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EL-12-1789Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 180778 Scheduled Inspection Date: October 29, 2012 Inspector: Devaney, Michael Owner: OHARRIZ, VICTOR & ELIZABETH Job Address: 276 NE 105 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ADT LLC Permit Number: EL -9 -12 -1789 Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alarm Phone Number Parcel Number 1121360130460 Building Department Comments ALARM INSTALLATION Infractio INSPECTOR COMMENTS Passed Comments False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments S�- i"z��� October 26, 2012 For Inspections please call: (305)762 -4949 Page 23 of 27 i f F ' Miami Shores Village AMALIE 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 Permit Type: Electrical JOB ADDRESS: c17 NCB (ac <v City: Miami Shores County: Miami Dade Zip: C...53) , Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: __,CMEM.V; Al SEP 2 J 2i)2 I All BY: ...... FBC 20 Permit No. E-) 1 Ue71 Master Permit No. 61 7(7 °` ` OWNER: Name (Fee Simple Titleholder): Phone #: Address: 02 142 A 10 C 5 1- City: M %-e..* S -vo Nretr State: FL Zip: 3'? 10P Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name: AZY Address: /,0:78.3- 'enacts\ o City: fyomdr State: i/ Qualifier Name: J. / 4,46- /l. /e-69,t /-G. c State Certification o Registration #: traziwa co (s_ Contact Phone #: 2 -04a,3 Email Address: DESIGNER: Architect/Engineer: Phone #igys .wee Phone #: Zip:<§- Certificate of Competency #: Phone #: Value of Work for this, Permit: $ _/9 6® Square /Linear Footage of Work: Type of Work: ❑Address L1d'Alteration UNew ❑Repair/Replace ❑Demolition Description of Work: ******** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * Fees************* * * * * * * * * * * * * * * * * * * * * ** * * * * * * * ** Submittal Fee $ Permit Fee $ CCF $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ CO /CC $ Notary $ Double Fee $ Structural Review $ Training/Education Fee $ Technology Fee $ "I'OTAi. FEE NOW DUE $ Po 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 MR 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 Applicat: 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. /n the absence of such posted notice, the inspection will not be approved an a reinspection fee will be charged. )Signature Owner or Agent The foregoing instrument was acknowledged before me this F7 day of SAL-CA-6110 by who is personally known to me or who has produced Lucen.t e As identification and who did take an oath. NOTARY PUBLIC: Sign: Pri My Commission Expires: #EE 091666 cp • -° • • Ir. C3 • �q'Q �,��ypandedlhN�•�. ��4 x:Kokm* * *=k kck: * ** c:ka->k�Fxx * ".`..... **** * * ** k:i * *** =**** 1'*ek=K****=k*-k k*=k k= **:,.:F,,,, ****** * * * * * *- * ** 4 /C, STA 0�� ,Rws/Z- Plans Examiner Signature z Contractor The foregoing instrument was acknowledged before me this day of 20k ab, b \01111111104 who is personally known to me ct wi c*�_, , •4 . • as identifii(jt4twho et oath. NOTARY B` C• 7▪ , I3 : * °' . ▪ ■t. t :mod o� '• ihN : OQa� Sign: Print: My Commission Expires: APPROVED BY Structural Review Revised ; /I2 /201-2)1 Re%iscd 07 /I0/07)(Rc\I <ed 06/10 /2009)(Revised 3/15/09) Zoning Clerk RESIDENTIAL SERVICES CONTRACT ACTIVATION) M1414o63Q��� ! D / /VA AC ACCOUNT NO VGZINWEIN CONTRACT DATE 9 1 5404UE00 LEAD SOURCE Section 1. Customer Info ADT LLC (°A dba ADT Security Services DT') Office Address IQ `r i3 S >uG y J1 tA" ..'e, w.ci r1, Fi 3 429- { A to (1--c31 IAA 1 ---4 -0 303 - 3,2.) -_2 al www.MyADT.com 1.800.ADT.• (1.800.238.2727) U/ Customer Name /� (•Customer° or °I° or 'me" or 'my°) I 1 I 1 I CA-'1 C /‘a 1 1 .—. 1 1 Premises' h r\ fl (d Address 4 I I 1 1 1 City et•i. 44, I L 40 ,,' `IJ"' 1 1 1 State 1E4 ZIP - ARIA `1'alx Exempt No . �� .'. +� ... % +< <- . .• 1; Tax Expire Date / / 1 . _ Traditional Phone 0 Other (Qualified) 0 Other (Non - Qualified) Protected Premises' ®,r1> 14- �m Telephone Alternate ��� b2 �4 Telephone 1 ?S O Home OD Cell O Work Alternate (# Telephone 2 ' 0 Home 0 Cell 0 Work 7__ O Fill in if billing address is the same ---a_ Billing 1 Address City .. , 1 1 1 I I I State m ZIP IF FAMILIARI ATION PERIOD IS REJECTED INITIAL HERE V MO (see Paragraph 14 of the Terms and Conditions for explanation) . a EMAIL i ( Communic�ataons 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 provided by me. I may unsubscribe or opt out the security system and new ADT and third -party by emailing donotcontactttadtcom or by calling Confirmation of Appointments: •I authorize ADT to call me using an automated calling device appointments and provide other information and notices about the alarm system at the telephone to deliver a pre - recorded message to set/confirm number(s) provided by me. Initial here EQUIPMENT TO REMAIN THE PROPERTY OF ADT. All equipment installed by ADT pursuant to this Contract shall be owned by ADT unless ADT has agreed to give me ownership of the equipment in a separate written agreement. ADT has the right upon termination of this Contract to remove or disable any or all of the equipment owned by ADT, in which case 1 will not be able to use the equipment for any purpose. See Paragraph 7 of the Teens and Conditions for more information. 1 acknowledge and agree to each of the agree to each and every term of this Contract Contract is three (3) years. (C) ADT is not range of equipment and services that may be purchased from ADT at an additional No alarm system can provide complete other incidents are unpredictable and time.of police, fire and medical emergency interrupted for any reason. (E) ADT recommends 1.800:ADT.ASAP orby logging in to www.MyADT.com. —any-equipment-or services, and if approval termination and refund any amounts following: (A) This Contract consists of six (6) pages. including but not limited to Paragraphs 5 and a security consultant and cannot address all of my potential ADT can provide me. Additional equipment and services cost to me. I have selected and purchased only the protection or guarantee prevention of loss or injury. cannot always be detected or prevented by an alarm system. personnel is outside the control of ADT. ADT may that I manually test the alarm system monthly (F) this Contract requires final approval is denied, then this Contract will be terminated, I paid in advance. � Before signing this Contract, I have read, understand and 18 of the Terms and Conditions. (B) The initial term of this security needs. ADT has explained to me the full over those identified in this Contract are available and equipment and services identified in this Contract. (D) Fires, floods, burglaries, robberies, medical problems and Human error is always possible, and the response not receive alarm signals if communications or power is and any time 1 change telephone service, by calling by an ADT authorized manager before ADT may provide and ADT's only obligation will be to notify me of such ADT Representative Jam\ �,y n n r " " -,...4.3 �V , , Rep. License No. Rep. • �'• (If Required) ID No. ��IN e ! Customer's Approval: Original Signature Required (Must match Customer Name in Section 1 above) 1 .L. X (1 , (r)a, d�/It 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. Section 2. Services to be Provided FINANCIAL DISCLOSURE STATEMENT THERE I5 NO FINANCE CHARGE OR COST OF CREDIT (0% APR) ASSOCIATED WITH THIS CONTRACT. B. AMOUNT OF EACH PAYMENT IS $ LI �4 TOTAL OF PAYMENTS FOR THE INITIAL TERM IS $ ) W �� �� A. NUMBER OF PAYMENTS FOR THE INITIAL TERM•. I5 36. (TOTAL MONTHLY SERVICE CHARGE FROM BELOW) (A. TIMES B.) (EXCLUSIVE OF ANY APPLICABLE 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 55.00. PREPAYMENT - IF I PREPAY THE SEE PARAGRAPHS 2, 7, 15 AND TOTAL OF PAYMENTS PRIOR TO 19 OF THIS CONTRACT FOR THE END OF THE INITIAL TERM ADDITIONAL INFORMATION OF THIS CONTRACT THERE IS NO ABOUT NONPAYMENT, DEFAULT PENALTY OR REFUND. AND ACCELERATION. ©2012 ADT LLC dba ADT Security Services. 1 of 6 Administrative Copy All rights reserved. (06/12) 111111 JOB NO RESIDENTIAL SERVICES CONTRACT (ACTIVATION) CONTRACT DATE CUSTOMER ACCOUNT NO • I�IIE!1 YI6� III LEAD SOURCE IIIII Section 2. Services to be Provided (continued) @p Initial/Annual Recurring Munidpal Fee billed separately 7 (Subject to change based on local law) Initial/Annual Fee ® 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 ' _+ ?- ': I �— , �^ °' Gt� ', SO Customer to obtain and for initial/annual municipal alatr tile permit Eailu obtain aid provide ADT with the municipal alarrrn use permit registration number could result in no munidpal fire/police response to an,alarm fgm the prenips and/or a fine. ® Standard Monthly Service, FirelSmoke Detection . Servicg Includes: Customer onitoring Center Signal 'Receiving add.Notificatioii ce for Fire, Manual Fire and Manual Police Emergency t"---- P _MI —' - f Municipal Electrical Peit Fee a Custonieptalfbtairtelececal permit O Carbon Monoxide 0 Flood 0 Low Temp Installation Price • V h O Medical Alert 4 ;. � ,.J) $ - jvn a (,. T Amount �,� ..o r Non - Taxable Amount • OD Safewatch Cellguard® O SecurityLink® $ Connection Fee Extended Limited Warranty /Quality Service Plan (QSP) $ L %..- Admin Fee $ O Guard Response Service $ Sales Tax on Installation* $ O Monthly Recurring Municipal Fee (Subject to change based on local law) 0 Customer to obtain and pay for municipal alarm use permit Totallnstallation Charge* /., %,/ _ - O Other $ Deposit Received $ I Di Total Monthly Service Charge 1 I $ L'LA .1 1 Balance Due upon Installation* $ 'a- *If applicable sales tax not shown, it will be added to the first invoice. - • I is •a 'II • ID - -• / / /,- Control il/ zc`so /446. ti 1 'gig 1 per °Sa i¢O°•J �csa �. cos-4 `a /e JO- yr°∎ Panel s on . °O° 1:: 4s °nom ,sib4 TN ,e.• \1\¢4°� lQJ\�•ace ,c J / of ,S°o� °o °s Os CO. ( Q% ,ZO°e c% ��+ L� 05\ ., p °'C�` P° P° Comments Package Name: ( 1 Includes: Foyer r 1 r T Living Room i H i•A 9 4 t i vim fir Family Room T Office Dining Room / i l Cr 0'I"s 1 4,..,!) i 5^ ci Ci l.J S Kitchen I inslrxtoom Hallway Master Bedroom Master Bath Bedroom2 Bedroom 3 Bath 2 Basement Garage Price Per Piece -._ 1 -, 1 <1,yi c'.4,-,, rr 4� •,-,,,r,-,j ( t f- 1- z19e .tdcieV £' o• t „-‘ , - t'-'�"i"., (- - ..t Cat /, Totals I E = Existing Equipment Start Date _ nr; ; /1 —A / 2. 1 Estimated Installation . - INSTALLER NOTES 8 !fr! ©2012 ADT LLC dba ADT Security Services.