EL-05-112inspect
Miami
ict: 50 N.E. 2nd A' FL
PI-P.3ne: (305)79E
-
Scheduled Inspection Date: March 13, 23C11
Inspector: Devaney, Michael
Owner:
Job Address: 261 102 Street
Miami Shores, FL
Project: <NONE>
Contractor: BRINKS HOME SECURI1 `e INC
Building Department Comments
March 12, 2009
inspector
• .•
iPartniit import,,,?,d Permit
Inspection Type° 1Fre Narm
cc
'"i31.1.i,c4).1 34960
" I , F2' - C.• INEZ
of °. 9
Passed
Failed
Correction
Needed
Re-inspection
Fee
No Additional Inspections can be scheduled until
re-inspection tee is paid.
March 12, 2009
inspector
• .•
iPartniit import,,,?,d Permit
Inspection Type° 1Fre Narm
cc
'"i31.1.i,c4).1 34960
" I , F2' - C.• INEZ
of °. 9
Miami Shores Village
Building Department
10050 N.E.2nd Avenue
Miami Shores, Florida 33138
Tel: (305) 795.2204
Fax: (305) 756.8972
BUILDING i v Permit No.
PERMIT APPLICATIO - -- { Master Permit No.
FBC 2001
Permit Type (circle): Building lectric Plumbing Mechanical Roofing
Owner's Name (Fee Simple Titleholder) / ,JCV Wei Phone # 9aS q 1/ 6/ 0
Owner's Address )P4/ Al Id f j
City /i /Amy ,,trig State Zip '3/3 Y
Tenant/Lessee Name Phone #
Job Address (where the work is being done)
City Miami Shores Village
County Miami -Dade
Is Building Historically Designated YES NO
Brinks Home Security
S327 N.W. 55th St., BIdg. 13
Ft. Lauderdale, FL 33309
Contractor's Company Name Phone: p54) 486 -6771 • Fax• (954) 466 .67 y Phone #
http://www.brinke.corro
Zip '3 3/ 3 V
Contractor's Address
City State Zip
Qualifier it) S LC"
Architect/Engineer's Name (if applicable) - Phone #
Architect/Engineer's Address
City State Zip
$ Value of Work For this Permit
Square Footage Of Work:
Number of: Bays Stories Families Bedrooms Baths
Type of Work: naddition
Describe Work:
DAlteration ❑New
❑ Repair/Replace ❑ Demolition
****************************Fees******************************
**** Fees** * * *, * * * *** **** * * * * *** * **** **
County Escrow Fee $ Permit Fee $ /114e249
Education/Training Fee $ Tech $ Scanning $ Radon $
Bond $ Struct. $
Code Enforcemea°�11 '��;,�1�
Continued on opposite side)
Minus Plans Check Fee $ � j �l�-- Total Fee Now Due $ (
Notary $
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 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 suc posted notice, the
inspection will not be approved and a reinspection fee will be charged.
r'
Signature
ar_ Signature _
y
Owner or Agent rContractor
The foregoing instrument was acknowledged before me this a, The foregoing instrument was acknowledged before me this
day of I �Cb . 20 rs, by p• day of jThi 1 , 200, by
who is personally known to me or who has produced al o is personally known to me or who has produced
LetiAl v-- As identification and who \ ekt • 4;11 /C /i� //ie as identification and who did take an oath.
NOTAR P : LIC: �Q' * �`�\SS19, �x'0 •yam
.n n �� S> ,41 20 ,. *t PUB
O:g �� iQg II..
'* #DD 3ga165 ; Q grim: ��� \N ttt,,
\��� QOl �WSjf Ms4S' 41
My Commission Expires: o0, •� sondea a c�;••Q� \ \\ GF• • • • • • • � ///
// 9,9 •d�Public�;.• • 0.A0
W65
Y Commission Expires: ,`Q� •• ��gSIONF yt. 1
(, r \ * * * * * * * * * * * * * * * * * * * * * * * * ** ' ��` *9 A , *•.pas► e
Certific b ti�petency Holder) = * g �m `.o `n 1,0k =
;* ®.®
Sign: (4 n a
Print:
ni);
State Certificate or Registration No. Li Q )'/
APPLICATION APPROVED BY:
Chc7/7 /03
Certificate of Competency No. i2 • #DD 388165 o
�9 4��ponded na '� s �O \ \a
/G✓ Plans
lElxaminer
Engineer
Zoning
Protective Insurance Company
1099 North Meridian Street
Indianapolis, Indiana 46204
(317) 636-9800 Ext. 254
CERTIFICATE OF INSURANCE
This certificate issued to:
CITY OF MIAMI SHORES
10050 NE 2 AVE
MIAMI SHORES, FL 33138
Certifies placement of insurance coverage for the account of
BRINK'S HOME SECURITY, INC.
8880 ESTERS BLVD.
IRVING, TX 75063
ragc l Ul L
Date issued:
12/10/04
SEQ# 00004426
00010992 -003
With the following insurers, individually and not jointly, providing insurance as listed:
Protective Insurance Policies: X001426
Company
For the following coverages:
General Liability including Personal Injury and Property Damage
For Limits $2,000,000 CSL per occurrence /$4,000,000 Aggregate
of
Effective: January 01 , 2005
Expiration: January 01 , 2006
In the event of policy cancellation or material change, every reasonable effort will be
made to advise the certificate holder named hereon, at the address indicated, of
such cancellation or material change within 30 (Thirty) days thereof.
Signed at Indianapolis, Indiana this 10th day of December , 2004
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER COVERAGE
AFFORDED BY THE POLICY LISTED HEREIN.
BY: (21.41,, *.4014.44:14.01
httpJ/ wvcwv. baldwinandlyons .corrillargefortn. asp? Ainfoan =THEVe2QPTTTSTON %2000MP... 1 :` t15
L0 3E$d 33S 3WOH S>NI88 E6t8L88SOE 8E:60 S00Z /Zt /t0
Certificate of Insurance
S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE I•OLLDER. THIS CERTIFICATE IS
T AN INSURANCE POUCYAND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED 8Y THE POUCIESLISTED BELOW.
This !S to Certify that
BRlNlCS HOME SECURITY, INC.
8880 ESTERS BOULEVARD
IRVING, TX 75063
T
Name and
4- address of
Insured.
Liberty
Mutual,.
at the issue dale el Otis certificate. inured by the Company under the policy %eel listed below. The insurdatte afforded by the listed poiicy(IBS) is subjed to all their terns,
Wiens and card>ttonS and is not abed by any requirement term or caialitwn 01 anyconbeCt or alba deCtmant with anew *which NO eerencele mill be issued.
TYPE OF POUCY
WORKERS
COMPENSATION
P. DATE:
CONTINUOUS
EXTENDED
POUCYTERM
111/2006
UMIT OF UABILITY
POLICY NUMBER
GENERAL LIABILITY
OCCURRENCE
3 CLAIMS MADE
RETRO DATE
WC7- 611-00417! -015
WA7-61 D- 004177 -295
N/A
COVEWAGEAFFORDED WC
ING
LAW OF THE FOLLOWING STATES:
ID.KS.OR,WI
AL,AK,ALAR,CA,GO,GT,DE,
DC. FL,GA,HI.II.,IN.IA,KY,LA,
M EMD.MA,MI,MN,MS.MO,MT,
NE,NV,NH,NJ.NM,NY,NC,
OK,PA,RI.SG,SD,TN,TX,UT,
VA
General Aggregate- 016erthan Prod
EMPLOYERS LIABILITY
BoddyinjwyBy Accident
$1,000,000 went
Bodily Injury By Disease
51.000.000y
t«aty Injury By see
$1,000,000
Person
leladaperatlans
"runs rctsiCompletecOperationsA gregate
6a�ylnjuryand Prape,tyDtainageLiablrty
Per
Occurrence
Personal injury
Other
Per Pe ton/
Organization
UTOMOBILE UABIUTY
23 OWNED
Et NON -OWNED
HIRED
THER
N/A
Each Accident- Single Limit
8.1. and P.D. Combined
Each Person
Each Accident orOcc rrence
Each Accident or Occurrence
.DDITIONtL COMMENTS
MI operationS of the insured and allot its wholly owned subsidiaries
It
PECIAL the car1l'bate exphatteadale is con$ruqus or Mended remn you wit be notified it coverage is terminated or reduced before U� certificate expiration dam
N P ATION OI(IO: A cutimc NTAN 1(9ARALSt^.ORTTECEP NESTAT MCNT W4G THAT
OF I NCEFAN PNAUD AGAINSTAN tN$URER. $i{B aT$
Worn teo T*FteeQAnoucTsto OCEarnlcATENO utTHSevevTYOUM AYEANTOUEST� tt� T Liberty Mutual
T1C6 REASgN,CONTACIY2UAl SAI.ESPliO R wM103ENAYEANOT I�M1MBfipppp6ARS
omit AMi�COA* MEAOFTM95CI: A17P1QATE .Tit4APPROPflNM'!'ki.00ALAAt� Ff�CE 68 Y
OTiOE A TiON. (NOT APPL A of DAYS 1S ENTERED BELOWM BEFORE STATED EXmaAT mATE TMiE 0010ANY
Ia1.NoTcANCA',LOAREm=T ErNatiRA Pena,
30 OAYs
SOUT H ICATEFORANY 6CAt NSOR Aril UAW► tSR IN THE Insurance Group
80 itniu7 1 SSMATALSO =ANEW/ CALLINOTtee
F ITv OF MIAMISHORES
SITIPtCATE
10050 NE 2 AVE.
MIAMISHORES, FL 33138
derorKe nazini. 4..411...11flPP i,.,, —,.... 3. o............■■ ...
90 9 d
33S BWOH SMNIel8
Christine Merlin
AUTHORIZED REPRESENTATIVE
Weston, MA (781) 891 -8900
OFFICE PHONE IWMBER DATE ISSUED
E61?8L8890E 8E :60 S00i; /Zt /te
Age.e.o.e
1/1/2005
1
Miami Shores Village
10050 NE 2nd Avenue
Phone: 305 - 795 -2204
Printed: 4/5/2005
Applicant: JENNIFER MICHELLE
Owner: TRECO -SAGE
JOB ADDRESS: 261 NE 102
Electrical Permit
Permit Number: EL2005 -112
TRECO -SAGE
JENNIFER MICHELLE
ST
Page 1 of 1
Contractor BRINKS HOME SECURITY INC Contractor's Address: 9960 N. W. 116TH WAY, SUITE 12
Local Phone: 305- 887 -8455
Parcel # 1132060134960
Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 18 & LOT 19 & W1/2 OF LOT 20 BLK 36
Fees: Description Amount
FEE2005 -4278 Building Fee $100.00
FEE2005 -4279 CCF $0.60
FEE2005 -4280 Technology Fee $2.50
FEE2005 -4281 Training and Education Fee $0.20
FEE2005 -4282 Scanning Fee $3.00
FEE2005 -4283 Submittal Fee ($50.00)
Total Fees: $56.30
Total Fees: $56.30
Total Receipts: $0.00
Permit Status: APPROVED Permit Expiration: 9/27/2005 Construction Value: $199.00
Work: ALARM
APR 11 PAID
Signed: (INSPECTOR)
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 responisibility for all work
done by either myself, my agent, servants or employes.
Signed: (Contractor or Builder) BY: