EL-11-299October 19, 2011
Security
Services
Miami Shores Village
Building Department
10050 N.E. 2 "a Avenue
Miami Shores, F133138
Re: Burglar Alarm # EL -2 -11 -299
10450 NE 5th Avenue
C# 69811094
To Whom It May Concern:
Please note that an installation was never performed and we are requesting a cancellation of the reference
permit. If you have any questions please contact Maria D. Perez at 954 - 266 -5275. She will provide any
information needed to close the referenced permit.
George Manginelli
EF0001121
ADT Security Services
ND
11111 1 i I, Miami Shores Village
Building Department
>0050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795.2204 Fax: (305) 756.8972
BUILDING
PERMIT APPLICATION
FBC 2004
Permit Type: Electrical (�
Owner's Name (Fee Simple Titleholder) e ���tJ�o 66,[c c& -06re3 Phone #
Owner's Address t 0 1.1e 0(
coil > -acr
-4-0A/t) (*V9-- SS/
Permit No. CAL. 1 1 — - l
Master Permit No.
tt FEB 232011
BY- ef±-4
City N.■((WV 5 Vi or? 3 State Zip 33 50
Tenant/Lessee Name SO /j A..) i<6 A.-4-0 S Phone #
E -MAIL:
Job Address (where the work is being done) /0 t/SO /U £ 5" Aka_
City Miami Shores Village County Miami -Dade
FOLIO / PARCEL # I (—P,31---015-090
Zip
Is Building Historically Designated YES NO
ADT EEL ITY SERVICES
Contractor's Comp
MARKS WAY
Contractor's AddresWOI
City State
Qualifier Name C.eisit.41.4 ivverw go N jpi it
State Certificate or Registration No. '''-(0 //Z /
E -MAIL:
Phone # 951— 2.44". " Sb / 7
Architect /Engineer's Name (if applicable)
Phone,
Certificate of Competency
Phone #
Value of Work For this Permit $ 1 RR. O 'v Square / Linear Footage Of Work:
Type of Work: DAddition
Describe Work: 1'w
['Alteration
e
Nue
❑ Repair /Replace
�.4ViC
❑ Demolition
*x Y.xxxxx x x x x xxxxxxxxxxxxxx*xxxxxxxxxxxx Fees
xxxxxxxxxxxx *xxxxxxxx
Submittal Fee Permit Fee $ /& f- , e,P t'' CCF $ CO /CC
Notary $ Training /Education Fee $ Technology Fee $
Scanning $ Radon $ DPBR $ Zoning $
Bond $ Code Enforcement $ Double Fee $
Structural Review. $ Total Fee Now Due $
See Reverse side —>
Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender ame (if applicable)
Mortgage Lender's Ad i ess
City
Zip
State
Zip
Application is hereby made to obta'n 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. 1 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 cops- of the notice of commencement and constr•uctionclien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded no of yrommencement must be posted at the job site
for the .first inspection which occ•zu•.s seven (7) days after the building permgls_ tied In the absence of such posted notice, the
inspection will not he approved and a reinspection.fee will be charged.
Signature
Owner or Agent
The foregoing instrument was acknowledged before me this
day of _ 20 ➢I , by eAt4Ardo
who is personally known to nee or who has produced
6 bad - rZtly- 69 OS5- d As identification and who did'' can oath.
NOTARY PUBLIC: NOTARY, _.'
Sign: 4.-•'"*"." 4.-•'"*"." „: J ;• 1.
�nr E7 i"d =Tii: I kIVIIC
Print:
My Commission Expires:
1,4i
ntract&- /J
he foregoin instrument was acknowledged before me th /%
day of ,2/” by
who is personally known to me or who has produced 6
as identification and who did take an oath.
NOTARY PUBLIC:
Sign: n
Print: %r A-Li4
'My Commission Expires:
xxxxxxxxxrF
APPLICATION APPROVED BY:
(Revised 02/08/06)
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Plans Examiner
Engineer
Zoning