HomeMy WebLinkAbout1320 E 26 PlCITY OF ,SANFOFLD PERMIT APPLICATION
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Permit No.: 2-t! - Date: 03 –12--02.
Job Address: 1,320 E Place , �U.r►-�rard r L 3.2 –1 l '-� -
Permit Type: k Building Electrical N-1echanl«>l Plumbing _ Fire Alarm/Sprinkler
Description of Work: < T 601 � GZtnd on i
l y 2 -
Additional Information for Electrical & Plumbing Permits
Electrical: _ Addition/Alteration Change of Service Temporary Pole -New AMP Service (ff of AMPS
Plumbing/Residential: Addition/Alteration New Construction (One Closet Plus m_ _ _ Additional)
Plumbing/Commercial: Number of Fixtures Number of Water & Sewer Drainage Lines Number of Gas Lines
Occupancy 'Type: Residential Commercial _ _ Industrial Total Sq Ftg:
Type of Construction:
Parcel No.:
Owner/Address/Phone:
Contractor/Address/Phone:
i
M4 – �
Contact Person: . is
Title Holder (If other than Owner):
Address:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer
Address:
Flood Zone: Number of Stories:
-�.Z 74`%
0
l o e _30
Phone & Fax Number:
Value of Work: S- wo
Number of Dwelling Units:
(Attach Proof of Ownership & Legal Description)
Clave nd Nvd, Su -He. 1X0.
State License Number:
Phone No.:
Fax No.:
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 pennit 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 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 IMPROVEMENTS TO YOUR PROPERTY. IF YOU
INTEND TO OBTAIN FINANCINT, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE OF COMMENCEMENT. iI
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 districts, state agencies, or federal agencies.
Acceptance of permit is verification that 1 will notify the owner of the property of the requirements of Flo 'da Lien Law, FS 713.
Signature of Owner/Agent Date � at c of Contra for/Agent Date
me. Crews, VicePresidA-n+/AcLmin.
Owner/Agent's Erle��
Lure of Notary -State of Florida Date
NOTARY PUBLIC - STATF OF FLOA101A
JACQUELINE M. COCIsEP WAW
COMMI`rtS" $ t:crmt
EXPIAE3 3119%tW
HONDED T71'ersonally
ABA 14444101MY1
Owner/Agent is Known to Me or
Produced ID
APPLICATION AP
Special Conditions:
Contractor/Ageat's Name
of Notary -State of
NOTARY PUBUC - STATE OF FLORM
JACQUELINE M. COI;KERNeltaS
COPAMISSM! 4 pC72016
"Pimm 311W2W2
BONDED 11IRU A*A 1-858-WrARYi
Con actor/Agent is _ Personally Known to Me or
Produced ID _ I.00[)A p
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