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EL-10-1287Scheduled Inspection Date: November 02, 2010 Inspector: Devaney, Michael Owner: BACHOO, NICOLE Job Address: 162 NW 102 Street Miami Shores, FL 33150- Project: <NONE> Contractor: ALARM TEAM INC Building Department Comments November 01, 2010 Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 152673 Permit Number: EL -7 -10 -1287 For Inspections please call: (305)762 -4949 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alarm Phone Number (305)336 -9493 Parcel Number 1131010230120 Phone: (866)430 -2338 burglar alarm Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments 1 a � /6 p/V r�( fri 1/eYI"/6 Page 6of18 11V k0 BUILDING PERMIT APPLICATION FBC 2004 Permit Type: Electrical r� Owner's Name (Fee Simple Titleholder) v) c r �• ()Ma'am # 365 • •DQ • Owner's Address ILA NW I b s- City State Miami Shores Village FOLIO / PARCEL # Is Building Historically Designated YES Contractor's Company Name Contractor's Address City LLef s Z Qualifier Name c lf11'11S Type of Work: Describe Work: State Certificate or Registrati- . N E -MAIL: rt ► A► 4 Value of Work For this Permit $ ['Addition Miami Shores Village Building Department f0050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 Permit No. Ma c NO Zip Tenant/Lessee Name E -MAIL: Job Address (where the work is being done) ) 4 a N W t ST Master Permit No. Phone # County Miami -Dade Zip paammEn JUL 1 4 2010 BY:. Phone# cf3.5J0' &(J, 3 Certificate of Competency No. Architect/Engineer's Name (if applicable) Phone # Square / Linear Footage Of Work: ❑Alteration ❑New ❑ Repair/Replace Permit Fee $ e CCF $ 0* (0)0 Submittal Fee; Notary $ aining/Education Fee $ can__ Scanning $ Radon $ DPBR $ Bond $ Code Enforcement $ Structural Review. $ Total Fee Now Due $ See Reverse side -+ Technology Fee $ /� CO /C C 10' ❑ Demolition Zoning $ Double Fee $ 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 Ali i iDAVIT: 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 reinspection fee will be charged. 4 Signature Own- 7.r Agent Contractor The foregoing instrument was ackpowledged before me this 1 The foregoing instrument was acknowledged before me this day of 201 Q, by fiV �� • t � dAv of 20 /0, by who is personally known to me or who has produced C t-- who is personally known to me or who has produced NOTARY PUBLIC: My Commission Expires: APPLICATION APPROVED BY: (Revised 02/08/06) As identification MANit tfe oath. OTARY PUBLIC TATE OF FLORIDA # DD959307 Sign. i J if47 �' !', 2'i 14 Print: I t ! t (I I ML►. Q tq 1 1 4 My Commission Expires: 4,' �QJ Sign: Print: NOTARY PUBLIC: as identifica+ w• =► ,.; a, VaatilifiEEN NOTARY PUBLIC ST TE OF FLO - DA Plans Examiner Engineer Zoning THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDn7ON 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. AGGREGATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR 8 TYPE OF INSURANCE POLICY NUMBER U EFFECT DATE DATE (MMIDD/YYYY) wars B GENERALLIABIUTY X COMMERCIAL GENERALLIABIUTY FMMIO21388 12/31/09 12/31/10 EACH OCCURRENCE $ 1000000 PREMISES (Ea accidence) $50000 ■■ CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5000 PERSONAL &ADVINJURY $ 1000000 X Professional Liab GENERAL AGGREGATE $ 2000000 GEM. AGGREGATE UMIT APPLIES PER POLICY n jE n LOC PRODUCTS - COMP /OP AGG $ 2000 000 4 4 4 AUTOMOBILE X X X LIABILITY ANYAUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BAW(10)53781418 • 12/31/09 12/31/10 COMBINED SINGLE UMIT (Eaacmdent) $ 1000000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) GARAGE ■ ■ LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY AGG $ B EXCESS X ■ X / UMBRELLA LIABILITY CUMI000823 12/31/09 12/31/10 EACH OCCURRENCE $ 3000000 OCCUR CLAMSMADE AGGREGATE $ 3000000 DEDUCTIBLE RETENTION $10000 $ $ $ A WORKERS AND EMPLOYERS' ANY PROPRIETOR/P OFFICER/MEMBER (MandatoryinNH) If yes, desalbe SPECIAL COMPENSATION UABIUTY -*4 Y/N EXCLUDED? N xWW(10) 53781418 12/31/09 12/31/10 XI: ITORY LIMN S I I ER ELEACHACCIDENT $1000000 EL DISEASE-EAEMPLO $ 1000000 under , PROVISIONS below EL DISEASE - POLICY UMIT $ 1000000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Residential Alarm Installation 4Ri CERTIFICATE OF LIABILITY INSURANCE PRODUCER Hartsfield & Nash Agency, Inc. Post Office Box 1109 Wake Forest NC 27588 Phone:919- 556 -3698 Fax:919- 556 -8758 INSURED AlarmT eam, Inc. 5305 Raynor RQgd, Ste 100 Garner NC 27529 DATE (MMIDDIYYYY) OP ID LA ALARM -1 01/04/10 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURERA Montgomery Insurance INSURERS: First Mercury Ins Company INSURER C: INSURER D: INSURER E: NAIC # 14613 COVERAGES CERTIFICATE HOLDER ACORD 25 (2009101) Miama Shores Village 10050 NE 2 Avenue Miami Shores FL 33138 MIAM100 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 80 SHALL IMPOSE NO OBLIGATION OR UABIUTY OF ANY KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES. • 1.0111,111