HomeMy WebLinkAbout3923 St Johns Pkwy 03-2782 sprinkler system�J#yyf+y l
Permit #: 03 - maw Date:
Job Address: � , j K , Jut' vv�-/t
Description of Work: % r-)
Historic District: h Zoning: Value of Work: S J e o o
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/' farm Pool ^
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & $nergy Ca. Required)
F.:.
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair— Residential or Commercial _
Occupancy Type: Residential Commercial X Industrial Total Square Footage: ^
Construction Tyne: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
.dam:..
Parcel #: (Attach Proof of Ownership & Legal Description)
Owners Name & Address:
Phone:
Contractor
fName &'Address:j''/t{�>�F�'/y j 7 y
` j�/Q�y 1 V 1 4ACcj/ ,7 .Q_( (� State License Number:�1'! d�/ll rl.J__�_`
Phone & Fax:O" �ryU' �[ f i - �J� Contact Person: �4 1�j(, vi ��_�_Phone: �t6�S
Bonding Company:
Address: -------�-
Mortgage Lender: --
Address: ----- -- -
.Architect/Engineer: Phone: -- --- --- ---
Address ---- --..---
Fax:
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 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 ofthe foregoing information is accurate and that all work will be done in compliance with all applicabl(, €aav s regulating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULTIN YOUR ht�0.YING
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: 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
this county, and there may be additional permits required from other governmental entities such as water management distracts, state agencies, or federal agcacies.
Acceptance of permit is verification that l «III notify the owner of the property of the require tsionda L n>aa, FS 713.
SignaturcofOwner/Agent —----- Date Signature of Contractor/Agent Date
Print Owner/Agent's Narne
Signature of Notary -State of Florida Date
Owner/Agent is __ Personallc_ yno��il to �Vte or C
Produced ID
Y—M I%,— ) t.ea_J•.. t 1 at 2 k
rat Contractor .-\gcnt's Name
D
Date
APPL.I(:A I ION APPROVED BY: BId : q
b — ----- Lori i n g: _ ------
Initial & Date) (Initial S, Date)
�necial Cunditions:
ANDREA MCCAUIkY
+' M'f C0;�1h115SI01�' # �U 00335t`-
.oP>> FXf r ES:. February 21 2005
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(Initial � Date) (In