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EL-11-1490Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 176284 Permit Number: EL -8 -11 -1490 Scheduled Inspection Date: July 24, 2012 Inspector: Devaney, Michael Owner: Job Address: 373 NE 104 Street Miami Shores, FL 33138 -2017 Project: <NONE> Contractor: ADT SECURITY SERVICES, INC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alarm Phone Number Parcel Number 1121360130140 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 X47 74(/ July 23, 2012 For Inspections please call: (305)762 -4949 Page 21 of 25 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 I ,, V / lr OWNER: Name (Fee Simple Titleholder): )1 a U. L v i Phone #: 3S T bd c,g Lig Address: ✓1 �j G (D4 (� City: _) p „ . & L O f �1)Q State: P 1 Zip: P5�t. 3 s Tenant/Lessee Name: Phone #: Email: 71 C# C el or` Permit No. t 0 Master Permit No. JOB ADDRESS: 3`A ,v e.. I D T S* City: Miami Shores County: Miami Dade Zip: 3313% Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: ADT Security Services Phone #: 954- 266 -5137 Address: 10785 Marks Way City: Miramar State: FL Zip: 33025 Qualifier Name: George Manginelli Phone #: 954 -266 -5275 State Certification or Registration #: EF0001121 Certificate of Competency #: Contact Phone #: 954-266 -5137 Email Address: Iscastro @adt.com DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration °New CURepairlReplace ❑Demolition Description of Work: STRer ew ermit # Wigglier • Submittal Fee $ Permit Fee $ /'fd 6"f, 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, 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 bui .# ' permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee be c ged; _._. Signature alai/ Owner or Ag t The foregoing instrument was acknowledged before me this'° day of U'' , 20 by mell who i ersonally kno to me or who h slroduced As identification and who did take an oath. NOTARY PUBLIC: Sign; Print: My Co * * * * * * * * * * * * ** Contractor The foregoing instrument was acknowledged before me t is 3 1 day of , 201 9—, 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 ge 4 '74'?" P' Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10/2009)(Revised 3/15/09) ** * * * * * * * * * * * * * * * * * * * * ** MARIA O. PEE2 Notary Ptbk storm '140, f • Commission N EE 1116354 Clerk r-c' t 25/ errit 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: 373 ors /04i S t A.it %kl/l t 5 U/6rCrc,7 , State: e-( City: CocbSICro9 lEOZRW Master Permit No. ,c(alh(Ih Ud.V Tenant/Lessee Name: Phone #: Zip: 33/ 32 Phone #: Email: JOB ADDRESS: S 3 /Uv /04P si‘ City: Miami Shores County: Miami Dade zip: 33/ Folio/Parcel #: //— 013(0 — 0/3 21'1 D Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: A. hi ' ‘A Oa ( Phone #: AV 4 6.11464$0 o' t?S b M24 !j � l l� MI Address: II AA City: /241-0441-4 State::: Zip: 33Zs G.t �4 /,�,O9 ?)C)&' 1 Phone #: State Certification or Registration #:sue //�/' 000// 1 Certificate of Competency #: Contact Phone#: ./ 6' 5 Email Address: DESIGNER: Architect/Engineer: Phone#: Qualifier Name: Value of Work for this Permit Type of Work: ❑Address ❑Alteratio Description of Work: ` Square/Linear Footage of Work: UNew ❑Repair/Replace ❑Demolition ******** ********* ***** * *** *** ** *** ** *** Fees************* **** ******** ** * *** ***** * * ** **** Submittal Fee $ Permit Fee $ i® 0, 04? CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ tJ J 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) d ays r the h building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspects Signature Owner . r Agent The foregoing instrument was acknowledge. before me this /a' The foregoing instrument was acknowledged before me this ' ' e o� ill be charged. Signature ' tractor day of ,20 4_t ,by day of , 20 L, by who is personally known to me or who has produced L( 2)t- . who is . - onally kno to me or who has produced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBI. C: Sign: Print: My Commission Expires: APPROVED BY Sign. Print: ' •. j f% if l re.% My Commission Expires: r /Cr I/1-- *+ x*********** ** **+ x************** ***+ x+ x***** x: ***u :***+x **+x********** *+x*********+ *** 4 // Plans Examiner Zoning Structural Review Clerk (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Miami -Dade My Home My Home Show Me: Property Information Search By: Llest Item Text only tI Property Appraiser Tax Estimator Property Appraiser Tax Comparison Summary Details: Folio No.: 11- 2136 - 013 -0140 Property: Mailing Address: 373 NE 104 ST MALELLY VIDAL 373 NE 104 ST MIAMI SHORES FL 33138- Property Information: Primary Zone: CLUC: 1000 SINGLE FAMILY RESIDENCE 0001 RESIDENTIAL - SINGLE FAMILY Beds /Baths: 2/2 Floors: 1 Living Units: 1 Adj Sq Footage: Lot Size: Year Built: Legal Description: 1,505 9,225 SQ FT 1950 36 52 41 31 52 42 MIAMI SHORES SEC 5 PB 10- 7 LOT 22 & W1/2 LOT 23 BLK 117 LOT SIZE 75.000 X 123 OR 16838- 1175 0495 4 OR 27720- 0488 0611 19 Assessment Information: 2009 5142,38 7 ;12 D,82U 4 Year: Land Value: Building Value: 2010 $83,801 $115,919 ; Market Value: Assessed Value: $199,720 $266,207 $199,720 $99,583 Exemption Information: YES Taxable Value Information: < Year: Taxing Authority: Regional: 2010 Applied Exemption/ Taxable Value: $0/$199,720 2009 Applied Exemption/ Taxable Value: $50,000/$49,583 ACTIVE TOOL: SELECT ram 8/12/11 10:59 AM ' - MIAMI -DADE Vii, e r 105111 5' -.fix' • •' _�_ i;.i;: 50. `� i ..„... -:< t� z - -- - ;�;._u7. "'i ,: },�. fie 7:$� ,.� reAAC 4; 1 + tiE 4 .,+.,,� + ,^ P. " Ise. ' '' .1.�' i:,4. -1. ' ' rY 71 r vo.H.H. lilt > �_I': L .71 Di + r e- : r j r i' Ste . Aerial Photography - 2009 My Home I Property Information I Property Taxes I My Neighborhood I Property Appraiser 0 113 ft Home I Using Our Site I Phone Directory I Privacy I 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 Web Site © 2002 Miami -Dade County. All rights reserved. Legend e• Property Boundary Selected Property Street ,/ Highway Miami -Dade County Water w Page 1 of 2 /r,+wv c71', 'W) `RESIDENTIAL SERVICES CONTRACT is CONTRACT DATE CUSTOMER ACCOUNT NO 5104UE12 11111111111 N 771 -r • •II- a ADT Security Services, Inc. ("ADT") Office Address /00?5 c a? 5/rft, di /2i), )21/13V -;*Y-.)dc www.MyADT.com 1.800.ADT.ASAP® (1.800.238.2727) IF FAMILIARIZATION PERIOD IS REJECTED INITIAL HERE (see Paragraph 14 of the Terms and Conditions for explanation) Customer Name ( "Customer" or "I" or "me" or "my ") 4 he Address 131 414 State ® ZIP Protected Premises' Telephone 5 3 2 U 5 City Tax Exempt. No 0 Traditional Phone 0 Other (Qualified) 0 Other (Non - Qualified) Alternate Telephone 1 Alternate Telephone 2 EMAIL 9 5 C)— 22103311 Tax Expire Date 0 Home ® Cell 0 Work O Home 'OCell OWork: Communications Authorization: I authorize ADT to provide me with information and updates about the security system and new ADT and third -party products and services to the contact information provided by me. I may unsubscribe or opt out by emailing donotcontact ADT.com or by calling 888.DNC4ADT (888.362.4238). Initial here Confirmation of Appointments: I authorize ADT to call me using an automated calling device to deliver a pre- recorded message to set/confirm appointments and provide other information and notices about the alarm system at the telephone number(s) provided by me. Initial here Alarm System Ownership: a Customer -Owned • Dggvne 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 CONDITIONS. (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 AN ADDITIONAL 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 IS 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 I CHANGE TELEPHONE SERVICE, BY CALLING 1.800.ADT.ASAP OR BY LOGGING IN TO WWW.MYADT.COM. (F) THIS CONTRACT REQUIRES FINAL APPROVAL BY AN ADT AUTHORIZED MANAGER BEFORE ADT MAY PROVIDE ANY EQUIPMENT OR SERVICES, AND IF APPROVAL IS DENIED, THEN THIS CONTRACT WILL BE TERMINATED, AND ADT'S ONLY OBLIGATION WILL BE TO NOTIFY ME OF SUCH TERMINATION AND REFUND ANY AMOUNTS I PAID IN ADVANCE. ADT Representative me if ii? /t I ji/6-7AICG Rep. License No. Rep. k� (If Required) ID No. :.L.�( Customer's Appr va Origin ign ure ui st match Customer Name in Section 1 above) V 91/ I / f 1 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. I • • - • • -• FINANCIAL DISCLOSURE STATEMENT THERE IS NO FINANCE CHARGE OR COST OF CREDIT (0% APR) ASSOCIATED WITH THIS CONTRACT. A. NUMBER OF PAYMENTS FOR THE B. AMOUNT OF EACH PA INITIAL TERM IS 36. (TOTAL MONTHLY SERVICE CHARGE FROM BELOW) YMENT IS $ 419 -'1 $ I')31). 611 TOTAL OF PAYMENTS FOR THE INITIAL TERM IS • (A. TIMES B.) (EXCLUSIVE OF ANY APPUCABLE TAXES, FEES, FINES AND RATE INCREASES) • LATE CHARGE - PAYMENT IS DUE PURSUANT TO MY SELECTED BILLING FREQUENCY, PRIOR TO THE START OF SERVICE. MY FIRST BILL/CHARGE WILL BE SENT /MADE SHORTLY AFTER MY SERVICE BEGINS. ADT MAY IMPOSE A ONE -TIME LATE CHARGE ON EACH PAYMENT THAT IS MORE THAN TEN (10) DAYS PAST DUE, UP TO THE MAXIMUM AMOUNT PERMITTED BY LAW, BUT IN NO EVENT WILL THIS AMOUNT EXCEED $5.00. PREPAYMENT— IF I PREPAY THE TOTAL OF PAYMENTS PRIOR TO THE END OF THE INITIAL TERM OF THIS CONTRACT, THERE IS NO PENALTY OR REFUND. SEE SECTIONS 2, 7,15 AND 19 OF THIS CONTRACT FOR ADDITIONAL INFORMATION ABOUT NONPAYMENT, DEFAULT AND ACCELERATION. 1 of 6 Administrative Copy ©2011 ADT. All rights reserved: (04/11)