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EL-11-2252Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 168783 Permit Number: EL -12 -11 -2252 Scheduled Inspection Date: January 18, 2012 Inspector: Devaney, Michael Owner: ESSINGTON, MICHAEL & DOROTHY Job Address: 55 NE 100 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ADT SECURITY SERVICES, INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alarm Phone Number Parcel Number 1132060131420 Phone: (786)331 -3967 Building Department Comments BURGLAR ALARM Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments January 17, 2012 For Inspections please call: (305)762 -4949 Page 40 of 49 Miami Shores Village Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING PERMIT APPLICATION FBC 20 Permit Type: Electrical OWNER: Name (Fee Simple Titleholder) Address: ST- A(6 (O O r Permit No. Master Permit No. DEC 0 5 201 6 • Phone #: ,205 -(9)P -/-1Y3 City: /4/01/-04 ( S AS State: ft_ Zip: 3 31 3 it Tenant/Lessee Name: / Phone#: Email: JOB ADDRESS: CS Ai L (00' ST City: Miami Shores County: Folio/Parcel #: /r 3 .ao t" 013 -tcra-)-o Miami Dade Zip: 9 s 13 Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: '/J Phone #: � �/ �� //-173/- Address: /07 0 r /)/I&' Woe? / City: /fl State: '7C Qualifier Name: .0' 1 4 % .1 State Certification or Registration #: '� , / -3'/ Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Zip:1" Phone#: Value of Work for this Permit:gt 5 Square/Linear Footage of Work: Type of Work: ❑Addy Description of Work: ®4Alteration UNew ❑Repair/Replace CA o Gi- ❑Demolition + ****** ******* ***+x*********** ***** ***** Fees** ** ************** ** x**********m*:r******+r*** Submittal Fee $ Permit Fee $ / C (at> CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ 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, BOIT.RRS, 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 such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signatur Signature Owner or Agent The foregoing instrument was acknowledged before me this 1 day of , 20 [ (, by who is personally known to me or who has produced i 52 bs 2 v As identification and who did take an oath. NOTARY PUBLIC: Sign: Print: 4e crt GERRY BRIERRE My Commission Expires ti:: ,� LATOYA L CARTER MY COMMISSION # EE 100904 r '4 EXPIRES: June 7, 2015 _ A. MY COMMISSION # EE 139599 RP„ Bonded Thru Nay Public thienariters € `•`t EXPIRES: October 19, 2015 Bonded ThmNotaryPu ***** ************** ** *** * *** * *** ** x**** ****** e++ s*eze:************* ** * *** ********+x******* axe=* **x :***************** Contractor The foregoing instrument was acknowledged before me this day of Dec, 2. , 20 it , by who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: APPROVED BY Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) Miami -Dade My Home My Home larrfdade o Show Me: !Property Information Search By: Select Item lI Text only Property Appraiser Tax Estimator Property Appraiser Tax Comparison Portability S.O.H. Calculator Summary Details: Folio No.: 11- 3206 - 013 -1420 Property: 55 NE 100 ST Mailing Address: MICHAEL P ESSINGTON &W DOROTHY S ESSINGTON 55 NE 100 ST MIAMI SHORES FL 33138 -2314 Property Information: Primary Zone: 1000 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds/Baths: 3/2 Floors: 1 Living Units: 1 Adj Sq Footage: 1,790 Lot Size: 11,500 SQ FT Year Built: 1938 Legal Description: MIAMI SHORES SEC 1 AMD PB 10 -70 LOT 18 & E1/2 OF LOT 17 & W1/2 OF 19 BLK 10 LOT SIZE 100.000 X 115 OR 18087 - 3796 0498 1 OR 18087 -3796 0498 00 Assessment Information: Year: 2011 2010 Land Value: $99,015 $103,730 Building Value: $135,805 $135,924 Market Value: $234,820 $239,654 Assessed Value: $165,522 $163,076 Exemption Information: Year: 2011 2010 Homestead: $25,000 $25,000 2nd Homestead: YES YES Taxable Value Information: 1 ..a.. 1 aa.,. Page 1 of 2 ACTIVE -TOOL' SELECT Aerial Photography - 2009 0 112 ft My Home 1 Property Information 1 PropeM, Taxes 1 My Neighborhood 1 Property Appraiser Home 1 Using Our Site 1 Phone Directory 1 Privacy 1 Disclaimer If you experience technical difficulties with the Property Information application, or wish to send us your comments, questions or suggestions please email us at Webmaster. http://gisims2.miamidade.gov/myhome/propmap.asp 9 12/2/2011 RESIDENTIAL SERVICES CONTRACT CONTRACT DATE /I CUSTOMER ACCOUNT NO MUM 5104UE12 NI 3 3 JOB NO LEAD SOURCE NOTICE OF CANCELLATION I, THE CUSTOMER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. I ACKNOWLEDGE BEING VERBALLY INFORMED OF MY RIGHT TO CANCEL AT THE TIME OF EXECUTION OF THIS CONTRACT AND RECEIPT OF THIS NOTICE. FINANCIAL DISCLOSURE STATEMENT THERE IS NO FINANCE CHARGE OR COST OF CREDIT (0% APR) ASSOCIATED WITH THIS CONTRACT. A. NUMBER OF PAYMENTS FOR THE INITIAL TERM IS 36. B. AMOUNT OF EACH PAYMENT IS (TOTAL MONTHLY SERVICE CHARGE FROM BELOW) LATE CHARGE - PAYMENT I5 DUE PURSUANT TO MY SELECTED BILUNG FREQUENCY, PRIOR TO THE START OF SERVICE. MY FIRST BILL/CHARGE WILL OE SENT /MADE SHORTLY AFTER MY SERVICE BEGINS. ADT MAY IMPOSE A I�E -TIME LATE CHARGE ON EACH PAYMENT THAT 1S MORE THAN TEN (10) DAYS -PAST BUF, Up TO THE MAXIMUM AMOUNT PERMITTED BY LAW, BUT IN NO EVENT WILL THIS AMOUNT EXCEED $5.00. TOTAL OF PAYMENTS FOR THE INmAL TERM IS (A. TIMES B.) (EXCLUSIVE OF ANY APPLICABLE TAXES, FEES, FINES AND RATE INCREASES) PREPAYMENT - IF I PREPAY THE TOTAL OF PAYMENTS PRIOR TO THE END OF THE INITIAL TERM OF THIS CONTRACT, THERE 1S NO PENALTY OR REFUND. SEE SECTIONS 2, 7, 15 AND 19 OF THIS CONTRACT FOR ADDmONAL INFORMATION ABOUT NONPAYMENT, DEFAULT AND ACCELERATION. 1 -Of 6 Administrative Copy ©2011 ADT. All rights reserved. (04/11) ADT Security Services, Inc (°ADT°) Office Address fJ-rg tvlitrtit s Cval M' 4-►4N4 Y( 33k IA i (30 .0 ,3), 3 - D. 79/ www.MyADT.com 1.800.ADT.ASAP® (1.800.238.2727) Customer Name (Customer° or T or °me' or "my') I tec r 1 1 1 1 1 It5S, \kr0ot./ II Address 51 ,§ Ai : / 0 n 711 5/.." 1 l y y,11Af sffaif-E Cit- t 3 1 State ZIP Tax Exempt No. _ ..... •. e 6 Protected Premises' C /_/ I� D 7 S / Tax Expire Date .Telephone O Traditional Phone O Other (Qualified) 0 Other (Non - Qualified) . Altemate 3o --k 02 g a ( 7 8 2 , Telephone 1 - O Home O Cell O Work ' IF FAMILIARIZATION PERIOD IS REJECTED INITIAL HERE Altemate ' Telephone 2 0 Home 0 Cell 0 Work (see Paragraph 14 of the Terms and Conditions for explanation) EMAIL if r C lift ( - E S S. / A, c it) r,/ @ y4 i o C) . C a N Communications Authorization: I authorize products and services to the contact information 888.DNC4ADT (888.362.4238). Initial here ADT to provide me with information and updates about the security system and new ADT and third -party provided by me. I may unsubscribe or opt out by emailing donotcontact@ADT.com or by calling Confirmation, of Appointments: I authorize appointments and provide other information ADT to call me using an automated calling device to deliver a pre - recorded message to set/confirm and notices about the alarm system at the telephone number(s) by me. Initial here provided Alarm System Ownership: 0 Customer -Owned C�ADT -Owned I ACKNOWLEDGE AND AGREE TO EACH OF THE FOLLOWING: (A) THIS CONTRACT CONSISTS OF SIX (6) PAGES. BEFORE SIGNING THIS CONTRACT, I HAVE READ, UNDERSTAND AND AGREE TO EACH AND EVERY TERM OF THIS CONTRACT, INCLUDING BUT NOT LIMITED TO PARAGRAPHS 5 AND 18 OF THE TERMS AND CONDmON5. (B) THE INITIAL TERM OF THIS CONTRACT IS THREE (3) YEARS. (C) ADT IS NOT A SECURITY CONSULTANT AND CANNOT ADDRESS ALL OF MY POTENTIAL SECURITY NEEDS. ADT HAS EXPLAINED TO ME THE FULL RANGE OF EQUIPMENT AND SERVICES THAT ADT CAN PROVIDE ME. ADDITIONAL EQUIPMENT AND SERVICES OVER THOSE IDENTIFIED IN THIS CONTRACT ARE AVAILABLE AND MAY BE PURCHASED FROM ADT AT i .N'ADDmONAL COST TO ME. I HAVE SELECTED AND PURCHASED ONLY THE EQUIPMENT AND SERVICES IDENTIFIED IN THIS CONTRACT. (D) NO ALARM SYSTEM CAN PROVIDE COMPLETE PROTECTION OR GUARANTEE PREVENTION OF LOSS OR INJURY. FIRES, FLOODS, BURGLARIES, ROBBERIES, MEDICAL PROBLEMS AND OTHER INCIDENTS ARE UNPREDICTABLE AND CANNOT ALWAYS BE DETECTED OR PREVENTED BY AN ALARM SYSTEM. HUMAN ERROR IS ALWAYS POSSIBLE, AND THE RESPONSE TIME OF POLICE, FIRE AND MEDICAL EMERGENCY PERSONNEL 15 OUTSIDE THE CONTROL OF ADT. ADT MAY NOT RECEIVE ALARM SIGNALS IF COMMUNICATIONS OR POWER IS INTERRUPTED FOR ANY REASON. (E) ADT RECOMMENDS THAT I MANUALLY TEST THE ALARM SYSTEM MONTHLY AND ANY TIME 1 CHANGE TELEPHONE'SERVICE, BY CALLING 1.800.ADT.ASAP OR BY LOGGING IN TO W W W.MYADT.COM. (F) THIS CONTRACT REQUIRES FINAL APPROVAL BY AN ADT AUTHORIZED MANAGER BEFORE ADT MAY PROVIDE ANY EQUIPMENT OR SERVICES, AND IF APPROVAL 15 DENIED, THEN THIS CONTRACT WILL BE, T RMINATtD, AND AO S ONLY OBLIGATION WILL BETO NOTIFY ME OF SUCH TERMINATION AND REFUND ANY AMOUNTS 1 PAID IN ADVANCE. . ADT Representative Name y �I�7 Rep. License Na: Rep. /13 /'� (If Required) ID No. Customer's Approval: Orl I SI nature X/� V Required (Must match Customer Name in Section 1 above) / / NOTICE OF CANCELLATION I, THE CUSTOMER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. I ACKNOWLEDGE BEING VERBALLY INFORMED OF MY RIGHT TO CANCEL AT THE TIME OF EXECUTION OF THIS CONTRACT AND RECEIPT OF THIS NOTICE. FINANCIAL DISCLOSURE STATEMENT THERE IS NO FINANCE CHARGE OR COST OF CREDIT (0% APR) ASSOCIATED WITH THIS CONTRACT. A. NUMBER OF PAYMENTS FOR THE INITIAL TERM IS 36. B. AMOUNT OF EACH PAYMENT IS (TOTAL MONTHLY SERVICE CHARGE FROM BELOW) LATE CHARGE - PAYMENT I5 DUE PURSUANT TO MY SELECTED BILUNG FREQUENCY, PRIOR TO THE START OF SERVICE. MY FIRST BILL/CHARGE WILL OE SENT /MADE SHORTLY AFTER MY SERVICE BEGINS. ADT MAY IMPOSE A I�E -TIME LATE CHARGE ON EACH PAYMENT THAT 1S MORE THAN TEN (10) DAYS -PAST BUF, Up TO THE MAXIMUM AMOUNT PERMITTED BY LAW, BUT IN NO EVENT WILL THIS AMOUNT EXCEED $5.00. TOTAL OF PAYMENTS FOR THE INmAL TERM IS (A. TIMES B.) (EXCLUSIVE OF ANY APPLICABLE TAXES, FEES, FINES AND RATE INCREASES) PREPAYMENT - IF I PREPAY THE TOTAL OF PAYMENTS PRIOR TO THE END OF THE INITIAL TERM OF THIS CONTRACT, THERE 1S NO PENALTY OR REFUND. SEE SECTIONS 2, 7, 15 AND 19 OF THIS CONTRACT FOR ADDmONAL INFORMATION ABOUT NONPAYMENT, DEFAULT AND ACCELERATION. 1 -Of 6 Administrative Copy ©2011 ADT. All rights reserved. (04/11) RESIDENTIAL SERVICES. CONTRACT CONTRATE E/— / CUSTOMER ACCOUNT NO 3 3 1111 ll 5104UE12 tl 11 JOB NO LEAD SOURCE 1.1 -rvi - • •- ' • I•-• ( •• 1• -s) . ® Standard Monthly Service, Burglary Service includes: Customer Monitoring Center Signal Receiving and Notification Service for Burglary, Manual Fire and Manual Police Emergency Monthly Service Charge O Iniial/Annual Recurring Municipal Fee billed separately • (Subject to change based on local law) • InitiaVAnnual Fee $ ^ q) �j d 0 Customer to obtain and pay for initial/annual municipal alarm use permit Failure to obtain and. provide ADT with the municipal alarm Use permit registration number could result in no munidpal firelpolice response;to an alarm i from thepemises and/or a fine. ® Standard Montfiiy Service, Rre/Smoke Detection Service includes: Customer Monitoring Center Signal. Receiving and P btificadon Service for Fire,,Manual Fire and Manual Police Emergency 4P / n(C L Municipal Electrical Permit Fee O Customer to obtain electrical permit O Carbon Monoxide 0 Flood 0 Low Temp $ .Installation Price t I 7 Ji 0 Medical Alert $ + . Taxable Amount ® Safewatch Cellguard® $ / /J. Cl.- Non Taxable Amount O SecurityLink® $ Connection Fee ® Extended Limited Warranty /Quality Service Plan (QSP) $ / KYC u Admin Fee O Guard Response Service $ Sales Tax on installation* $70 gc 3 /((f' O Other $ Deposit Received $ 5-5—q Total Monthly Service Charge t $ 5a .4 -11k. Balance Due upon Installation* $ A)'. *If applicable sales tax not shown, it will be added to the first invoice. - •• • 1•• - • .- 1 .11 -• COntfQO 1 os`l ®�o�l s ¢ ono +sae `eOAJa ¢sa o$ ,5- . °a °` .�1\ Panel `ate 3 K ,,r, e� ossS �seao s O� sn�`o s c5` LaF o�d� C J�5¢oS�a J�5¢�ce �S® 6Q opoe *IV. 4 � RE 'loJ� c) se 40 G� oe. �®�o a�oefeSev C vs, .'l.e -i.9 \`a PSG c cee o � Comments Package Name: COAr\lyA),rt Includes: Foyer {'Cry , 'MIN �� % _(f fEri i .1 • ■� EL CEO,. (l a�4 R`ZK ■ ■ i ► 1, ,, C - u P F, iiL EI 1PJG • ■ llill y •1 Rc� ?fl �R'tl -s v-. Living Room . Family Room Ate (p 1-11/4. _- A MT/ IN/ GI_ Office Dining Room Kitchen AAD ■� Laundry Room Hallway Master Bedroom I III ■ Master Bath ■ ■ ■ ■ Bedroom 2 Bedroom 3 Bath 2 Basement Garage Totals E = Existing Equipment 5t(/3 Estimated Installation Start Date / / 1 / 1 ( INSTALLER NOTES 2 of 6 ©2011 ADT. All rights reserved. (04/11)