HomeMy WebLinkAbout2520 French Ave 03-1596 SignCITY OF SA.N*ORD PERMIT APPLICATION
PermitNo.:
Permit Type: __X __ Building __A__ Electrical _ Mechanical
Description; of Work: J �
r �
Date:
Plumbing Fire Alarm/Sprinkler
Additional Information for Electrical & Plumbing Permits
Electrical: —Addition/Alteration Change of Service —Temporary Pole New AMP Service (# of AMPS �
Pl4iling/Residential: Addition/Alteration New Construction (One Closet Plus Additional)
Pluubing/Commercial: Number of Fixtures Number of Water & Sewer Drainage Lines Number of Gas Lines
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occupancy Type: Residential X,,Commercial — Industrial Total Sq Ftg. Value of Work: $
Type of Construction: lood Zone: Number of Stories:. _ Number of Dwelling Units: T
Parcel No.: �_' �_�� (Attach Proof of Ownership & Legal Description)
Owner/Address/Phone: ,,,z Zt� S H� Z/7-
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contact Person:_
role Holder(If other than Owner):
Address:
Bortdig Company:
Mortgage Lender:_
Address:
Arclittect/Engineer
Address:
_ State License Nrnnber:�_ `-_
Phone & Fax Number:
Application is hereby ms:de 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 ,i BOILERS, HEATEMS, TANKS, and AIR CONDITIONERS, etc.
OWNER'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 construction and'zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTSTO 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 maybe additional permits, required from other governmental entities such as
water management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of
Signature f Owner/Agee �i'tq-
PTODate Sign eAnn
wner/gentXac
Signature of Not -rida Date
,•�py+pU+ Mary L. Muse
oG�„Commission # CC 8516,14
Expires Aug. 4, 2003
Bonded '1'hru
Atlantic I3ondin Co ,Inc.
Owt�}}er/Agent is Perso�}alf Known to Me or
V Produced ID --FL L L `tea - C, (CX `J�
of Florida Lien Law, FS 713,
W-3
Date
Pri
oVactor/A'g briI's Ne
Signature of Nai
y-Mate of 1?lerida
Date
o 'Y`Pa
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Mar L.
'onunisslon C
r # 851644
Expires -'��f7FFL���• P� Aug. 4, 2003
hru
Atlautibded
onding Co., Inc.
Contractor/Agent is I' sonally Known to Me o cD
c.Produced ID - �K�'Ct(,i�J�- to
APPLICATION APPROVED BY: % Date:
Special Conditions: (� (,
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SANFpRO SUILD1r1(, DEPT.
'ACC P PLANS ARE REVIf WEO
ACCEPTED I=pR PeR1vI+T. AND CUrJDITfONAL+ Y
CONSTF UFD 1p EE A + +CI'ERMIT (5
Tf iE WORK AND f hSF SUED SHALL DE
CANCEL NOT AS AU'rf-10 I YFiOCEED WITFf
PROVISIONg Tf R, oR SFT ASID r0 VIOL.ATF
OF' E F
DEP7AFR E OF ArPER,H 7f�(NR AI_. CODE' NOROSHALL.
TION pI_ q vi THErj F`/ENT TJiF, sUl
' k'RROF2S pfAF rER REQI �1121NG LDINC
Oft 07F{ER VIOLATHE PLANS, CONS A C ORREC-
f-IorJS OF . 11 C 7"RUCTION
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