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EL-13-741 Inspection Worksheet Miami Shores Village 10050 N.E.2nd Avenue Miami Shores, FL Phone: (306)796-2204 Fax: (306)756-8972 Inspection Number: INSP-202398 Permit Number: EL-4-13-741 Scheduled Inspection Date: November 04, 2013 Permit Type: Electrical- Residential Inspector: Devaney, Michael Inspection Type: Final Owner: LIJFOCK,VIRGIL&DIANE Work Classification Alarm Job Address:948 NE 97 Street Miami Shores, FL Phone Number Parcel Number 1132060143170 Project: <NONE> Contractor: ADT LLC Building Department Comments ALARM Infractio Passed Comments INSPECTOR COMMENTS False Inspector Comments Passed Failed Correction ❑ Needed Re-Inspection Fee No Additional Inspections can be scheduled until re-inspection fee is paid. November 01,2013 For Inspections please call: (305)762-4949 Page 33 of 37 Miami Shores Village APR 1 013 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 FBC 20 10 BUILDING Permit No. 3 PERMIT APPLICATION Master Permit No. Permit Type:Electrical JOB ADDRESS: 9y� Af 97&Aa t City: Miami Shores County: Miami Dade Zip: C3e3 W Folio/Parcel#:J I laou 0(4 3 I Ty Is the Building Historically Designated:Yes NO Flood Zone: OWNER:Name(Fee Simple Titleholder):AO/Qpe9—o all—.Y/ ,k Phone#: "M57 757-?7-W Address: 90? '414F 97,5Ae_e"A City: 5120 l r State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: "7- .&C Phone#/04!OUd-J Address: City: //Q/!,Y State: Zip:CJc1�2.� Qualifier Name:aed!'A i ce,/, Phone#(012*"00 _ State Certification or Registration#: / //a/ Certificate of Competency#: Contact Phone#: Email Address: /zgoo2r + &elf DESIGNER:Architect/Engineer: Phone#: Value of Work for this Permit:$ L�� -00 Square/Linear Footage of Work: Type of Work: ❑Address 11�Alteration ❑New ❑Repair/Replace ❑Demolition Description of Work: E !!�>✓ �M ��.f i'�t1� Submittal Fee$�Q Permit Fee$ CCF$ CO/CC$ Scanning Fee$ Radon Fee$ DBPR$ Bond$ Notary$ Training/Education Fee$ Technology Fee$ Double Fee$ Structural Review$ TOTAL FEE NOW DUE$ 1W 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 einspectwn fee will be c rged. B a � Signatur Signature Owner or atV Contractor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this 0 day of 11- ,20[3,by l lAht LlampgL day of ,20 17-;by do121 a mC/� who is personally known tome or who has produced,_ who is personally known to me or who has produced L 20 to 16M I�As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: �y ,�2 y L°�rr� &.. Print: 61. _ Print: .EDWARDS M Commission Ex pi P..611r."'' EXPIRES:June 7,2015 M Commission Expires: NOTARY PUBLIC Y P t Tft N0Wy Pa*uMl re y P STATE OF FLORIDA 19117 a �"EES76249 2119017 APPROVED BY 7 // 10-IP12- Plans Examiner Zoning Structural Review Clerk (Revised 3/12/2012)(Revised 07/10(07)(Revised 06110/2009)(Revised 3/15109) R � MM Job# Notice to Building Official of Account# Use of Private Provider Project Name: Parcel Tax ID: f f -3�4 6 O f 4 3 1`70 Services to be.provided: Plans Review Inspections X Note: If the notice applies to either private plans review or private inspection services the Building Official may require, at his or her discretion, the private provider be used for both services pursuant to Section 553.791(2) Florida Statute. I, ,the fee owner, affirm I have entered into a contract with the Private Provider indicated below to conduct the services indicated above. Private Provider Firm: MTCI Private Provider Services Private Provider: Lester Triana Address: 97 N.E. 15th Street, Homestead, Florida 33030 Telephone: (305) 246-0696 Fax: (305) 242-3716 Email Address (Optional): mtc @mtcinspectors.com Florida License, Registration, or Certificate#: PE65707 I have elected to use one or more private providers to provide building code plans review and/or inspection services on the building that is the subject of the enclosed permit application, as authorized by s. 553.791, Florida Statutes. I understand that the local building official may not review the plans submitted or perform the required building inspections to determine compliance with the applicable codes,except to the extent specified in said law. Instead, plans review and/or required building inspections will be performed by licensed or certified personnel identified in the application. The law requires minimum insurance requirements for such personnel,but I understand that I may require more insurance to protect my interests. By executing this form,I acknowledge that I have made inquiry regarding the competence of the licensed or certified personnel and the level of their insurance and am satisfied that my interests are adequately protected. I agree to indemnify,defend,and hold harmless the local government,the local building official, and their building code enforcement personnel from any and all claims arising from my use of these licensed or certified personnel to perform building code inspection services with respect to the building that Is the subject of the enclosed permit application. I understand the Building Official retains authority to review plans, make required inspections,and enforce the applicable codes within his or her charge pursuant to the standards established by s. 553.791, Florida Statutes. If I make any changes to the listed private providers or the services to be provided by those private providers,I shall,within 1 business day after any change,update this notice to reflect such changes. The building plans review and/or inspection services provided by the private provider is limited to building code compliance and does not include review for fire code,land use,environmental or other codes. ioi2 r r 4 I. Qualification statements and/or resumes of the private provider and all duly authorized representatives. 2. Proof of insurance for professional and comprehensive liability in the amount of$1 million per occurrence relating to all services performed as a private provider, including tail coverage for a minimum of 5 years subsequent to the performance of building code inspection services. Individual Corporation /� -71 LG Partnership Print Copp tion Name Print Partnership Name AIMMUNIAM By:KNISIMMEW(s re) (signature) (signature) Print \ Print ADT LLC Print Name: L to J6_ Name: 10785 MARKS-WAY Name: Address: to Its: a MRAN MAIM ci Qnno Its: A4 t rL SM&A ? Address: ' Address: Telephone s No.: Tel ne � Telephone No. Jv No.: Please use appropriate notary block. STATE OF EL COUNTY OF IPME Individual . r Corporation Partnership Before me,this W day of Before me,this / day of Before me,this day 203 personally 2V j, of ,20_,personally appeared nft&JL onally appeared • appeared f who executed the foregoing instrument, of partner/agent on behalf of and acknowledged before me that same ,a , was executed for the purposes therein corporation,on a partnership,who executed the expressed. behalf of the state corporation,who foregoing instrument and acknowledged executed the foregoing instrument and before me that same was executed for acknowledged before me that same was the purposes therein expressed. executed for the purposes therein expressed. I p t Personally known ;or Produced identification_Z Type of identification produced L X)1� c 6 g J S Q'7]'a C%ML IE ug Signature of Note Print Name Notary Public:NOTARY SIAM EkY ONION#EE 100904 My commission expires: E 7,201 s 2 of 2 Miami-Dade My Home Page 1 of 2 My Home MIAMI-CDADE "awwamQ, • Show Me: Property Information 3' Legend Search By: " Property p y Fs_e1_ec_t1t_em­j- NEWT, g 1 H Boundary Selected Property Text only M �:: " Street Property Appraiser Tax Estimator � � M:*i Property Appraiser Tax __ Highway Comparison 11S7t#° Miami-Dade f,� County Portability S.O.H.Calculator Water Summary Details: N Folio No.: 11-3206-014-3170 Property: 48 NE 97 ST ti W E Mailing DIANE LIJFROCK TRS ti£tTNt. Address: IRGIL LIJFROCK TRS S 48 NE 97 ST MIAMI FL 33138- . Property Information: Primary Zone: 1100 SGL FAMILY- tdE H 2301-2500 SO 0001 RESIDENTIAL- CLUC: SINGLE FAMILY A, Beds/Baths: 413 Floors: Living Units: 11 di Sq Footage: 3,213 Aerial Photography-2012 0 112 ft Lot Size: 9 160,1;Q FT ear Buift: 1974 MIAMI SHORES SEC 3 PB 10-37 LOT 5 BLK 77 Legal LOT SIZE 9160 SO FT My Home I Property Information I Property Taxes Description: OR 20515-4795 06 2002 I My Neighborhood I Property Appraiser 1 OR 27814-0514 0711 11 Home I Using Our Site I Phone Directory I Privacy I Disclaimer Assessment Information: Year: 2012 1 2011 Land Value: $109,645 $104,424 Building Value: $273,807 $275,444 If you experience technical difficulties with the Property Information application, Market Value: $383,452 $379,868 or wish to send us your comments,questions or suggestions Assessed Value: $383,452 $377,45 2 please email us at Webmaster. Exemption Information: ear: 1 2012 �$275§000 Web Site Homestead: $25,000 ©2002 Miami-Dade County. 2nd Homestead: YES All rights reserved. Taxable Value Information: Year: 2012 2011 Applied Applied Taxing Authority: Exemption/ Exemption/ Taxable Taxable Value: Value: Regional: $50,000/ $50,000/ $333,452 $327,452 County: $50,000/ $50,000/ $333,452 $327,452 City: $50,0001 $50,000/ $333,452 $327,452 School Board: $25,000/ $25,000/ $358,452 $352,452 Sale Information: Sale Date: 7/2011 Sale Amount: $100 http://gisims2.miamidade.gov/myhome/propmap.asp 4/9/2013 w 1 RESIDO11TIAL SERVICES CONTRACT '5401 Ur=03 77QO � caNTRA NT �` O LEAD DATE Nm URC E Section 1. Customer • ADT LLC Customer Name dba ADT Security Services(-ADT-) (°Customer'or'I'or°me'or°my°) f A (Office tsAddress //��� k,ellimiq l l k 3 3:oys Preml- ((3.� State© 7J I j i p' t Exempt No. �'�s" Tax Expire Date WWW.MyADT.com 800.AD7 ASAP® Protected Premises' GbTradhlonal Phone O Other(QwliflcO Other(Non-Qed) Tele bone � t (800.238.272 7) p � tP Alternate ® D O Home Ca tell O Work Attemate-� ' O Home GI" O Work Telephone 1 Telephone 2 ° 016.1 O Fill in if billing address Is the same Billing �. ` Address City State m ZIP LLLLiJ IF FAN IZATION PERIOD IS REJECTED INITIAL HERE Paragraph 14 of the Te and Conditions Of explanation) EMAIL Communica-ftns Authorization:I authorize ADT to provide me with informaatt[Io�n,and upd'ateslbout the security system and new ADT and third-party products and'services to the contact information provided by me.I may umu6scrYbe or opt ou)!by emailing donotcontactUadtcom or by calling 888.DNC4ADT(888362.4238).Initial here If I have provided ADT with a phone number,including but not limited to a cell phone number or a number that I later convert to a cell phone number,I agree that ADT may contact me at this number.I also agree to receive calls and messages such as pre-recorded messages,calls and messages from automated dialing systems at the number(s)provided. EQUIPMENT TO REMAIN THE PROPERTY OF ADT.All equipment installed by ADT pursuant to this Contract shall be owned by AiA'T unless ADT has agreed to give me ownership of the equipment in a separate written agreement ADT has the right upon termination of this Coritract to r6r6ove 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 Terms 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,ondeistahti'in* agree to each and every tern i of this COpFract indudingbut rrot limited to:Paragraphs 5 and 18 of the Terms and Conditions."8 ThonWal term of this Contract is three(3)yearsS(C)ADT is of a secu►Ity corsultarrt and`cannotaddresslall'of in cl! ntlal security needs.ADT has eXplained to me the full P- range of equipment and services that ADT can provide mg Addaitiona equiprn eM nde ces over those Identified in this Contract are available and may be purchased from ADT at all Wdltional cost to m&I a'vla'sele�and pry a I'the equipment and services identified in this Contract(D) No alarm system can provide complete protect)on or reverTtion of loss'or injury.Fires,floods,burglaries,robberies;. Ica]problems and other inddents are unpred$ta�ile.BrNl'taTlnot always tied or p rrted.by an alarm system Human error is always le,and the response time of police,fire and medical emergency personnel b ide the control of ADT.ADT may not receive alarm signals H communications or power is Interrupted for arty reason.(q ADT recommends that I m nosily test the alarm system monthly and any time i change telephone service,by calling BW ADTASAP or by 1 gang Iri.to www MyyADT.com;# t�r Is req uires final of" by an ADT authorized manager before ADT may provide any equipment or se ce5,�afid'N ap�rovitllWillahled,thelt�ntract will be to ninafed,and ADrs only Aligatlon will be to notify me of such termination.and refu arty amounts 1 pa at,dvanTL _e ADT Representative Rep.License No. Rep. (If Required) ID N. C Nbr'g- 'Otlg&s81 TI #td(t(lustl . CustomerNai�in9 r1'above) ,. NOTICE OF C,�NfE4EkaION THE CUSTOMER,MAY CANCEL`THIS TRANSACTION AT A11111(Y TiME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY NFTER THE DATE OF THIS TRANSACTION.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION 3F THIS RIGHT.I ACKNOWLEDGE BEING VERBALLY INFORMED OF MY RIGHT TO CANCEL AT THE TIME OF EXECUTION 3F THIS CONTRACT AND RECEIPT OF THIS NOTICE. Section • be Provided FINANCIAL DISCLOSURE STATEMENT THERE IS NO FINANCE CHARGE OR COST OF CREDIT(0%APR)ASSOCIATED WITH THIS CONTRA.CT. A.NUMBER OF $ a 0 6 J PAYMENTS FOR THE B.AMOUNT OF EACH PAYMENT IS � 5 TOTAL OF PAYMENTS FOR THE INITIAL TERM IS U INITIAL TERM IS 36. (TOTAL MONTHLY SERVICE CHARGE FROM BELOW) (A.TIMES B.)(EXCLUSIVE OF ANY APPLICABLE TAXES,FEES,FINES AND RATE INCREASES) LATE CHARGE•'-PA I$T IS D E VURSUANT TO MY SELECTED BILLING PREPAYMENT-IF I PREPAY THE SEE PARAGRAPHS 2,7,15 AND FREQUENCY,PRIOR TO THE START OF SERVICE.MY FIRST BILUCHARGE WILL BE SENTIMADE SHORTLY AFTER MY SERVICE BE{aINS.ADT MAY IMPOSE A TOTAL OF PAYMENTS PRIOR TO 19 OF THIS CONTRACT FOR ONE-TIME LATE CHARGE ON EACH PAYMENT THAT'it MORE'THAN TEN(10) .s,.J THE E4O OF THEiNmAL TERM ADDITIONAL INFORMATION DAYS PAST DUE,UP TO THE MAXIMUM AMOUNT PERMITTED BY LAW,BUT IN OF THIS CONTRACT,THERE IS NO ABOUT NONPAYMENT,DEFAULT NO EVENT WILL THIS AMOUNT EXCEED$5.00. PENALTY OR REFUND. AND ACCELERATION. Of 6 02012 ADT LLC dba ADT Security Services. Administrative Copy All rights reserved.(10/12) RES16Ek�SERVICES CONTRAST NOUN 5401UE03 LEAD CONTRACT ' J o. uRCD U o14I.L iSection 2. Services to be Provided (continued) Montt Service Charge 4 1 Annual Reaming Municipal Fee billed separately InWal/Annual Fee I t T'. (Sa�Ject to change based on local lam 0 Standard.Monthly Service,Burglary - Service Includes:Customer Monitoring Caner Signal ' . OCustomer to obtain and pay for in tiallannual murridpa Receiving oral Notification Service for Burglary, _ alarm use p$mtlt Failure taabt;hhar provide AD l Manual Fire and Manual Police Emergenq _ 1=Ahe municipal alarm use permit registration r urnb it •nsult in no municipal firelpolke response to an alarb. . . / l from#wprernWes door a fine. ®Standard M"ft So ft FirefSmuite Detection Servicee haludes.Custo Mr0Wcbe ng Center Signal ,/ Munkipal Electrical Permft,Fee Rr3ceWing.arril NotHicat3dn orrice far Fire Manual Flre I K E L O fnsbohrer to obtain electrical pehnit and Manual Police Emergency O.Carbon Monoxide O Flood O Low Temp $ Installation Price O Medical Alert 6 Amount 4 (f)Safewatch Cellguard* �r° Non-Taxable Amount O SecurityUnk° _ Connection Fee 0 Extended Limited WanantylQuality Save Plan(QSP) $ 1 Al C Z Admin Fee O Guard Response Service $ Sales Tax on Installation* $ TO 8E Bit t6 6 O Monthly Recurrip uniapal-Fee (Subject to cEh ii=on local law) ¢ O Customer to obta)n and pay for p Total Installation Charge* municipal alarm use permit O Other . +v ._ °< et`R eti Total Monthly Servke Charge C 99 Balance Due upon Installation* .� *if applicable sales tax not shown,it will be added to the first invoice,if not collected at the time of installation. Section • • to be e• Contro Panel C Oe � OetajOOC��5 ( pO�v PO�C�`e�PO PV Comments Package Nape: u�Se l+ Includes: 121W 4 ` Foyer Living Room - p TFI-0 ZI Family Room office /D ining Room. M kitchen d Cc I zlf:& LA)ndry�Room *. Bedroom 2 Bedroom 3 l ` Bath 2 -— Basement I I Garage Price Per Piece i Totals j E�=}Existing�E�quiipment Estimated Installation Start bate L � L1J_°T/ NOTES ,"770-,J-4`tN 66c,+./4L hC9mki&k sr__Pown --- Of.6 02012 A&uC All rights reserved.(10/12)