EL15-2248 Miami Shores Village
Building Department
SSP 2015
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305)795-2204 Fax: (305)756-8972
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 20 )o
BUILDING Master Permit No.kcf f�_
PERMIT APPLICATION Sub Permit No. 2-
❑BUILDING LECTRIC ❑ ROOFING ❑ REVISION ❑ EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS [:] CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS: Y5
City: Miami Shores County: Miami Dade Zip: 3
Folio/Parcel#: Is the Building Historically Designated:Yes NO
Occupancy Type: Load: r--Construction Type: / / Flood Zone: BFE: FFE:
OWNER: Name(Fee Simple Titleholder): ti l�jNr', f'� A� 1 ,JLV-r1 SL Phone#:2c)—s—.305--222
Address: 9 Sv;-S 7?!>k SGp•�1
City: SNC\ORQ- S State: L Zip:
Tenant/Lessee Name: Phone#:
Email: t d5t��.�i( /�Yv1 L�SS�C Q ►1�/ V/
CONTRACTOR:Company Name: G Phone#:
Address:
Stater Zip: LJL
Qualifier Name: 2. Phone#:e-947- 4&7
State Certification or Registration#: 3cOCA4 Certificate of Competency#:
DESIGNER:Architect/Engineer: Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ 300C Square/Linear Footage of Work:
Type of Work: ❑ Addition P Alteration ❑ New ❑ Repair/Replace ❑ Demolition
Description of Work:—'ay `MQ►
Specify color of color thru tile:
Submittal Fee$ (7 Permit Fee$ 0y CCF$ CO/CC$
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$
TOTAL FEE NOW DUE$
(Revised02/24/2014)
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 ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS,TANKS,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 reinspection fee will be charged.
Signature Z Signatur
ANER or AGENT CONTRACTOR
The foregoing instrument was acknowledged before me this The foregoing instrument was acknowledged before me this
y day of by ��day of 20 I
S-
20 by
L11 tON ( j�who is personally known to �MA� �:ctrva�;�,who is personally known to
�1Z
me or who has producedL--!V21U — as me or who has produced as
identification and who did take an oath. identification and who
�0 Notary Public State of Florida
NOTARY PUBLIC: NOTARY PUBLIC: Erika Osborne
My Commission FF 208477
o, Expires 04/14/2019
A ON Ph ON
Sign: Sign:
Print: Print: k A0Q- /vJ
Seal: o00°os� Notary Public State of Florida Seal:
r Sindia Alvarez
c4 My Commission FF 156750
9?pff�o� Expires 09,`0312018
APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
Sindia�Alvarez
From: Ellington Osborne <eosborne@ombssecuritysystem.com>
Sent: Thursday, September 03, 2015 10:07 AM
To: Sindia Alvarez
Subject: Regading Permit Card
To: Building Official
Ishmel Naranjo
Good morning,
Please let this letter serve that we no longer need permit# EL15-2248.
Please cancel this permit.
Thank you,
yenefis a es
OMBS Security System LLC
F 13 1 St :.e t
none: R
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