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EL-13-1242' a Miami Shores Village -I & 3 v L � Building Department JUN ® 5 200 10050 N.E.2nd Avenue,Miami Shores,Florida 33138 2°° Tel: (305)795.2204 Fax:(305)756.897 ®� ®®�' INSPECTION'S PHONE NUMBER: (305)762.4949 FBC 2® /C) BUILDING Pert No. PERMIT APPLICATION Master Permit No. Pert Type:Electrical JOB ADDRESS: 3Y 9 /al�/Z 73-2M 46 City: Miami Shores County: Miami Dade Zip: Folio/Parcel#: Is the Building Historically Designated:Yes/! /�N�O Flood Zone: �j OWNER:Name (Fee Simple Titleholder): &2e_1& (�✓i� 1&20 Phone#:��� 79 - 1 fz Address: 7L 7 Aew &/ 74 f f;_P M, City: .00he 4 State: Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR:Company Name: Phone#: Address: /0_77_5� City: 5&rV/jl/i6+� —State: Zip: QualifierName: aeaff-ge- �1l?a/1w.'c Phone#• — State Certification or Registration - ©��1/ Certificate of Competency#: Contact Phone#: r l ,l�, Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit:$ /(3W.400 Square/Linear Footage of Work: Type of Work: ❑Address ILteration ONew ❑Repair/Replace l]Demolition Description of Work: L!J',&o. : azf,, j aekl G�li f1/ Z40-42"l- Submittal 40-42 Q _ Submittal Fee$ 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$ B-onding 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 IWROVEMENTS 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$2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be approved and a reinspection fee will be charged. Signature � r7'1 ' Signature Owner or Agent ContrActor The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this day of , � by 6,`d34S L'h�sa r�c�� day of � 20 3�,by C9 61w.whoo is perso �Y20 known to me or who has produced / eS who is personally known to me or who has produced L" As identification and who did take an oath. as identification and who did take an oath. NOTARY PUBLIC: NOTARY PUBLIC: Sign: ` Sign: Print: 12r' Print: ��•�l�d � �t�,. My Commission ExpiELIZABETH M CAMPOS My Commission Expires: "= MY COMMISSION#FF021823 �f q pp PLOQ`OP �,��/� ATHALIE L.EDWARDS EXPIRES May 27,2017 � NOTARYPUELIC • s lAA�It�i.6f7/®/6�sp APPROVED BY Plans Examiner E�cn 46*MV17 Structural Review . Clerk (Revised 3/12/2012)(Revised 07/10/07)(Revised 06/12009)(tevised 3/15/09) Miami-Dade My Home Page 1 of 2 ,I My Home r- s; � j• MIAfVU-DAI3E • ► . . Q s. Show Me: Property lnfomtation ( Legend Search By Property oundsry X Select Item t# " * 4 kY g B Selected Property Text only rc i F Property Appraiser Tax Estimator flw9"t� Street Properly Appraiser Tax Highway Comparison 1 Miami-Dade CI g County Portability S.O.H.Calculator t H 1 #I$T Water Summary Details: e Folio No.: 11-2136 001 0480 ' "° 3K x Pro e 9 NW 111 TER T A I Y1 E Mailing CARLOS CHAMORRO Address: € � 9 NW 111 TER MIAMI b HORES FL 3168 ------------- ��tlWglyt{tyf � Property Information: 700 SGL FAMILY- -" Primary Zone: 1551-1700 SQ CLUC: 001 RESIDENTIAL- INGLE FAMILY 3x - Beds/Baths: /2 Floors: 1 Living Units: 1 Aerial Photography2012 0 110 ft Ad) Footage: 1,510 Lot Size: 7,500 SQ FT Year Built- 1954 NEW MIAMI SHORES Legal ESTS PB 51-80 LOT 30 My Home I Property Information I Property Taxes Description: BLK 2 LOT SIZE 75.000 1 My Neighborhood I Property Appraiser 100 CF 738155151 OR 27182-3303 0110 19 Home I Using Our Site I Phone Directory I Privacy I Disclaimer Assessment Information: E1dlnVal..-:,.E 2012 2011 $37,701 $37,701 $113,042 113,042 If you experience technical difficulties with the Property Information application, $150,743 150,7or wish to send us your comments,questions or suggestions $150 743 150 743 please email us at Webmaster. Exemption Information: ear: 1 2012 1 2011 Web Site [Homestead: $25,000 11$25,000 ©2002 Miami-Dade County. nd Homestead: YES 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/ $100,743 $100,743 County: $50,000/ $50,000/ $100,743 $100,743 City: $50,000/ $50,000/ $100,743 $100,743 chool Board: $25,000/ $25,000/ $125,743 $125,743 Sale Information: ale Date: 1/2010 Rale Amount: 0180,000 h :// 'sims2.miamidade. ov/m home/ ro ma .as 6/4/2013 � g Y ttP p P P P RESIDENTIAL SERVICES CONTRACT y IWI���lll�lllllll�lluulUllllll�� 5401 UE03 v , CONTRACT / /�� CUSTOMER ?-wB M LEAD DATE � W/ LiJ�'ACCOUNT NO P70I�I�I SOURCE Section • • ADT LLC i 1 Customer Name dba ADT Security Services("ADT")i(•Customer'or"I"or"nre'u,'my') ! OffirL&Address Premises' Address � �`/�� City c' StateF/1 zip LSI J=AI R vvvvw.MyADT.com Tax Exempt No. Tax Expiret Date ,000.ADT. Protected Premises' (800.238.2727)2727) Telephone O Traditional Phone O Other(Qualified) O Other(Non-Qualified) - _ Alternate O Home ®Cell O Work Alt mate 7 (Home ®Cell O Work Telephone 1 Telephone 2 10 Fill in if billing address is the same Billing Address . CRY State m ZIP IF FAMILIARIZATION PERIOD IS REJECTED INITIAL HERE (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 ernAing donotcontacteadtcom or by calling' $88:ONC4ADT(888.362.4238).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 nu mF e I also agree_to r eive calls and messages such as pre-recordgd messages,calls and messages from automated dialing systems at the ntslmber(s)pr ded. , ;: EQUIPMENT TO REMAIN THE PROPERTY OF ADT.All equipment Installed by ADT pursuant to this Contract shaft be owned by ADT unless ADT has agreed to give me ownership 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 win not be able to use the equipment for any purpose.See Paragraph 7 of the Terms and Conditions for more information. I aclulowledge and agree to each of the following:(A)This Contract consists of six(6)pages.Before signing this Contract,l have read,understand and agree to each and every term of this Contract,including but not nmited 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 peterntia)security needs.ADT has explained to one the fall range of equipment and services that ADT can provide me.Additional equipment and services over those identified k 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 Iry this Contract(D)j No alarm system can provide complete protection or guarantee prevention of loss or Injury.Fires,floods,burglaries,robberies,medical problems and otter 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 rmt receive alarm signals H 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,'IW calling 8W 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 H 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 aepresMI Rep.Ucense No. Rep. / J (if Required) ID No Custom71provaf:Orl Signature Required(Must matrh*,c=6n et Name in Section 1 abow) �r IJP IJW� r NOTICE OF 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.I ACKNOWLEDGE BEING VERBALLY INFORMED.OF MY RIGHT TO CANCEL AT THE TIME OF EXECUTION OF THIS CONTRACT AND RECEIPT OF THIS NOTICE. !!!�ction 2. Services to be Provided FINANCIAL DISCLOSURE STATEMENT THERE IS NO FINANCE CHARGE OR COST OF CREDIT(0%APR)ASSOCIATED WITH THIS CONTRACT. .�yL� A.NUMBER OF TOTAL OF PAYMENTS FOR THE INITIAL TERM IS $ .1 PAYMENTS FOR THE CB.r AMOUNT OF EACH PAYMENT IS F (A.TIMES B.)(EXCLUSIVE Ofd LI S,F FS„FINES INITIAL TERM IS 36. ' (TOTAL MONTHLY SERVICE CHARGE FROM BELOW) AND RATE INCREASES) Oro, , �j4�r3 X LATE CHARGE-PAYMENT IS DUE PURSUANT TO MY SELECTED BILLING PREPAYMENT—IF I PREPAY THE SEE PARAGRAPHS 2,-7,1S 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 Amoumr PERMITTED,%BYLAW,BUT IN PENALTY OR REFUND.„ r AND ACCELERATION. NO EVENT WILL THIS AMOUNT EXCEED SS.00. N®2012 ADT LLC dba ADT Settli ty Services e AdmirliLsbative Copy 1 All rights reserved.(10112: RESIDENTIAL SERVICES CONTRACT 1o7�R7ag� II0���1�111111101111111�1�10W0 5401UE03 ,,�� *� q CONTRACT TE �J CUSTOMER JOB LEADy/y_,►' I � DATE Lte!J1J/ V�J� rL-�J ACCOUNT NO NO SOURC�� Section 2. "Services to be Provided (continued) Monthly Service Charge O Initial/Annual Reaming Municipal Fee billed separately I InitlaVAnnual Fee (Subject to change based on local lavr) A Standard Monthly Service,Burglary -— -- Service includes:Customer Monitoring Center Signal O Customer to obtain and pay for initiaVannual munidpal Receiving and Notification Service for Burglary, alarm use pemniL Failure to obtain and provide ADT with Manual Fire and Manual Police Emergency the municipal alarm use permit registration number could result in no municipal firefpofice response to an alarm from the premises andfor a fine. bStandard_Monthly Service,_ - ---- -- FrelSmoke Detection Service includes:Customer Monitoring Center Signal Municipal Electrical Permit Fee _ Receivingand 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 O Medical Alert Taxable Amount � 3 9� CC7 _ _ _ _ ®Safewatch Celiguard® $ Non-Taxable Amount $ O O SecurityUnk® $ Connection Fee $ DU-C6 b Extended Limited Warranty/Quality Service Plan(QSP) $ Admin Fee $ ^ O Guard Response Service $ Sales Tax on Installation* $ 6. C:>Monthly Retuning Municipal Fee _ YII (Subject to change based on local law) Total Installation Charge* O Customer to obtain and pay for municipal alarm use permit 7 0 O other $ Deposit Received $ Total Monthly Service Charge Balance Due upon Installation* $ — Q — *If applicable sales tax not shown,it wdll be added to the firs4 invoice,if not collected at the time of installation. Section • • to be Installed Control °�� �5° e oo°� t�` �a o�g� �0 t° O QZ` v O oe C?�O S �` L� POJ Po49 PO Comments Package Name: ^ t Includes: / --; Foyer Living Roomf r /F CJ�i S Family Room29 Office c 10 Dining Room S / t'✓/ �'. �"{ ? / S/ F/? Kitchen LI �� Laundry Room° ctn� `J O t Hallway Master Bedroom �+ r U. L .�,G �" 'r'. '0' Master Bath ti, J 1 . e Bedre om 2 Bedroom 3 Bath 2 -i-)/ F Basement G •� /!� �� ('karage G .0 Price Per Piece Totals E=Existing Equipment Estimated Installatlon Start Dat NOTES. ' V i Q ®2012 ADT LLC dba ADT Security Service: 2 Of 6 All rights reserved.(10112