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EL-12-1934Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP- 187975 Permit Number: EL -10 -12 -1934 Scheduled Inspection Date: March 26, 2013 Inspector: Devaney, Michael Owner: BROOKS, GARY & FRANCES Job Address: 10502 NE 4 Avenue Miami Shores, FL 33138 -2014 Project: <NONE> Contractor: ADT LLC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alarm Phone Number Parcel Number 1122310130180 Building Department Comments INSTALL BURGLAR ALARM Infractfo Passed Comments INSPECTOR COMMENTS False Passed Failed Correction Needed Re- Inspection Fee No Additional Inspections can be scheduled until re- inspection fee is paid. Inspector Com 20 March 25, 2013 For Inspections please call: (305)762 -4949 Page 13 of 19 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 9 ,gyp ® ,34 PERMIT APPLICATION Permit Type: Electrical JOB ADDRESS: A/e `7 � kE OCT 142012 r_ . FBC 20(� Permit No. :C.1 2--\ 93`1 Master Permit No. City: Miami Shores County: Miami Dade Zip: '? 3/3 6 Folio/Parcel #: 1/ g3--3/ Q/ 3 0/go Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder): 077".7/ 73,02:9/4"...s Phone #: v— oVO/ - -/901-9 Address: /a5-6'.?" she //�y� City: )22,9--i/ .. State: Zip: .3..3/3 8 Tenant/Lessee Name: Phone #: Email: CONTRACTOR: Company Name: ADT LLC Phone #: lSV Z'ot ) ` 3 3 10785 MARKS WAY Address: MRAMAR, FL $$025 City: State: • Zip: Qualifier Name: )��. i * /��/?YGL! • Phone #: State Certification or Registration #: c-1-40'0®"%L6 Certificate of Competency #: Contact Phone #: Email Address: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ 4,2 9.S. '13 Square/Linear Footage of Work: Type of Work: DAddress 'Alteration New ❑Repair/Replace ❑Demolition Tsai/ Jam' — #�7 Description of Work: ***** * **** ** **- '**** fickx=: k:k:kX:E%K:k.k**•k*:k:k** Fees* k: k: k *=k•k:k *:k:k=k:k:E=k** **:E:k* F* =k:k=k* *:F k** ** **:F:k*** Submittal Fee $ Permit Fee $ /m "ePe) CCF $ CO /CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ Training/Education Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOV DUE $ 1'`' PH STIER WPWANCoN # EE838321 exPREs September 28, 2016 mm My Commission Expires: and who did take an oath. Contractor The foregoing instrument was acknowledged before this /� day of 1 , 20 /k y �� /� d�� /G� ioep who is personally known to me or who has produced as identification and who lid tike an oath. ,,��R tl0I',iy0 ,e,,s Q.• ..: ;............ ,• P y0� V r ?p^ya x th 6' : �yi ,%,0 I I Rio. NOTARY PUB Sign: Print: pry E 4 - e, ®� A g� M My Commission Expires: • coxQx i+ w y _ 6, •.;t fry ,••• J��% °1's,„ OTAR'I po0% a. * **** * **** * *%k=k k*.k***%k*** * * * * ** k*-k 1= k- k*- k- k> k*= k:;;*** * *** * **** *** **•k>k:k **** ****•x, *ok** *** - k**** • **** *** * *-k*>k-k%k*>k **** *** APPROVED BY //� ,/,"-j`24j2. Plans Examiner Structural Review ( Revised 3/12/20 1 _ II Rey keel ()7/I I) /07 )1 Revised (16/111/2009 )( Revised 3/15/091 Zoning Clerk • CUMULATIVE SUBSTANTIAL IMPROVEMENT VERIFICATION WORK SHEET In accordance with 1'EMA regulation and Miami Shores Village Flood Damage Prevention Ordinance the costs of all improvements must be monitored. The costs of any improvements in the past 12 months and the costs of any proposed improvements must be shown on the worksheet. The cost of improvements must include demolition, raw and finished materials (include those donated), labor (including volunteer and self - performed), construction supervision and management, and overhead and profit. A list of items the costs of which are to be included as well as those excluded is attached for your reference. (A Copy of the Contract must be attached) PROPERTY OWNER: PERMIT # ADDRESS: FOLIO NUMBER: FLOOD ZONE: BASE FLOOD ELEVATION: FREEBOARD: EAST OF FL.CCCL: COST OF PAST IMPROVEMENTS (12 MONTHS): COST OF PROPOSED IMPROVEMENTS: (ATTACH COPY OF CONTRACT) TOTAL CUMULATIVE COST OF IMPROVEMENTS (past and proposed): VALUE OF PRINCIPAL STRUCTURE (attach appraisal): OWNERS SIGNATURE: DATE: PLANREVIEWER: PLAN REVIEWER SIGNATURE: DATE: Created on June 2009 Miami -Dade My Home My Home is idade.go! Show Me: Property Information Search By: I Select Item Text only Property Appraiser Tax Estimator Property Appraiser Tax Comparison Portability S.O.H. Calculator Summary Details: Folio No.: 11- 2231 - 013 -0180 Property: 10502 NE 4 AVE Mailing GARY S BROOKS &W Address: FRANCES Living Units: 10502 NE 4 AVE MIAMI Adj Sq Footage: SHORES FL Lot Size: 33138 -2014 Property Information: Primary Zone: 1000 SGL FAMILY - 2101 -2300 SQ CLUC: 0001 RESIDENTIAL - SINGLE FAMILY Beds/Baths: 2/1 Floors: 1 Living Units: 1 Adj Sq Footage: 2,105 Lot Size: 8,025 SQ FT Year Built: 1935 $50,000/ $166,436 FIRST ADD TO City: PASADENA PARK PB 6- Legal 82 LOT 1 & S1/2 LOT 2 Description: BLK 11 LOT SIZE 75.000 X 107 OR 19702 -1362 04 2001 1 OR 19702 -1362 0401 00 Assessment Information: Year: 2012 2011 Land Value: $71,891 $71,891 Building Value: $144,545 $144,545 Market Value: $216,436 $216,436 Assessed Value: $216,436 $213,060 Exemption Information: Year: 2012 2011 Homestead: $25,000 $25,000 2nd Homestead; YES YES Taxable Value Information: Year: 2012 2011 Applied Applied Taxing Authority: Exemption/ Taxable Exemption/ Taxable Value: Value: Regional: $50,000/ $166,436 $50,000/ $163,060 County: $50,000/ $166,436 $50,000/ $163,060 City: $50,000/ $166,436 $50,000/ $163,060 School Board: $25,000/ $191,436 $25,000/ $188,060 Sale Information: Page 1 of 2 ACTIVE TOOL: SELECT Aerial Photography - 2009 i My Home I Property Information 1 Property Taxes I My Neighborhood I Property Appraiser 0 111 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. Web Site © 2002 Miami -Dade County. All rights reserved. Legend Property Boundary Selected Property Street Highway Miami -Dade County ■ Water http: / /gisims2. miamidade .gov /myhome /propmap.asp 10/10/2012 RESIDENTIAL SERVICES CONTRACT (ACTIVATION) CONTRACT DATE r / / cuSTOMER ACCOUNT No 11 111 111 e "II III 54 UEt ^ JOB NO EAD SOURCE - i.1 .I -r f. ADT LLC dba ADT Security Services MDT') Office Address 0%r S r'' I4,'r);'(f)7Z it __:._-;07i Customer Name ('Customer" or °I° or "me` or °my`) ) rZ ri) ) C t- 5 p r+ { Q. It A L L .._...__. -__ --- .- _-- __.... , E, 1 „ i t- i. i-1 5) 5-- 2' - 3 v` www.MyADT.com 1.800.ADT.ASAP® 0,900.238.2727) Premises' ) L) f.. 2. t.J e r{ �:S U (: Address . City f State i L ZIP � �� � "' ,; � /�l��'��l� Tax Exempt No ', •... ., . , ,. • . ! , .. , ,. Tax Expire Date i i v l�l� Protected Premises' J • y c, 9 A- 1 j ,> ? ® Traditional Phone O Other (Qualified) 0 Other (Non - Qualified) Telephone Alternate ° b z 0 I e: 1 i O Home Cell O Work Alternate O Home O Cell O Work Telephone 2 Fill in if billing address is the same Billing C State ZIP IF FAMILIARIZATION PERIOD IS REJECTED INITIAL HERE (see Paragraph 14 of the Terms and Conditions for _ explanation) EMAIL l e 6 6 5 1 o S I r 0 Q V A i{ O u e. O ,-1 Communications Authorization: I authorize (products and services to the contact inform SSS.DNC4ADT (888.362.4238). Initial here ADT to provide me with information and updates about the security system and new ADT and third -party tianprovided by me. I may unsubscribe or opt out by emailing donotconT"act@adt.com or by calling a t 1 !: Confirmation of Appointments: I authorize ADT to call me using an automated calling device to deliver a pre - recorded message to setkonflrm appointments and provide other information and notices about the alarm system at the telephone number(s) provided by me. Initial here' 1 ( 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 ownershlp 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 Tenor and Conditions for more information. 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 inddents 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 1 manually test the alarm system monthly and any time I change telephone service, by calling 1.800ADTASAP 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 ADTs only obligation will be to notify me of such termination and refund any amounts 1 paid in advance. ADT Representative - ---1--)E-1 -k-'1 n 1 iA Rep. License No. Rep. (If Required) ID No. SY I Customer's • ro t, ri nal 5 nature X Required (Must match Customer Name in Section 1 above) 4/ / ,/ / e 4 ... NOTICE OF CANCELLATION 4 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. FINANCIAL DISCLOSURE STATEMENT THERE 1S NO FINANCE CHARGE OR COST OF CREDIT (0% APR) ASSOCIATED WITH THIS CONTRACT. A. NUMBER OF PAYMENTS FOR THE INITIAL TERM 15 36. B. AMOUNT OF EACH PAYMENT 15 $ (TOTAL MONTHLY SERVICE CHARGE FROM BELOW) TOTAL OF PAYMENTS FOR THE INITIAL TERM IS °/ t Cr (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 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.O0. 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 PARAGRAPHS 2, 7, 15 AND 19 OF THIS CONTRACT FOR ADDITIONAL INFORMATION ABOUT NONPAYMENT, DEFAULT AND ACCELERATION. 1 of 6 ©2012 ADT LLC dba ADT Security Services. Administrative Copy All rights reserved. (06/12) RESIDENTIAL SERVICES CONTRACT (ACTIVATION) ti of 5a '' UE( ' IL CONTRACT DATE / / / / Z CUSTOMER ACCOUNTaO JOB CAD • � • •- • • • -• •• a .'s NO SG.;RCE Standard Monthly Service, Burglary vile Service includes: Customer Monitoring Center Signal Receiving and Notification Service for Burglary, Manual Fire and Manual Police Emergency Monthly Service Charge O Initial/Annual Recurring Munidpal Fee billed separately (Subject to change based on local law) Initial/Annual Fee ;1E/7 I7 C I O 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 fire/police response to an alarm from the premises and/or a fine. !� O Standard Monthly Service, Fire/Smoke Detection Service Include Customer Monitoring Center Signal Receiving and Notification Service for Fire, Manual Fire and Manual Police Emergency t Munidpal Electrical Permit Fee O Customer to obtain electrical permit O Carbon Monoxide 0 flood 0 Low Temp $ Installation Price $ 12 4J--r., C7 .€ �; 0 Medical Alert $ . Taxable Amount 46 Safewatch Cellguard® $ ,Z- (( Non - Taxable Amount $ O Securitylink® $ Connection Fee $ ® Extended Limited Warranty /Quality Service Plan (QSP) $ .24 c ( Admin Fee $ O Guard Response Service $ Sales Tax on Installation* $ O Monthly Recuning Municipal Fee (Subject to change based on local raw) 0 Customer to obtain and d pay for . municipal alarm use permit � Total In Installation Charge* g J $ 2` -� r ,3 / % T O Other $ Deposit Received Total Monthly Service Charge $ 472 - ), Balance Due upon Installation* $ ---e-- *If applicable sales tax not shown, it will be added to the first invoice. 1 li -I -• Control �� 0�1 °oae a`a°aA® ao� 0P 0,)• eve J`a�° Panel vat\ ems° �`' ooe 0 %g' 4p' s. . °T, tai° is¢ f'� �s¢�ce� �Se� 0 o ° Sk• .`"°° G0 p¢ *# L. % S'i•° ° L V >\r IP�fi P���a� � t" Comments Package Name: Includes Foyer ,3r/ /,v ,4.. 5 y.S i b')i l O £6N ,...)11.3 i 5 ZNt 7713 et& 0 Living Room �� , �" --- -- Family Room ,„:"e` (o Li le . t 5 - Office Dining Room ,L; 0 [n� 5 / o O ,-..5e- / JJ E P Kitchen s " . Laundry Room /r /.1av6 E 0 vt 72- ess 0,71 r.J 1- /01. U 5 t,..rC E (,L ($.)111 2 D Hallway (p4 -%a ( D Master Bedroom kt' 7,90.04 Master Bath ° ee. j% 0tJ¢,LL-e/' Bedroom 2 j. _ .. 43 t{.,oh 1 I_J r.6/( , Lc ,3 >. aeee r ,.e.,e- Bedroom-3- Bath 2 , AAA 1' / keypo a(, Basement ,. Garage Price Per Piece Totals E= Existing Equipment Estimated Installation Start Date /a�� INSTALLER NOTES 2 of 6 02012 ADT LLC dba ADT Security. All rights resery e