Permit Application — Marco Rubio, Process # 77941 (2012)

NOTE: ALL SHEETS MUST BE REVIEWED West Miami MIAMI-DADE COUNTY BUILDING DEPARTMENT Herbert S. Saffir Permitting and Inspection Center 11805 SW 26th Street (Coral Way), Miami, Florida 33174-2474 (786) 315-2100 CUST # 89299956 C 2013022493 PERMIT APPLICATION CITY OF WEST MIAMI PROCESS # 77941 IF SUBSIDIARY PROVIDE MASTER PERMIT NUMBER HERE LOCATION OF IMPROVEMENTS Job Address 6060 SW 13TH DR Folio 15 4012 077 0040 Lot 4 Block Subdivision EL RETIRO SUBDIVISION Metes and bounds CONTRACTOR INFORMATION Contractor No. EF20001026 Last four (4) digits of Qualifier No. 5349 Contractor Name ADT, LLC Qualifier Name MARK RICCARDI Address 10785 MARKS WAY City MIRAMAR State FL Zip 33025 TYPE OF IMPROVEMENTS [ ] New Construction on Vacant Land [x] Alteration Interior [ ] Alteration Exterior [ ] Relocation of Structure [ ] Short Term Event [ ] New Roof [ ] Recovery (Roof) [ ] Permit by Affidavit [ ] Enclosure [ ] Repair [ ] Repair Due to Fire [ ] Demolish [ ] Shell Only [ ] Addition Attached [ ] Addition Detached [ ] Re-Roof [ ] Foundation Only 11/16/12 Current use of property Residential Description of Work Install Burglar Alarm Sq. Ft. Units Floors Value of Work 3884.00 PERMIT TYPE [ ] Building* Category [x] Electrical 02 [ ] Mechanical [ ] Plumbing [ ] LPGX CHANGE TO AN EXISTING PERMIT [ ] Chg. Contractor [ ] Re-Issue [ ] Extension [ ] Supplement [ ] Reinspection OWNER'S NAME Owner MARCO RUBIO Address 6060 SW 13 ST City WEST MIAMI State FL Zip 33144 Phone Last four (4) digits of Owner's Social Security No. PERSON TO PICK UP PLANS Name ADT LLC Address 10785 MARKS WAY MIRAMAR, FL 33025 City State Zip Phone ARCHITECT/ENGINEER Name Address City State Zip Phone BONDING Name Address City State Zip Phone MORTGAGE LENDER Name Address City State Zip Phone *See reverse side for Building Category Application is hereby made to obtain a permit to do work and installation as indicated. I certify that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits are required for ELECTRICAL, PLUMBING, GAS, REFRIGERATION, ELEVATORS, AND OTHER WORK and there may be additional permits required for other governmental entities. OWNER'S/PERMIT APPLICANT AFFIDAVIT: I certify that all of the foregoing information is accurate and that I have no unpaid civil penalties, administrative hearing cost investigative, enforcement, testing or monitoring costs or unpaid liens which are liens of Miami-Dade County. WARNING TO OWNER: IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR ATTORNEY OR LENDER BEFORE RECORDING YOUR MOTION. Signature of Owner or Owner's Agent PRINT NAME Marco Rubio STATE OF FLORIDA COUNTY OF MIAMI-DADE Sworn to and subscribed before me this day of 10/30/12, 20 by Signature of Qualifier PRINT NAME Mark Riccardi STATE OF FLORIDA COUNTY OF MIAMI-DADE Sworn to and subscribed before me this day of 10/30/12, 20 by Mark NOTARY PUBLIC STATE OF FLORIDA Kenneth Herzbrun My Commission EE147722 Expires 11/20/2015 CITY OF WEST MIAMI COMMISSION EXPIRES OCT 31 2013 FREE 100509 PUBLIC STATE OF FLORIDA

MIAMI-DADE COUNTY CITY OF WEST MIAMI DEPARTMENT OF PERMITTING, ENVIRONMENT AND REGULATORY AFFAIRS ELECTRICAL FEE SHEET PROCESS # 7794 *Attention applicant: you are responsible for filling out this application correctly. If you have any questions concerning what category your work falls under, please see an inspector or processor for your trade. Refunds will not be given in case of error on your part and you will be charged a double fee for doing work without a permit. Minimum fee for electrical permits is $130.00. Under penalties of perjury, I declare that to the best of my knowledge, the facts stated in this document are true. I understand that perjury is a felony of the third degree. Mark [Signature] Signature (L.S.) Category 01 General Electric G080 Residential wiring 0.10¢ per Sq. Ft. # of Sq. Ft. (Please note the fee will be calculated based on the square footage on the master permit) (Includes all residential items under Category 01 except common areas of Group H occupancy South Florida Building Code (SFBC) or Group R Florida Building Code (FBC) and service change all groups) G081 Residential wiring alteration or repair 0.058¢ per $1.00 in Value Est. Value including all residential items under category 01 except common areas of Group H occupancy (SFBC) or Group R (FBC) and service changes all groups G005 All other wiring/outlets (includes empty conduit system) $ 2.30 per Outlet # of Outlets G008 AC/refrigeration system elec. work $ 8.59 per Ton # of Tons G009 Fixture $ 2.30 per Fixture # of Fixtures G010 Plugmold Track Lighting $ 4.45 per 5 Feet # of Ln. Ft. G012 Generator/Transformer/Strip heater KW $ 10.03 per ea. 10 KW # of KW G025 Single station residential smoke detector—Carbon Monoxide Alarm (does not include outlet) $ 1.71 per Device # of Device G033 Electrical Feeders $ 17.18 per Feeder # of Feeders G034 Permanent Service to Buildings (Need master permit number) $ 6.45 per 100 Amps # of Amps G067 Repair or upgrade of existing service (If commercial and no building permit must be processed) $ 6.45 per 100 Amps # of Amps G082 Special outlets $ 10.03 per Outlet # of Outlets G041 Commercial equipment $ 10.03 per 10 KW # of KW G045 Electrical equipment (switchboard control board) $ 28.63 per Board # of Boards G083 Motors install repair or replace $ 12.89 each Motor # of Motors G076 Conduit ductbank $ 2.59 per Ln. ft. # of Ln. ft. G075 Time Clock $ 10.03 per Time Clock # of Time Clocks G077 Underground Manhole $143.11 per Manhole # of Manholes G073 Screen bonding ground $ 85.88 per Installation # of Installations G079 Safety check for reconnection $ 6.45 per 100 Amp # of Amps G115 Fixture retrofit $ 64.61 per jobs # of Jobs G122 Demolition $ 64.61 per structure # of Structures 123.01-5 12/11 PAGE 1

Fee Code Description Fee Calculations Units # of Units Fee Category 02 Burglar Security Systems Groups H and I of SFBC or Group R FBC G089 Installation Wiring $ 64.41 per System # of Jobs G090 Installation Devices $ 64.41 per System # of Jobs G105 Complete System $128.81 per System # of Systems G091 Repair to System $ 64.41 per System # of Systems All Other Groups G104 Installation Wiring $ 64.41 per System # of Jobs G103 Installation of Devices $ 64.41 per System # of Jobs G106 Complete System $128.81 per System # of Systems G107 Repair to System $ 64.41 per System # of Systems Category 04 Fire Alarm (needs processing) G087 New systems and upgrades $178.90 per system # of Systems G088 Repair and additions to existing system $ 85.88 per system # of Systems Category 06 Master T.V. Antenna G020 Master T.V. $ 28.63 Control # of Controls G120 Devices $ 1.71 per Device # of Devices G069 Repair to existing system $ 1.71 per Device # of Devices G113 Cable T.V. $ 64.61 per System # of Systems G114 Satellite Dishes $ 64.61 per System # of Systems Category 06 and 35 Combination Master T.V. Antenna/Telephone Communicators G121 Antenna & Communication $ 64.61 per System # of Systems Category 07 Sound & Intercom G092 New System (Single Family Residence or Duplex) $ 85.88 per System # of Systems G093 New System (Other Groups) $128.81 per System # of Systems G094 Repair System $ 85.88 per System # of Systems Category 08 Utility Electrical (needs processing) Note: for replacement of power supplies in County rightway easement G099 Electrical Service $128.81 per Service # of Services Category 14 Temporary Service for Construction (Must list master Bldg. permit #) (Must have separate application) G002 Temp for Construction $130.00 per Service # of Services G078 Temp service for asbestos removal $130.00 per Service # of Services Category 15 Temporary for Test (ELEVATORS) (Good for 180 days two affidavits required. One affidavit to be kept at job site, other delivered to inspector's office) (Must have separate application) G038 Temp for Test (elevator) $130.00 per Elevator # of Elevators Category 16 Specialty Wiring (includes circus, carnival, fair and Christmas tree lots) (Must be processed if no building permit.) G086 Per ride or structure $ 71.56 per Ride or # of Rides or with electrical wiring Structure Structures Category 18 Energy Service Management G095 Per Floor $150.28 per Floor # of Floors G096 Repair per Floor $ 85.88 per Floor # of Floors Category 21 Agricultural Services (Must be processed by Zoning prior to Electrical review) G035 Agricultural Service (permanent) $130.00 per Service # of Services Includes pump and related equipment Category 22 Trailer Service (Must be processed if no building category 86) G036 Trailer Service (construction) $171.74 per Service # of Services G037 Trailer Service (residential) $130.00 per Service # of Services G008 A/C System Electrical work $ 8.59 per ton # of Tons Category 23 Swimming Pools (Must be tied to building permit except for repairs of electrical only) G026 Pool or Spa (Residential) $ 85.88 per Pool or Spa # of Pools or Spas G027 Pool or Spa (Commercial) $200.36 per Pool or Spa # of Pools or Spas G056 Pool/Spa (Residential) $128.81 per Pool or Spa # of Pools or Spas G059 Pool/Spa (Commercial) $271.93 per Pool or Spa # of Pools or Spas G097 Repair Residential Pool $ 85.88 per Pool or Spa # of Pools PAGE 2