HomeMy WebLinkAbout1295 W Airport Blvd 06-2283 SprinklerP"I nk #
Job Adahra.: r
Decriptiaatr
Dist: :
CITY OF SAMOORD PERMIT APPLICATION
Date-. (Yln,e.,r ECEIVED
MAY 4ssW
0
Value
Permk Type: Building Electrical Mechanical Pluming Fire Sprinkler/Atum Pool
Electrical: New Service — # of AMPS Addition/Almration Change of Service 'TenWraty Pole
Meeban scat: Residential Non -Residential Replacetrnent New (Duct Layom & Erne Calc. Required)
PlumbloW New Comruesrcial: # of Fixtures # of Water & Sewer Lines # of Gas I roes
PlatubbWNew Residential: # of Water Ooscts Plumbing Repair -- Residential or Cmuneccaal
Occupancy Type: Residential Commercial Indust W Tots! Square Footage:
Comhrwetka Type: # of Storks: # of Dwdlig Urtdts: Flood Zotarw (n%1A fora re%W d for eum thm X)
Parrd #: C).1—' C(' ( ) Q() t P " UCX(A4ncb Proof of OwneraYip do 1.1 Dacriptlon)
aaerAddress:
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C«atraemr Nme �iAddrwt �__ 0 rl / 'r-P , v : ' 1r,- En CI
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Address:
MerWV Leader b\) 11i
Addreu:
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Adams: 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
ua issnce of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. 1 u dersUM that it separate
permit roust be seared for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVTf: I certify that all of the foregoing information is accurate and thin all wok will be done in congaliance 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 1MPROVEMEDTfS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTIQ: In addition to the requirements of this permit, there may be additional restrictiow applicable to this property that may be found in the public rearms of
this county, and there may be additional permits required from oher governmeartal entities such as water management districts, state agencies, or federal agencies.
Acoeplannee of permit is vaifiadion that I will notify the owner of the property of the requirements of Florida L' , FS 713.
x or/
Signature of Owner/Agem Date Sigrunturc f Comnrctor/ t Date
Print Owner/Agent's Now �ontroctor/A s ame
Signature of Notary -State of Florida Date i gnature of Notary -State of Florida oate
Owns/Agent is Personally Known to Me or Conductor/Agent is —1 P"Wv rlly Known to Me or
Produced ID Produced ID `n�/i1�1G1
APPLICATION APMOVED BY: Bldg:
(Ntw &) (buhal do Due) (ln»al & Due)
Special Conditions: -
pp KAREN M. 131NNER
MY COMMISSION # 04 265856
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