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EL-11-2080Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 189578 Permit Number: EL -11 -11 -2080 Scheduled Inspection Date: April 22, 2013 Inspector: Devaney, Michael Owner: Job Address: 1190 NE 100 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ADT LLC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Addition /Alteration Phone Number Parcel Number 1132050180020 Building Department Comments burglar alarm 03/15/2013 - SAME QUALIFIER Infractlo Passed Comments INSPECTOR COMMENTS False Passed 1,/ Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Comments CREATED AS REINSPECTION FOR INSP - 166453. No access at 4.22 p. m.. A7/I April 19, 2013 For Inspections please call: (305)762 -4949 Page 26 of 38 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 20t-10 Permit Type: Electrical Permit No. Master Permit No. $ 1' / /7"/ OWNER: Name (Fee Simple Titleholder): Phone#: Address: %0 f® 41 /de ST. City: ^'o•2.•le `k" State: fL Zip: Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: ,// 7' N /AO fr City: Miami Shores County: Miami Dade Zip: Folio/Parcel #: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Alfr 6C Address: /07 ff Z'1 "Cif/ r �'2 Zip: 336 City: Y� -410. r State: Qualifier Name: -GD 4'Q,410,9® 4 Phone#: ef'>a''5:01' 7c State Certification or Registration #: 4",.0170 //3-/ Certificate of Competency #: Contact Phone #: %'°% L -P 7f Email Address: DESIGNER: Architect/Engineer: Phone #: Phone #: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: DAddress UAlteratigry New ❑Repair/Replace ODemolition Description of Work:- �!�'CGJ +x*+xx **** *****: x* ******+x*r<******* **+r***** Fees+ r+ x** ***m r<****** * * ****x:***:x*****may**** * * ** ** Submittal Fee $ Permit Fee $ 1 C,(.) . «.-- CCF $ CO /CC $ Scanning Fee $ 5 - c 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 building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged before me this day of ,20_,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: Signature Contractor The foregoing instrument was acknowl ged before me this t/ V day of , 20 b� who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: Sign: ■ Print: ak4A1PliA ti My Commissio xpir '_ tdotacy M44* r 'c My Coma; u 514x% MOX 7 aC Commission * if 1'' *********%********************************* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** APPROVED BY Plans Examiner Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Zoning Clerk Miami Shores Village Building Department NV08Nil BY: 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972 INSPECTION'S PHONE NUMBER: (305) 762.4949 j Permit No: 11 Master Permit No. BUILDING PERMIT APPLICATION FBC 20 Permit Type: Electrical OWNER: Name Fee Simple Titleholder Address: '• 1E 1 City: J . !� /I -�1/ r a State: FL- Address: - Agin l G� �✓ Phone #: zip:3343A Tenant/Lessee Name: Phone #: Email: JOB ADDRESS: 1/90 L City: Miami Shores} �*C�ouuntty�: Folio/Parcel #: �p2 5 Q /7.(_iCrO�.a Is the Building Historically Designated: Yes NO Flood Zone: r` Phone #: 9z?9 Zi • -r Miami Dade zip: 93)3 V CONTRACTOR: Company Address: `�' /O S- City: Qualifier Na State Certification or Registration #: Contact Phone #: ame: State: Phone #: Certificate o f Competency #: 494O7`.441,. Email Addres DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit:cf/ Square/Linear. Footage of Work: Type of Work: UAddress AAlteration Description of Work: 60`"7 New ORepair/Replace ❑Demolition ***************************************Fee s******************************************** Submittal Fee $ Scanning Fee $ Notary $ Double Fee $ Permit Fee $ ��' �0' f9' CCF $ CO /CC $ Radon Fee $ DBPR $ Bond $ Training/Education Fee $ Technology 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 attach lso, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occ n (7) days after the building permit is issued. In the absence of such posted notice, the inspection wi • • , • • • - . e• a, a r- 'on fee will be charged. Signature Owner or Agent The foregoing instrument was acknowledged be ore me this day of G( /03 ,2011 ,by 66P1; 70'S Vl7 , who is personally known t. me or who has produced A and who did take an oath. NOTARY PUBLIC: My Commission Expires: Signatur Contractor The foregoing instrument was acknowledged before me this day of WO , 20 % � , by &)' e' inert j 4, `, who is personally known to me or whoo has produced NOTARY P Sign: Print: as identification and who did take an oath. IC: `eit14l1!!!Nl���j� ..�'t.. '••10RI•EX•' /� I�� s i ! = �� ° .� • of ��• y a��' My Commission Expires: Pik . ••.�,0 F' tans Examiner Zoning Structural Review (Revised 07 /10 /07)(Revised 06 /10 /2009)(Revised 3/15/09) Clerk Miami -Dade My Home My Home Show Me: !Property Information Search By: !Select Item ji Text only Property Appraiser Tax Estimator Property Appraiser Tax Comparison Summary Details: Folio No.: 11- 3205 - 018 -0020 Property: 1190 NE 100 ST Mailing Address: SHALOM 1190 LLC 1190 NE 100 ST MIAMI SHORES FL 33138 -2602 Propert y Information: Primary Zone: 1100 SINGLE FAMILY RESIDENCE CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds /Baths: 4/2 Floors: 1 Living Units: 1 Adj Sq Footage: 2,795 Lot Size: 17,680 SO FT Year Built: 1951 Legal Description: REV PL MIAMI SHORES SEC 8 PB 43 -69 LOT 2 BLK 178 LOT SIZE IRREGULAR COC 26260 -0219 03 2008 4 OR 26260 -0219 0308 01 Assessment Information: Year: 2011 2010 Land Value: $255,940 $213,283 Building Value: $243,803 $245,221 Market Value: $499,743 $458,504 Assessed Value: $499,743 $458,504 Taxable Value Information: Year: 2011 2010 Taxing Authority: Applied Exemption/ Taxable Value: Applied Exemption/ Taxable Value: Regional: $0/$499,743 $0/$458,504 County: $0/$499,743 $0/$458,504 City: $0/$499,743 $0/$458,504 $0/$499,743'$0/$458,504 School Board: Sale Information: Page 1 of 2 ACTIVE TOOL: SELECT Aerial Photography - 2009 My Home 1 Property Information 1 Property Taxes I My Neighborhood 1 Property Appraiser 0 117 ft 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. 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All rights reserved. http://gisims2.miamidade.gov/myhome/propmap.asp 11/4/2011 Miami -Dade My Home Sale Date: 3/2008 Sale Amount: $0 Sale O/R: 26260 -0219 Sales Qualification Description: Sales which are disqualified as a result of examination of the deed View Additional Sales Additional Information: Click here to see more information for this property: Community Development District Community Redevelopment Area Empowerment Zone Enterprise Zone Zoning Land Use Urban Development Boundary Zoning Non -Ad Valorem Assessments r Environmental Considerations http://gisims2.miamidade.gov/myhome/propmap.asp Page 2 of 2 11/4/2011 www.sunbiz.org - Department of State Page 1 of 2 Home Contact Us E- Filing Services Document Searches Forms Previous on List Next on List Return To List No Events No Name History Detail by Entity Name Florida Limited Liability Company SHALOM 1190, LLC Filing Information Document Number L08000005506 FEI/EIN Number 261944883 Date Filed 01/15/2008 State FL Status ACTIVE Principal Address 1190 NE 100 STREET MIAMI SHORE FL 33138 Mailing Address 1190 NE 100 STREET MIAMI SHORE FL 33138 Registered Agent Name & Address MY CORPORATION USA.COM 1075 NE 99TH STREET MIAMI SHORES FL 33138 US Name Changed: 03/03/2011 Manager /Member Detail Name & Address Title MGRM ECHT, GUSTAVO F 136 NE 968 STREET MIAMI SHORE FL 33138 Title PTS ECHT, GUSTAVO F 1190 NE 100 STREET MIAMI SHORE FL 33138 Title MGRM Entity Nam ___. _._..__.......__..____......... http: / /sunbiz.org/ scripts /cordet.exe ?action= DETFIL& ingdoc_number= L08000005506 &i... 11/7/2011 www.sunbiz.org - Department of State Page 2 of 2 EIDELSTEIN, ROBERTO MR. PANAMA 729 CAP. FEDERAL, BUENOS AIRES BA ARGEN -TINA AR Title MGRM ECHT, SILVIA MRS. PANAMA 729 CAP. FEDERAL, BUENOS AIRES BA ARGEN -TINA AR Annual Reports Report Year Filed Date 2009 03/17/2009 2010 04/07/2010 2011 03/03/2011 Document Images 03/03/2011 — ANNUAL REPORT 04/07/2010 -- ANNUAL REPORT 03/17/2009 — ANNUAL REPORT 01/15/2008 — Florida Limited Liability View im -in P Viewm Iri PDF' for V imp to PIKE form View rp Note: This is not official record. See documents if question or conflict. Previous on List Next on List No Events No Name History Retum To List 1 Home I Contact us 1 Document Searches I E- Filinq Services i Forms 1 Help 1 Copyright © and Privacy Policies State of Florida, Department of State Entity Narr ............ ............................... http: / /sunbiz. org/scripts /cordet.exe ?action= DETFIL& inq _doc_number--L08000005506 &i... 11/7/2011 RESIDENTIAL SERVICES CONTRACT CONTRACT DATE 1 1111 CUSTOMER ACCOUNT NO 11 III YI 5104UE12 11 Iflll 7 560- JOB NO LEAD SOURCE Section 1. Customer Info ADT Security Services, Inc. ( "ADT ") Office Address 7o 1Ael{- LA 1. ) 1 ,1 Customer Name ( "Customer" or "I" or "me" or "my ") 1 ✓ V/ ;%1 Address v L A 5 g_16 / L) / r') State ri ZIP Protected Premises' Telephone 7( L/ �v , O Traditional Phone 0 Other (Qualified) www.MyADT.com 1.800.ADT.ASAPe Alternate (1.800.238.2727) Telephone 1 IF FAMILIARIZATION PERIOD 15 REJECTED INITIAL HERE (see Paragraph 14 of the Terms and Conditions for explanation) EMAIL Alternate Telephone 2 City Tax Exempt No. 0 Other (Non - Qualified) 3 L +� Tax Expire Date 0 Home 0 CeII 0 Work 0 Home 0 Cell 0 Work M LAO 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/confirrn . appointments and provide other information and notices about the alarm system at the telephone number(s) provided by me. Initial here Alarm System Ownership: 0 Customer -Owned ® 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 CONDITIONS. (B) THE INITIAL TERM OF THIS CONTRACT I5 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 I5 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 I5 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 I5 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 Representa$ve Name /V l�l-,� Signatulre Required (Must'match Customer Name in Section 1 above) NOTICE ::-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. 1 ACKNOWLEDGE BEING VERBALLY INFORMED OF MY RIGHT TO CANCEL AT THE TIME OF EXECUTION OF THIS CONTRACT AND RECEIPT OF THIS NOTICE. Rep. License No. Rep. (If Required) ID No. X • •_ - • •-• FINANCIAL DISCLOSURE STATEMENT THERE I5 NO FINANCE CHARGE OR COST OF CREDIT (0% APR) ASSOCIATED WITH THIS CONTRACT. A. NUMBER OF PAYMENTS FOR THE B. AMOUNT OF EACH PAYMENT IS $ INITIAL TERM I5 36. (TOTAL MONTHLY SERVICE CHARGE FROM BELOW) LATE CHARGE - PAYMENT IS DUE PURSUANT TO MY SELECTED BILLING FREQUENCY, PRIOR TO THE START OF SERVICE. MY FIRST BILUCHARGE 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. TOTAL OF PAYMENTS FOR THE INITIAL 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 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 Customer Copy ©2011 ADT. All rights reserved. (04/11) RESIDENTIAL SERVICES CONTRACT CONTRACT DATE \ ®9 } CUSTOMER ACCOUNT NO 11 IIffl III 11 i IMI 5104UE12 JOB NO LEAD SOURCE - • 1 - - • • - ' • 0 -. ( • 1 .-•) Standard Monthly Service, Burglary Service includes: Customer Monitoring Center Signal Receiving and Notification Service for Burglary, Manual Fire and Manual Police Emergency 0 Standard Monthly Service, Fire/Smoke Detection Service includes: Customer Monitoring Center Signal Receiving and Notification Service for Fire, Manual Fire and Manual Police Emergency Monthly Service Charge - -- - - -- - r -- - r } �% �' t 0 Initial /Annual Recurring Municipal Fee billed separately (Subject to change based on local law) Initial /Annual Fee 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 municipal fire/police response to an alarm from the premises and/or a fine. Municipal Electrical Permit Fee 0 Customer to obtain electrical permit a ( } J 4 J O Carbon Monoxide 0 Flood 0 Low Temp 0 Medical Alert $ $ Installation Price $ $ Taxable Amount 0 Safewatch Cellguard® O SecurityLink® 3 Extended Limited Warranty /Quality Service Plan (QSP) ` (' 1 $ Non - Taxable Amount $ —.-- Connection Fee $ $ \ /✓ ( Admin Fee O Guard Response Service O Other $ Sales Tax on Installation* $1-0 + Deposit Received 1 0 0 Total Monthly Service Charge $ ��'fi Balance Due upon Installation* $ it *If applicable sales tax not shown, it will be added to the first invoice. - •1 • . •11-1 • .- 1 . -� COntr01 ) 0`1 .. e��oc �e�o`� ' 'z e\ej a ��o\ ,o����;r aJ \e J`aeo ,� Panel i ,` 5 S e a`� /e. 1 /0)* oc e� 5� cot,* .k,C; S� S°%S� . e.0 \Se,% ``` l et (P.- O tc) ;�6° - o;��oo�aSSQ�¢ 9e;t\5 edo o¢ �a aoaQ\. `,CaO Q��` s'k`r O QJ,,*°,' . Q� se �` " Q cf. 'e Q,' S 4` L P \ P i. P4 J P� . ,. Q e ,'' Comments Package Name: Includes: Foyer Living Room I I ! ! If } ) 1'', Family Room i Office j s j I_ \- -�, n -�. J Dining Room l Kitchen = -2 ! , Laundry Room j - - 1 (.../ t/q e 6 Hallway i Master Bedroom ? j Master Bath Bedroom 2 Bedroom 3 } Bath 2 Basement Garage i -1--- - 1 i I j I Totals 1 i E = Existing Equipment Estimated Installation Start Date / 1 A5/ ( / INSTALLER NOTES 7 ervl _A OT ©2011 ADT. All rights reserved. (04/11)