HomeMy WebLinkAbout750 W Lake Mary Blvd 08-1843r.-rY nF ceNFnan PFRMrr oval TCATION
Application # : l)
lob Address:. LSD
Parcel ID: " Zoning:
Submittal Date:
Value of Work:
Historic District:
Description of -Woirli '1� t'��?�� C��S�%G� /?%�:f')1�7r/C'cs Square Footage:
Permit Type: Building ❑ Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler /Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service - # of AMPS Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
Mechanical: Residential ❑ Non - Residential ❑ Replacement ❑ New ❑ (Duct Layout & Energy Calc_ Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair - Residential ❑ Commercial ❑
Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑ Occupancy Use Group(s):
construction Type: # of Stories: # of Dwelling Units: Flood Zone: �/ (FEMA form required.)
'ropertyO tier... �,1l �i�i^�P /y •.............. •.••.•Contractoi-i••[T� /C/�J ♦//;`�&/ /••zr7 /', .••.••...
\ddress: �% 4,E AYU Address: ��r�� �(_'c1
'hone-- E -mail: / Phone: State License Number:�CC OZO 7
3onding Company:
\ddress:
\rchitect/Engineer:
\ddress:
'Ian Review Contact Person:
Mortgage Lender:
Address:
Phone:
Fax:
Phone: Fax:
E -mail:
application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no wodc or installation has commenced prior to the
ssuancc of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate
-ermit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
SIR CONDITIONERS, etc.
)WNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
onstruction and zoning.
VARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE 10B SITE BEFORE THE
'IRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
IOTICE OF COMMENCEMENT.
IOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of
its county, and there may be additional permits required from other govemmental entities such as water management districts, state agencies, or federal agencies_
ce f rmit veri6 a-Z I will notify he owner of the pro wri r e , ents o t nda Lien Law, FS 713.
,_SignatureofOwner /Agent ate Sign of ntractorlAgent e
Print Owner /Agent's Name
$ignaturc of Notary-State of Florida Date
Owner /Agent is _
Produced ID
TPROVALS: ZONING:
pecial Conditions:
ev 07.07
Personally Known to Me or
UT[L:
Print.Contractor /Agent's N
Si99 ure $ Idiit S Datc
DD 761975
EXPIRES: March 23, 2012
- f3OFF,Oe Ban W 7hN BudgBt NoIW SOMces
Contractor /Agent is _ Personally Known to Me or
/Produced ID
FD: ENO: BLDG: