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EL-10-99 j33� i alrff ' ° � p m 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 r �o . . ; • .�; � ; � a°_•� '° ; CA Sign: _�� �N. < a _` g - �•^. ' ° y: �_ S Si ign: N ° Print: a,• _ 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 r' �oF FL�P\o� Bonded EXPI Thor Budget Notary Bow - X �' ������' k� hZS �sg��sp: e2tR�A�� �* c� r^ eRs$$ i$ og�C�t�e��k �L��k���R3RR3b '$�i83��. �$&'+&� ski$$ &$ v'�k�B�&6kAR�$�$A�$��✓�i �k�. �. ��R$�kk�F'Fk�&R�. a'' -�'k 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 $2540, the applicant must promfse in goesferlth that a CON Of the notice of commencement and construction lien law brechnet'e will be detheed to the person lrt�se i fs sulriem t to attachment. Also, a corded copy of the recorded notice= of coom»menceme?nt must be posted at the job site for the first inspection wht ocrnrxs seven (7) days after the building )rermff xs #ssnrect In ehe absence of such postman notice, - the inspection will not c rprc' neAcn re. slreictiotr fee will be ekare e Signature Signature •�, % we7r or Agent Contractor The f mstrumeunt was wledg before me; this+_ The re a' insnuxnent.was acknowledged before one thi4��_ day of by 1± da 2t1 by who rally known to a or twhoas l� who is personally known to me o who has "aced ;� LTO" ck • "i&atior and who did take an 0 . as identification and who did take an oath. NUTAR LfC' �.�,��,�,� NOTARY plc; ,►, Sign= `i�'�'�°. Sign.. Print: 4` ' Print: u ttAa ` f ` uct my Commission Expires: M —� •,t. �+' Y Commission Expirm MAY: 0t , 20 12 � I 'R9MeA"'dt 'lk#rk'la'�P�'A�"k' Z�i'#'ik 7k7Tr1�'$' 1kuL"k ftk9ktklY' #tkiF?f'l lb lral dl'+k 9 F'k'A'�P'k'k#te71t71!.lkttl4 I�IHF _' °" f f # ;i�ylp �� ---------- APPROVED BY Examiner � -- � zoning Engmcea Clerk checked (Revised 07110/07xRavised 06/1012009) s � m � R Y 3 � t xyY k y' Y t yt C fz In W- V 3 i „ - !!3 y ,�a t..�; ,• -.�`'° ..t�7'� i "q -i�':t IP _'. MWO " o r I z � �,.rg� _,;'i � - 5� 1sea .. 3 m � �° € J� 9 .c � 4 ,&� � ,�,.. " � �"' �'` &�{ �'t?"_ '= r.r� sit• - . , .. a.. .d:. 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 *° w 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 P DAMAGE : 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 s DEDUCTIBLE- $ RETENTLON s x $ W01tl09lsCOMPSIMAT" X V¢CSTATU 1 JOTII- ANDEMPLOVMLIASIM YIN RL ANY PIEraRrPA ( ROPR E.L. EACH ACCIDENT s 1100 0,000 P = 0 11" 0=64d. a I " J 2399,'39009 8/14/2009 8/14/2010 ELL sE- EAEMPL. a 1,000,000 E4 DISEASE - POLICY UWr S 1 000 000 o7fLeR DEBCMnMOFCMMTXMILCrArOMBIVEHUMIEtCLUSUSAMEDOYBODORsemmTispemo6LPRovown 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