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EL-11-1308Miami Shores Village Building Department MA,« x 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 No. PERMIT APPLICATION Master Permit No. k7/ -7 FBC 201C) Permit Type: Electrical OWNER: Name (Fee Simple r City: State Zip: Tenant/Lessee Name: Phone#: Email: JOB ADDRESS: /a 7 9 A4r / -7 Ar— City: TCity: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Y�r/zf Phone#: Address: .f a'j - City: 4 9l —C.4y State pzl�Zip: Qualifier Name: z CO Phone#: �.�s/,'✓'rs 7J' State Certification or Registration #: e Certificate of Competency #: Contact Phone#: 03 0'��-.rte%J-0 Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration / ❑New ❑Repair/Replace u Description of Work: 92i.6ti % l- ZY42e Submittal Fee $ Permit Fee $ l 00 .cam CCF $ CO/CC $ Scanning Fee $ CD Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ ❑Demolition V Miami Shores Village Building Department AUG 212014 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 No. �-�- ' ` — 30 PERMIT APPLICATION Master Permit No. FBC 20 Permit Type. Electrical OWNER: Name (Fee Simple Titleholder): d / D rt Phone#: Address: .2 City: T ' State: Tenant/Lessee Name: Phone#: Email: JOB ADDRESS:/ 2-'-] q /Q E q 7 f—,T (( . :?":C r- l/ S -— City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: J2 �� 0 0 q 04 (� Q Is the Building (Historically Designated: Yes CONTRACTOR: Company Name: �7 � Address: D $� Oy City: f ' State: Qualifier Name &oenr 4f!:A/? NO Flood Zone: State Certification or Registration #/-1 Contact Phone#: �66'�3 f37 Email Address: Phone#: Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Address Description of Work: ❑New ❑Repair/Replace Submittal Fee $ Permit Fee $ / e ,104> CCF $ CO/CC $ Scanning Fee $ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ DBPR $ Bond $ Technology Fee $ TOTAL FEE NOW DUE $ ❑Demolition Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 CONDMONERS, 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 beWroved and a reinspection fee will be charged - -----7 0 Owner or Agent The for instrument was acknowledged before me this dL day of 0N, by , who is personally known to me or who has produced As identification and who did take an oath. NOTARY PUBLIC: Sign: My Co> s. ,r _ T , PGa�� Notary Public Stae of Florida t Joanna M Feliciano T, a< My Commission FF 082753 9✓e__ o� _..I" ..I s 01112120 111 212 01 8 APPROVED BY The foregoing Instrument was Y'knowledged before me this 2— O day o , 20 0 , by C 4 0e- (V PDLr I'�� who is personally known to me or who has produced l Plans Examiner (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) as identification and who did take an oath. NOTARY PUBLIC: Sign: WISSE IE O1, I Rte = MY COMMON n 1 c 14'4M EXPIRES: Nomnber 17, ?,15 Bonded Thru Notary Public Unda w;.tars i Zoning Structural Review Clerk Invoice Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL 33138-0000 Phone: (305)795-2204 Fax: (305)756-8972 For Inspections please call: (305)762-4949 eturn o ria Shores Village Invoice Number: EL -8-14-52705 N.E. 2nd Avenue Invoice Date: August 21, 2014 Shores, FL 33138-0000 Permit Number: EL -7-11-1308 Bond Number: Bill To Comments. JORGE & MAGALYS TOLEDO 1279 NE 97 Street MIAMI SHORES, FL 33138-2559 Date Fee Name Fee Type Fee Amount 08/21/2014 Scanning Fee Calculated $3.00 08/21/2014 Expired Permit Renewal Fee Calculated $100.00 Total Fees Due: $103.00 Payments Date Pay Type Check Number Amount Paid Change 08/21/2014 Check 063249 $103.00 $0.00 Total Paid: $103.00 Total Due: $0.00 Thursday, August 21, 2014 Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State zip 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 roust 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: Signature Contractor The foregoing instrument was acknowled ed before me this day of (-3 , 20 40,, by (� who is personally known to me or who has produced identification and who did take an oath. NOTARY PUBLIC: Sign: Sign: Print: Print: My Commission Expires: APPROVED BY Plans Examiner Structural Review (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15/09) `" h^AR!A D. PEREZ My Com ' �' des: . E Notary Public Sate of Florida :'' _ ° •? My Comm. Expire;; May 7, 2016 Commission # EE 196354 Zoning Clerk r . 4 Miami Shores Village \P Building Department 10050 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795.2204 Fax: (305) 756.8972s, U INSPECTION'S PHONE NUMBER: (305) 762.4949 BUILDING Permit No. 2 L i -11- 13 PERMIT APPLICATION Master Permit No. FBC 20 Permit Type: Electrical 1-1 OWNER: Name (Fee Simple Titleholder):�� Address: Q-11 )ME Q9 e_-7:> City: State: Tenant/Lessee Name: Email: JOB ADDRESS: 1 Z -)"1 'V F_ ci —) 5-u- City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: Phone#: Address: City: State ADT LLC Zip: Qualifier Name: MIRAMAR EI 33025 Phone#: State Certification or Registration #: E- Cbm l l Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑Address ❑Alteration ❑New ❑Repair/Replace ODemolition Submittal Fee $ Permit Fee $ /0 CCF $. CO/CC $ Scanning Fee $ �-L' ' e Radon Fee $ DBPR $ Bond Notary $ Training/Education Fee $ Double Fee $ Structural Review $ Technology Fee $ TOTAL FEE NOW DUE $ Bonding Com6any'§ Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip 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 CONDMONERS, ETC..... OWNER'S AFF1mAVIT: 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 EMIPROVEMENTS 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 $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature Signature Owner or Agent C tractor jb The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this6" day of, 20 _, by day of x';420 who is personally known to me or who has produced who is personally known to me or who has pro uced As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: Sign: Print: Print: S My Commission Expires: My Commissioff ; LUISSErMCASMY COMMISSION # EE 147407 EXPIRES, November 17 2015 Bonded Thru Notary Pub9c Undaw t , �k�kok�k�k�ksk�k�k��k�IeskskBegeXe�Ie�Iegc�k�k :k �F�k�k�k�$sek�k�k��k8:�k��k�I:��Is��ksk��k��k�k�k�k�k�k�k��k�k�k�k�k��k��k��k�k APPROVED BYT Plans Examiner Structural Review (Revised 07/10107)(Revised 06/1012009)(Revised 3/15/09) Zoning Clerk ilo4}?/31��1a 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 20 Permit Type: Electrical Permit No. _j I l� Master Permit No. OWNER: Name (Fee Simple Titleholder): -T0Qe, D lea D Phone#: 3ys q9 j - 65 Address. A I I R7 q N6 75f. City: a'ra State: Zip: X3/3`8 Tonant/Lessee Name: Phone#: Email: JOB ADDRESS: /a.71? A1E 177 Ji. City: Miami Shores County: Miami Dade Zip: 33/x? Folio/Parcel# /1-3200 - 00q' — eq q i) Is the Building Historically Designated: Yes NO Flood Zone: CONTRACTOR: Company Name: AV- SZallri±?.fi d%tes Phone#: 95Y AgIP-5057 Address: `07 5 44a, -Its Gt)tta/ City: Mira -en -a.— -State: F -l- . Zip: "050IXS Qualifier Name: 9s y -a -WP ,50,57 State Certification or Registration #: [; rD D D / /a- l Certificate of Competency #: Contact Phone#: �iYa c e66- Email Address: Ct�?'i e� ia-& CL & "t , e& -x, DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: $ qj5-, _ Square/Linear Footage of Work: Type of Work:- DAddress GIAlteration ONew ORepair/Replace ODemolition Description of Work: I nS 1)Cd)Q Q 1>Fbtu-.-9lo-r �4ir�1�, ,t.1� 7i2 �t G/CtJIGeS Submittal Fee $ Permit Fee $, CCF $ CO/CC $ Scanning Fee $ Radon Fee $ DBPR $ Bond $ Notary $ TraininglEducation Fee $ Technology Fee $ Double Fee $ Structural Review $ TOTAL FEE NOW DUE $ � a Bonding Company's Name (if applicable) 0 Bonding Company's Address City State Mortgage Lender's Name (if applicable) i MoYtgage,Lender'S Address: City State Zip 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 WORD, 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. "WARNI +�N �G TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF GOA/ MNCEME ��-MAV UTA SULT TA�rnw%./ A_�7T�►T!� TLfTt!IT T- A71 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 whi o urs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be apoved and a reinspection fee will be charged. Owner or Agent The fore o' g instrument was acknowledged before me this i.3 day of v1 20 J-, by Toga ToLEo% , who is personally known to me or who has produced_ Tg3o-S's3'yoS�riAs identification and who did take an oath. Signature actor The foregoing' ent was acknowledged before me this Ie! day of 20 � G' � "' Oby -AQ who is personally known to me or who has produced as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: ".. �� Sign: OA&AZI-o Print:Print: Aracelis TrWdad My Commission Expires: Dl1RAN My Commission Ex a°00 pu NO��' i'uWio State of Florida MYCOMMISSION @ EE 090257 Aracelis Trinidad y� 3 2 o%J � EXPIRES: May 3, 2015 � . >. poq My commission D0945822 ' Bonded Treu Nalmy Pubs Undewitem OF 11� Expires 12/14/2013 N��kk�W�B#��kkd��R+k APPROVED BY A -/Z:--1 , Plans Examiner Zoning Structural Review Clerk (Revised 07/10/07)(Revised 06/10/2009)(Revised 3/15109) I Miami-Dade My Home Illy Home 0 Text only 13'Property Appraiser Tax Estimator 13 Property Appraiser Tax Comparison Portability S.O.H. Calculator Summary Details: Prooertv Information: Primary Zone: 11-3205-009-0440 $98,636 1279 NE 97 ST CLUC: JORGE LUIS TOLEDO r MAGALYS A VITIELLO Beds/Baths: TOLEDO Floors: 1279 NE 87 ST MIAMI FL Living Units: 33138- Prooertv Information: Primary Zone: 1400 SINGLE FAMILY $98,636 RESIDENCE CLUC: 0001 RESIDENTIAL - $203,899 SINGLE FAMILY Beds/Baths: 3/2 Floors: 1 Living Units: 1 d' Sg Foota e: 2,465 Lot Size: 8,175 SQ FT Year Built: 1952 5 53 42 EARLETON SHORES PB 43-80 LOT Legal 19 BILK 3 LOT SIZE Description: 75.000 X 109 OR 14571- 3336 0690 1 OR 27451- 0837 0510 02 Assessment Information: Year: 2010 2009 Land Value: $98,636 $144,21 Building Value: $190,584 $203,899 Market Value: $289,220 $348,112 Assessed Value: $206,272 $200,850 Exemption Information: ear: 1 2010 1 2009 Homestead: $25,000 $25,000 nd Homestead: I YES I YES < Taxable Value Information: ear: 2010 2009 Applied Applied axin Authorit : Exemption/ Exemption/ 9 Y r..., -W r --- 1,i. Page 1 of 2 Aerial Photography - 2009 0 111 ft My Home I Property Information I Property Taxes I My Neighborhood I Property Appraiser Home I Using Our Site I Phone Directory I Privacy I 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. http://gisims2.miamidade.gov/myhome/propmap.asp Web Site © 2002 Miami -Dade County. All rights reserved. 0 7/18/2011 RESIDENTIAL SERVICES CONTRACT iuu�m10aE12ii�flW ; CONTRACT DATE� tilLEAD L' 1" � ACCOUNTO JNO m SOURCE Off' .. : u�i©OCi�i D��L�iR��iG7��:©i©iiiiiiiiiiiiiiiiiii "19©9a Protected Premises' Telephone imiiiiiiiiiiiiii . _ ... iiiiiiiiiiiii�' Tax Expire Date EHA�E O Traditional Phone O Other (Qualified) 4b Other (Non -Qualified) C- fiM(,, u? www.MyADT.com 1.800.ADT.ASAP® Alternate (1.800.238.2727) Telephone 1 11 1 1 1 1 O Home O Cell O Work IF FAMILIARIZATION PERIOD IS Alternate111111111117 REJECTED INITIAL HERE Telephone 2 O Home O Cell O Work (see Paragraph 14 of the Terms and Conditions for explanation) EMAIL 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/confirm 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 1 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 INCIDENTS 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 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 IS 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 Representative Name Rep. License No. (If Required) Required (Must match Customer Name in Section 1 above) Rep. ID No. 4XIA 111511511 NOTICE OF CANCELLATION I, E CUSTOMER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY ER THE DATE OF THIS TRANSACTION. SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION THIS RIGHT. I ACKNOWLEDGE BEING VERBALLY INFORMED OF MY RIGHT. TO CANCEL AT THE TIME OF EXECUTION F THIS CONTRACT AND RECEIPT OF THIS NOTICE. FINANCIAL DISCLOSURE STATEMENT THERE IS NO FINANCE CHARGE OR COST OF CREDIT (0% APR) ASSOCIATED WITH THIS CONTRACT. A. NUMBER OF t Wr PAYMENTS FOR THE B. AMOUNT OF EACH PAYMENT IS - � TOTAL OF PAYMENTS FOR THE INITIAL TERM E � ` ES, INITIAL TERM IS 36. (TOTAL MONTHLY SERVICE CHARGE FROM BELOW) A TIMES B.) (EXCLUSIVE OF ANY APPLICABLE TAXE ,FEES, FINES AND RATE INCREASES) LATE CHARGE - PAYMENT IS DUE PURSUANT TO MY SELECTED BILLING PREPAYMENT - IF I PREPAY THE SEE SECTIONS 2, 7, 15 AND FREQUENCY, PRIOR TO THE START OF SERVICE. MY FIRST BILUCHARGE WILL TOTAL OF PAYMENTS PRIOR TO 19 OF THIS CONTRACT FOR BE SENT/MADE SHORTLY AFTER MY SERVICE BEGINS. ADT MAY IMPOSE A THE END OF THE INITIAL TERM ADDITIONAL INFORMATION ONE-TIME LATE CHARGE ON EACH PAYMENT THAT IS MORE THAN TEN (10) OF THIS CONTRACT, THERE IS NO ABOUT NONPAYMENT, DEFAULT DAYS PAST DUE, UP TO THE MAXIMUM AMOUNT PERMITTED BY LAW, BUT IN PENALTY OR REFUND. AND ACCELERATION. NO EVENT WILL THIS AMOUNT EXCEED $5.00. 1 of 6 Office Copy ©2011 ADT. All rights reserved. (04/11) RESIDENTIAL SERVICES CONTRACT iwmu104AE12�n� CONTRACT LEAD DA E Itil i`� /El� AC OUNT NO ` 6 ` CUSTOMER ,NO OB m SOU CE Section 2. Servir�es to be Provided (continued) Monthly Service Charge O Initial/Annual Recurring Municipal Fee billed separately Initial/Annual Fee (Subject to change based on local law)N GL Standard Monthly Service, Burglary Service includes: Customer Monitoring Center Signal O Customer to obtain and pay for initial/annual municipal Receiving and Notification Service for Burglary,alarm Manual Fire and Manual Police Emergency �NG 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. O Standard Monthly Service, Rre/Smoke Detection Service includes: Customer Monitoring Center Signal $ Municipal Electrical Permit Fee J/ $ Receiving and Notification Service for Fire, Manual Fire O Customer to obtain electrical permit and Manual Police Emergency O Carbon Monoxide O Flood O Low Temp $ Installation Price $ S 3 O Medical Alert $ Taxable Amount •SafewatchCellguard® $Z�%G Non -Taxable Amount $ 140 O SecurityLink® $ Connection Fee _ $ -9- 0 Extended Limited Warranty/Quality Service Plan (QSP) $ Admin Fee $ "®— O Guard Response Service $ Sales Tax on Installation* O Deposit Received $ I I O Other $ Total Monthly Service Charge x Balance Due upon Installation*is 5 38-50 *If applicable sales tax not shown, it will be added to the first invoice. Section• • to be installed , Control i' a Z ti�°� o�``°�' 4,ae° '' `e f ¢�°0 5� tit 's� .s �¢ , Panel J`Qa oK" � Comments Package Name: Z i Includes: Foyer I Living Room 2 - Family Family Room { Office Dining Room j Kitchen Laundry Room Hallway f Master Bedroom I i Master Bath Bedroom 2 f Bedroom 3 Bath 2 Basement Garage { Totals I;Taiisfae �tlirrr a f�Y Estimated Installation Start Date INSTALLER NOTES (��i% f�/.�//� /l e3-1 1 A10 O gni _ 2 Of 6 02011 ADT. All rights reserved. (04111) y � f tyctm l Fire & / I Security AU l ,eCUntY JerviCek IRC. p, Permit Information Sales Rep: lA 6 J)U'1� � Date: Install Date: Security Screens: Job#: Customer Name:TO 1906 C _ Tell: 30S' (`'10S� Address: f 27 -9 jo'�' Sirens/Sounders: Suite#• , Tel is City: M (w 1M i 2� 0p C5 ZIP.: Municipality: Alt Contact: Hood Connections: Tel: Lot#: Block#: Subdivision: Folio#: Master Permit#: Job Cost: $ System Type(s): Automation Burg OAccess Fire ❑CCTV oHome' Job Type: ❑Under Construction ❑Prewire Only ❑Prewire & Trim Rurolar Alarm nPviene Control Panels: Audio Glassbreaks: Pull Stations: Keypads: Security Screens: Door/Window Contacts: Smoke Detectors: Transmitters: Motion Detectors: z Other: Sirens/Sounders: Other: Watertiow Connections" Holdup Buttons: BURG DEVICE TOTAL: CCTV Devices Cameras: Monitors: VCR/DVRs: CCTV DEVICE TOTAL: A rr sea ■ 1lA AA -0c Card Readers: Maglocks/Door Strikes: Pull Stations: Shunt/RTE Motion Detectors: Other: ShuntJRTE Buttons: ACCESS DEVICE TOTAL: Transmitters: Wira Alarm nPi1;&"— Control Panel Model(s): Control Panels: Smoke Detectors: Horns: Pull Stations: Duct Detectors: Strobes: Transmitters: Heat Detedors: Horn/Strobes:; . Watertiow Connections" Fire Pump RUN Connections: Fire Pump FAIL Connections: PIV/Tamper Connections: Hood Connections: Other: Commercial Info Shopping Center: Property Owner: Com 6ts (continue on back if needed) Business Park: Building#: Owner's Address: