MR, Issue ' � i Expiration: 071241201
Project Address Parcel Number Applicant
440 105 Street 1122310150040
Miami Shores, FL 33138- Block: Lot: DOUGLAS COHEN
Owner Information Address Phone Cell
DOUGLAS COHEN 440 105 Street
MIAMI SHORES FL 33138 -
Contractor(s) Phone Cell Phone
Valuation: $ 1,000.00
HOME ALERT INC (866)787 -3033
_._ _._ u.... _...— ._..__.. _......_.. M....µ.... ... ..,_ ..,. Total Sq Feet: 0
Type of Work: ALARM For Inspections please call:
Additional Info: ELECTRICAL (305)762 -4949
Classification: Residential Available Inspections:
Inspection Type:
Fees Due Amount Invoice # Total Amt Paid Amt Due
CCF $ 0.80 EL -1 -10 -36862 $ 104.60 $ 104.60 $ 0.00
Education Surcharge $0,20
Permit Fee - Additions/Alterations $100.00
Scanning Fee $3.00
Technology Fee $0,80
Total: $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
February 09, 2010
Authorized Signature: Owner / Applicant / Contractor / Agent Date
Building Department Copy
February 09, 2010 1
Miami Shores Village
g
Building Department
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972 VC
BUILDING Permit o. ELIO — � 1
PERMIT APPLICATION Master Permit No.
FBC 20
Permit Type; ELECTRICAL
Owner's Name (Fee Simple Titleholder) Phone # aL xl - I 5
Oc, -tl�
Owner's Address
City k NN �j �- State 4 L z 7 � (O %
Tenant/Lessee Name M Phone #
Email
Job Address (where the work is being done)
City Miami Shores Village County Miami -Dade Zip f
FOLIO / PARCEL #
Is Building Historically Designated YES NO Flood Zone No
Contractor's Company Name � 0/'1 G A Lt 1 61L • Phone # �" 0 �' - 3 0 a'
Contractor's Address )Q- 'S✓L'SE
City State L Zip
Qualifier Name ® Q �" ^Y Phone #
�K State Certificate or Registration No. L Z0�360 �� Certificate of Competency No.
Contact Phone OV� — � 0 ��' E -mail roV m 61 6y\eo j Cr;* �'�
Architect/Engineer's Name (if applicable) Phone #
Value of Work For this Permit $ �J� Square Linear Footage Of Work:
Type of Work: ❑Addition ❑Alteration []New ❑ Repair/Replace ❑ Demolition
Describe Work: GC.J (t� r V 0 L.A21\
t(
Submittal Fee $ Permit Fee $ CCF $ CO /CC
Notary $ Training/Education Fee $ Technology Fee $
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
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 ha
commenced prior to the issuance of a permit and that all wcrk will be performed to meet the standards of all laws regulatin;
construction in this jurisdiction. I understand that a separate permit must be securOd for ELECTRICAL WORN,, 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 al
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: IAN ATTORNEY BEFORE RECORDING YOUR NOTICE ®F
COMMENCEMENT."
Notice to Applicant: As o condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice. the
inspection will not be approved and a reinspection fee will be charged ti
Signature L_�oc Si ature
a.
Owner or Agent Con actor
The foregoing instrument was acknowledged before me this 5 The foregoing instrument was acknowledged before me this
day of _ fF13 , 20 ( , by C�� r day of a 9 , 20IC2, by J1? 6 who is personally known to me or who has produced -L who is personally known to me or who has'produced
As identification any tiNUiintrr -`
Vito did tai+ oath. AV ®• 200 as identification and who did take an oath.
NOTARY PUBLIC: "• P � NOT=PC
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Print: Gt P' /�t�tU
My Commission Expires: /'�i�/////;11111 ��`� My C 1 mission Expires: J ✓1�u'� 7�i l3
/ a o ' . Bk,, MmmQuNONES
' * PAY COMMISSION 11 DD 8WN
RES: January 7, 2013
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APPLICATION APPROVED BY Plans Examiner Zoning
Engineer Clerk checked
(Rcvised 07 /10/07)
Miami S - hores V JAN 2 0 2010
Building Department BY ___ oa_m
10050 N.E.2nd Avcme, Miami Shots, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
INSPECTION'S PHONE Nt7MER: (305) 762.4949
a
t FiUIELDTNG Permft Afia
PERK APPLICATION Aster Permit No.
FCC 20 .
t Permit Type: ELECTRICAL
ow,am -'s ]Name (Fee Unple, Titleholder) �JG�rS C Phone #
o'$ Address
City Part lt0@a State I - ti lap r /
Tenant Nam � e - f /^ - Phone # nl / A
i --
Email
Job Address (where the work is Ding done) ___ { ® 05T _
City M" ores VOIagg County MkAkDade zip
FOLIO t PARCEL #
Is Bulidlag H Deslguated YES NO Flood Zone - f3
C Company Nair
Contractor's Addrm i m SM - �,• "Y ""
City Zip 3 `* 1 0
��
Qualifier Name_ Phone #
State Cerdficate or titm Na. ��d `l r C�aficate ofC�e�nru 10tt ey No.
Contact Phone 1 � - ? Email �Qb�YI �.�o wdla xm
Arcftf tertlSagineear's (ifsplicabic} P hone #
Value of Work For this Permit S S Square I Linear Footage Of Work:
Type of Work: C]Addition ElAlteiation DNew [}-R Replace ❑ Demolition
Describe Work: _ , 4 &5
r�a��r, �waaa�# �, r�a* asn�asr *�x,�F���r�aaar,kt�t+wr
Submittal Fee $ Permit Fee $ ��� P �� G $ CQlCC $
Notary S TrandoWEducation Fee $ Technology Fee $ 0
Scanning $ Radon $_ DPBR $ Band $
Double Fee $ Violation date:
Structural Review. $ Total Fee Now Due $
See Reverse side ->
IN
�.Y
Bonding Company's Name (if applicable)"
Bonding Company's Address
City State
zip
Mortgage Leouller's Name {if applicable )
Mortgage Lender's Address
city State zj�
T
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or i ptallation has
commemed prior to the kmmm of a permit and that all work will be parfotmed to meet the ndards of all laws regulating
construction in this jurisdicdOL I understand that a separate permit must be secured for ELECTRICAL - WORK, PLUMBING, SIGNS,
WELLS, POO l~_C RNACES, BOILERS, HEATERS, TANKS and Alit CQNDTTIQNEl , ETC._
OWNER'S AFRIIMAVIT: I certify that all the foregoing information is ac ourate and that - all work w ll`be done in compliance with all
applicable laves regulating construction and zoning.
"WARNING To' OWNER: YOUR FAILURE TO RECORD A► NOTICE OF
COMMENCEmENT NIA's' RESULT IN YOUR PAVING TWICE FOR
IMPROVEMENTS NTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN
FINANCING Ct" NSULT WITH YOUR. LENDER OR AN ATTORNEY BEFORE
RECORDIN ;YOU .IwO TI+CE OF C+fIMMEN CEN NT."
Notice to 4pipl w. As a cord Lion, to the iss once r�, f a building permit with an estimated malue a xesdhng $2540, the applicant must
promfse in goesferlth that a CON Of the notice of commencement and construction lien law brechnet'e will be detheed to the person
lrt�se i fs sulriem t to attachment. Also, a corded copy of the recorded notice= of coom»menceme?nt must be posted at the job site
for the first inspection wht ocrnrxs seven (7) days after the building )rermff xs #ssnrect In ehe absence of such postman notice, - the
inspection will not c rprc' neAcn re. slreictiotr fee will be ekare
e
Signature Signature •�,
% we7r or Agent Contractor
The f mstrumeunt was wledg before me; this+_ The re a' insnuxnent.was acknowledged before one thi4��_
day of by 1±
da 2t1 by
who rally known to a or twhoas l� who is personally known to me o who has "aced ;� LTO" ck
• "i&atior and who did take an 0 .
as identification and who did take an oath.
NUTAR LfC'
�.�,��,�,� NOTARY plc;
,►,
Sign= `i�'�'�°. Sign..
Print: 4` ' Print: u ttAa ` f ` uct
my Commission Expires: M —�
•,t. �+' Y Commission Expirm MAY: 0t , 20 12
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APPROVED BY Examiner � -- � zoning
Engmcea Clerk checked
(Revised 07110/07xRavised 06/1012009)
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CITY OF MAITLAND
FINANCE DEPARTMENT
1776 INDEPENDENCE LANE
MAITLAND, FL 32751
8159
HOME ALERT INC
DOUGLAS RICHARDSON
13722 HARVARD PL
FARDINA, CA 90249
This is our Business Tax Receipt,
previous ,, .y., known. as -an -Occupational- License.. w ... �... . _
If you have any questions about your receipt
please contact Dodie Beach at 407 539 - 6253.
-- ---CUT HERE
CITY OF MAITLAND
1776 INDEPENDENCE LANE
MAITLAND, FL 32751
BUSINESS TAX RECEIPT
BUSINESS
LOCAL TAX RE 8159
EFFECTIVE: 10/01/I I 09/30/2010
LOCATION: 1800 ROq,
µ
HOME`. ALERT*
CATEGORY: BUS IN SS
TYPE: RETAIL ,. POST IN A CONSPICUOUS PLACE
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The Persok fbm. or corporation named above is hereby granted this apt for time paid bD tho City of Maitland for ft bushum dembed
above for the period IndkxNed. Granting of #ft recaipt does not entltlm tha haMer to operate ar maintain a btwffim In vbwm of any
law or oMinsnee. The City of Maitland does not guarantee the quallIlmoons of the holder of this raosipt.
NOT VALID UNLESS SIGNED BY CITY OFFICIAL CITY OFFICIAL
DATES �pLUloioim►h
CERTIFICATE OF LIABILITY INSURANCE 11/5/2009
PRODUCE (323) 845 -9541 FI1R- (323) 845 -9917 THIS CERTIFICATE DI ISSUED AS A MATTER OF INFORMATION
Rids Comber lnw=ance Services, Inc ONLY AND CON NO RIGHTS UPO THE CERTIFICATE
Ch L:L wwe #OC97578 A TTHE COVERAGE AFFORDED BY THE P SE
D OR
c LLOW.
3387 Blair Dr.
Los Angeles CA 90068 INSURERS AFFORDING COVERAGE NAIC S
01MURED Nmnmk First Mercury Ins Co 1007
HoMee Itilert, Inc. Indoonity Co of Ct 2-
13722 Harvard Place, ft LNL;uRERC.
IFIfi4MRER Q
C��i 90249 I NSURPR E:
COVERAGM
THE POLICIES OF WWRAHCE LISTED BELOW HAVE BMW" TO THE INSURED NAMED ABOVE FOR 7HE POLICY PERIOD NDICATED NOTIMTH STANOM
ANY REQUIREMENT, TERM OR CON7ITM OF ANY CONTRACT OR OTHER DOCENT tMTH RESPECT TO VYM WH IM CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE 04SURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT 70 ALL THE TERM EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
nm AM POLICY HEMMER Lmm
ANAL LM9UTY ;; OCC= $ 1,0
X COMMERCIAL GENMAL LIAWTY $ _._ 1
A B CLAIM MAW ®OCCUR MaO063773 5/5/2009 5/5/2010 MEDEW (kw arroPa>on) $ 5 000
Z 2-tor i Osdsaiam PERSONAL i MW MARY i Amendment
X L)1, 000 Deaf. Applies GEE3tAL AGGREGATE $ 5,000,000
GOWL AGGREGATE UMT APPLIES PEIt PRODUCTS - COM PLOP AGG f 51 000,000
X POLICY PRO LAC
AUTOMOBILE LIABILITY COMBINE) SINGLE LOST
ANY AUTO QEa
ALL OWNED AUTOS BODILY INAW
SCHEDULED AUTOS fie► pm- y $
FIRED AUTOS SO
N0N4W *D AUTOS =
PR OPERTY
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OARAOELIABMITY AUTO ONLY -EAACCIDEW f
ANY AUTO OTFER THAN SA ACC $ __
AUTO ONLY- AGG S
LL7om /LM/MRv" UAI MITY EACH OCCA E $
OCCUR ❑ CLAIMS MADE AIGGREGATE M
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RETENTLON s x
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Tba Certificate Eolder and any Ruses, parsons, or Organisatims listed on the acwbftle of the 002011 11 /es(to follow
fr0s Carrier) are included as addltianal insered'a with reapeot to the liability created by the Errors, Acts, and
Omissions of the Named insured herein. Additional insured applies to General Liability policy only. Thirty Day Notice
of Cancellation, except ton days for Nan - payment of premium. This certificate revises and replaces certificate issued
10/19/09. Re: 350 Crenshaw Blvd., Suite A103, Torrance, CA 90503 -1725
CERTIFICATE HOLDER CANCELLATION
SHOUL ANY OFTHEADOWGINGROW DICER BECANCL9 LEd 684M THE LLTION
DATE THER80F, Tm woup O MNMIIIlMt YwML. ermvoR TO mAL 30 DAYS wwrTMN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO TW LEFT, BUT FAILURE TO 00 90 SHALL
WOW NO OK MiAT10N OR LWWLTrY OF ANY KIND UPON THE MEAL, ITS AGENTS OR
TATLYF$
AUTHORtM IMPINMENTATIVE
Fi ck Gombar /AARONA /�+!•�.�""
ACORD 25 (2088101) 01!85,2009 ACORD CORPORATION. AN dab% nmrved.
OBmOp The ACORD NartFe and kq* an mend ILM 1 of ACORD
03/01/2010 11:04 FAX 1 800 685 7530 DATA SCAN FIELD SERVICES IMM006 /010
Inspection Worksheet
Miami Shores Village
10050 N.E. 2nd Avenue Miami Shores, FIL
Phone: (305)795 -2204 Fax: (305)756 -8972
Inspection Number: INdSP- 136089 Permit Number: EL- 1 -10 -99
Scheduled Inspection Date: March 01, 2010 Permit Type: Electrical - Residential
Inspector: Devaney, Michael
Inspection Type: Final
Owner: COHEN, DOUGLAS Work Classification: Alarm
Job Address: 440 NE 105 Street
Miami Shores, FL 33138- Phone Number
Parcel Number 1122310150040
Project: <NONE>
Contractor: HOME ALERT INC Phone: (866)787 -3033
Building Department Comments
SERVICE ALARM
Inspector Comments
Passed
Ln
Failed
Correction ❑
Needed
Re- Inspection
Fee
No Additional Inspections can be scheduled until
re- inspection fee is paid.
February 26, 2010 For Inspections please call: (305)762 -4949 Page 8 of 19