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EL-12-2239Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795 -2204 Fax: (305)756 -8972 Inspection Number: INSP - 189246 Permit Number: EL -11 -12 -2239 Scheduled Inspection Date: April 16, 2013 Inspector: Devaney, Michael Owner: RILEY, SUSANNE & JOHN Job Address: 1104 NE 98 Street Miami Shores, FL 33138- Project: <NONE> Contractor: ADT LLC Permit Type: Electrical - Residential Inspection Type: Final Work Classification: Alteration Phone Number Parcel Number 1132050180360 Building Department Comments BURGLAR ALRM Infractio 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 Comments cil/L April 16, 2013 For Inspections please call: (305)762 -4949 Page 15 of 18 (p ti)inif0 C/ ? # 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 Permit Type: Electrical JOB ADDRESS: PO S/ /VC 96 c cab RECFrvED NOV 272012 FBC 20 Permit No. �" I Z'' 3 9 Master Permit No. City: Miami Shores County: Miami Dade Folio/Parcel #: NLI9OreYer c 2i1 ? Is the Building Historically Designated: Yes NO OWNER: Name �(Fee Simple Titleholder): Van Cli crtietrek2/� �r Address: NO Vs N ' ei-ficS/A-ae , any City: P /+�/ %® U�ZO - State: ` Z P: r , Tenant/Lessee Name: Phone #: Email: Zip: L.53:78 Flood Zone: Phone #: CONTRACTOR: Company Name: /t-e � - Phone#' ?J f `$� 3 Address: /e9 bt ° City: s",?/',Ai eg)," State: Zip: _" Qualifier Name: Phone #: State Certification pr- Registration #: " 0'0,4. Contact Phone #: 19_ J c)-(.6767 —�?� Email Address: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone #: Value of Work for this Permit: $ Type of Work: ClAddress Description of Work: 7 - > Square/Linear Footage of Work: L1!'Alteration ❑New ❑Repair /Replace 11:;'2.4"" 1 ❑Demolition x: i_****: k• k: k****: k****= k> RX ::k:k>k,k%k**:k*:k:k%kx=** ** *Fees******************* epl***************** k ***** Submittal Fee $( Permit Fee $ 01■07Q'1' Oa' 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 c rtify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating cons uction and zoning. "WARNING TO C COMMENCEMENT IMPROVEMENTS FINANCING, CON RECORDING YOUF WNER: YOUR FAILURE TO RECORD A NOTICE OF MAY RESULT IN YOUR PAYING TWICE FOR TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN ULT WITH YOUR LENDER OR AN ATTORNEY BEFORE 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 c v of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to au chntent. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which ccurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not he approved rnd a reinspec•tion fee will be charged. of ignature Owne Agent The foregoing instrument was acknowledged before me this day of � � 20 )d--by 4e_ who is personally known to me .r who has produced As identification and who did take an oath. NOTARY PUB C: it Sign: Print: My Commission Ex %k%S**** k ** * ** k k k k* ***** *** APPROVED BY Signatu Contractor The foregoing instrument was acknowledged before me this P day of // , 20 / -by tGi%� ' 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: owlrof ,r 6656E1 .. d."2 . os. &,t cy - k= k> k %k** **,Fx=****-k>k>k:g** ** * * * ** k:k%k **** **** ** * *** k k=k=k-k *>k**** * *** **'440W 25-- !/. e.v2. Plans Examiner Structural Review 1Revised ;/ 12/ 21) 12u Rex i' cd(1 7/)1)1 07) iRccikcdl)(i /II) /200-)))Rcciked 3/15/001 Clerk CUMULATIVE SUBSTANTIAL IMPROVEMENT VERIFICATION WORK SHEET In accordance with FEMA 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 ST CTURE (attach appraisal): OWNERS SIGNATU — &.- DATE: 2 / / PLANREVIEWER: PLAN REVIEWER SIGNATURE: DATE: Created on June 2009 Property Viewer Search Enter either folto, owner name, or address. Selected Property Information Back to Results IIProperty information • Legal Description IIAssessment Information 1 Exemption infatuation ISales information Addlional Information Featured Online Toole .61 lisx Comparison • Tax Estimator el TRIM Notice 111 View Motes • Additional Online Toole NE 98TH ST http://gisweb.miamidade.gov/PropertySearch/ Page 2 of 3 Folio: Property Address: Owner. 11-3205.-018-0380 1104 NE 98 ST JOHN M RILEY &W SUSANNE Mailing Address: 1104 NE 98 ST MIAMI FL 33138-2508 Legal DasorIpllasc 5-6 53 42 P13 43-69 REV PL WAN SHORES SEC 8 LOT 19 IS.K. 180 LOT SIZE 59:183ULAR OR 00000-0000 0472 00 1 11/20/2012 RCS L SERVICES CONTRACT CONTRACT DATE LEAD SOURCE Section 1. Customer info ADT: LLC dba ADT Security Senile& L "ADT") Office Addrett Premi Address www.MyADT.coriii 80Q.ADT.A.SAP® (800.38.2727), Alternate Telephone 1 Protected Premi; Telephone RAWER o Fill in if billin Billing' Address address is the same State Tax Expire Date / raditional Phone 0 Other (Qualified) 0 Other (Non-Qualified) 0 Home 0 CeII 0 Work. IIIIIIINIMNPI 1lNiMligiiiillIllIl State, ZIP N. PERIM- S, RE ECT1;1N IN(TI. Paragraph t4-of the Termsand .Condltionsfprexplanatio0) EMA izatiorctoothoriee4oTtoiarceridente withc nfocmatiorn a thoointact informatien.prOVRItel, by trre I may unsubscribe FI(ltiathef it the Seetrit'irsyst ern and new -ADT and thIrd pasty emaifing donott entartkeekt.torrror rby, caiiing Canfiirmatibn of App'ointmenlls. I at#alaisCiae` tt3 call tree using ata.outorneted9Callirta device tocreliver -pre- recorifed r essagetu set/confirm appointments and provide other information and notices Oho alarm systern at the teiephoniviulm€ier(s) provided hy'me. Initial here bas e if`>3gfilith er . " •'ser`Yic maybe purchased from ADT a;t an additional .001As rf rrp�rovide rnplaie.pf rith,erfacklerits rtatta rer6 latradroaarrotsll tirrte=ofpoiite,- fhdand med prgencyi Tatertiirpteddb* anlr.rea444. ' ,� 'ri slir 801LADT:ASAPIorF)r14 1 any+equipdnent or ser Eshinii atIOn mid reflirld 7rr'0 f Qii~a IFLEffie osa rI -In T s' pre , ,h10. and: •ip►nentadu1Servieesl erlirrthl ar8 t.(D: ' • robberies, tisedlcabprebiemsand.. alvagxiE ' !Mt:44 111.: eaIaeYri.+ a1 1€ t littsor arsio ei is `endanytime' gel: hht>+aservtce bya.calling p)5rra 1 by:ad ADT4ifilioi4zed t5hegdI beforeA[ Miry provide 1-1)04errs5i{rretetL ifttrilMano:orily.01,41tris*IPbelOolfritlfy me of such Rep. License No.,. (If Required)' Customers Approval: Original Dire Required (Must match Customer Heine in Section 1 a*oye) NOT pF CANCELL A� )O(11 THE CUS OMR MAY CANCEL THIS TRANSACTION .AT ANY Time PRC It TO MIDNIGHT OF THE THIRD- BUSINESS DAY .TER T Ir DATE OF TEM NS CTION. SEE THE ATTACHED NOttFitE OP CANCELLATION FORM I OR AN EXPLANATION *THIS RIEr1<IT 1 ACKN, 9 EDGE BEING ERRALJ.Y INFORMED Ox MY R1GFIrIV CAWS. AT THE TIME OF EXECUTION )F THIS .i 3N i P1 41 C I tTF )f is I CI . iNAiticIA D1$CL(3SU E'- S'TATEMEN7 THERE 1S v 0 FINANCE CHARGE F OR COST L OF CREDIT (O% APRTASSOCIATED WITH THIS CD A. NUMBER OF PAYMENTS FOR. THE. INfTFAL *FERMIS 36. VAMOUNT OE EACH PAYMENT Is $ (rOTAI. MONTHLYSERVICE;CHARRGE FROM *BELOW). TO14 OF PAYMENTS FOR THE :IN1TLAI TERM I5 $ (A. TIMES E.),(6XLILISIVVE OF ANY APPLICABLE. TAXES, FEES, FINES. AND RATE INCREASES) LATE CHARGE 'PAYMENT IS DOE PoR5UANT TO MY Si;CECTED BILLING FREQIUEN Y PR1ORTO THEITART 00 SERVICE. MY;FIRST BIGL/CHARGEWILL BE SENT/MADE SHORTLY AFTER MY SERVICE BEGINS ATIT MAY IMPOSE A TINE TIME 1. TE CHARGE.O►11 EACH PAYMENT THAT iS MORE THAN TEN'(IOY, DAYS PASTPUEF UP To THE MA)CIMIIM`AMOUNT_PERMITTED BY LAW, BUT IN NO EVENT WILL THIS AMOUNT EMCEED' $SO0 PREPAYMENT -IF I. PREPAY THE TOTAL OF PAYMENTS PRIOR TO TINE END OF THEINITIAL'TERM QF THIS C.ONTRAC1 ,THEREISNO - .PENALTY OR REFUND. - SEE PARAGRAPHS 2, 7, 15. AND 19 OF THIS CONTRACT FOR ADDITIONAL INFORMATION ABOUT NONPAYMENT, DEFAULT ANDACCELERATiON. Administrative Copy 02012 ADT LLC dba ADT Security Services. All rights reserved: (001 IDENl'IAL SERVICES CONTRACT gum CONTRACT DATE OB. LEAD SOURCE r Standard Monthly Service, Burglary Service l dudes: Customer Monitoring Center-Signal Receiving and Notification Service for Burglary, Manual'€ite and Manual Police Emergency koridily C� IniUaWAnnua Ream iiritapel' ee billed separately ifi)tlaUAnniial ? e (Subletx orage oirlocal I�w) O Customer, o . an " 'for initiallannual.municipaL alarm use r • obtain. and Provide-ADT:i itli the munfdeal:abtrre perinitrogiSbetkin number could -.: result in o ,r i,: re/lolicetespanseto an'alanrr a fine. x`. b.. a Manual Police Emerge Fir��mokeDetection nlldring Center Signal ce fgr'Fire; Manual Fire hicrpal I We Customi 0 Carbon Monoxide 0 Flood 0 Low Temp Safewatch Cellguardo Irrfte#lation Price Non- Taxable Amount SecurityLink' Connection fee Extended Limited Warranty /Quality Service (QSP) 0 Guard Response Service O Monthly Recurring Municipal Fee (Subject to change based on Iocal law) 0 Customer to obtain atld,.p(iy for munidpal alarm use Peittit Adrnin l=ee Sales Tax on Installation!!r Total thstaflation'Charge* Total Monthly Servi€k-rhar_ge epo„t Rue upon;l ,11 Control ftnni Package Name: Fo er Faml)ytoorn Office :Dining Room eh .)fatlway i er Bed, m MesterBath Bedroom Bedroom., . •Bath 2 Basement Garage on *:r; 11111111111111111EMMEMIMINIMISIONEM :4111111111111111 tats,,. E'= E W1410l:quipr ited t I >; n Stark _late. 8 of 6 ©2012 ADT LLC dba ADT Security Services. All rights reserved. (09/122).