HomeMy WebLinkAbout1211 Rosecliff Cir1x1permit#: oc - d L//
Job Address' .a-& R JC
CITY OF SALFORD PERMIT APPLICATION
C41
c/R
Date: 6-"- o G
,S,9-v;Xb4 0 FL
a77
Description e►f Work: R C Qo o TOW Square Footasye 60 W
Historic District: Ztrt/N✓t'7f`R'� YalaeofworL S '
Permit Type: Building Electsicsl Mechanical , Plumbing Fre SprinlrleadAlwm Pool
EleetricW: New Service - f of AMPS AdditioulAltoation Change of Saviee Temporary Polo
yledranical: Residential ?Toa-Rtaadt Uvl Rrplacemout New (Duct Layout & Energy Calc. Required)
Pktmbine New Commerml• d of ri dum k of Water & Sewer Lincs d of Gas Lines
Plumbiug/New Resdea6aL d of Water Cbsots Phmbhsg Repair -Residential or Commercial
Oecupmey Type: Residential Commercial Industrial
Construtlion Type: # o[Stwjaw. X of Duelling Cnits: Flood Zone: (FEMA corm reiuirod )
Owners name& Address: To
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Contractor Name&Addrac PAR,
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Phone& Fax: (� 7
Beading Company:
Address:
Mortgage Leader:
Address:
ArebilectMogineer:
Address:
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7 931 -iL,�y
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F h 155, 0% ce Al- 3rf 7 VAte Lives. Nnnber: G 6 V C S 7
a 83 d Contact Persoo: D LET r✓ Locale _rhare: y 0 7 3
Moor
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Application is %,,b7 andato obtain a pesroit to do the work and Wtallatiwa r indicted. I ocr* that no work at insultafwn has commaKed prior to tho
issuance of a permit and that a0 work will be performed to road d a"dnds of at1 taws regotating constructien in this juradiGion. 1 andastand that a separate
pc mil must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc
n_wvFtt'S AFFIDA4Tf: I certify do all of me finegoag mLamurtior s aecmale and mat a0 wartwi8 6e dons m eomplioaee with an applicable tows regulating
construction and maing_ 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 FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEl1ENT.
NOTICE: In addition to the roquuemmts of Ws permit, these may be additional restrictions appticsble to this property mat may be found in the public records of
this wonty, and Were may be alldimW permits required from other goveromeedal astilies such as water rwnagwerd districts, state agencies, or &dmi agencies.
Aaxptamce of permit is verification mat I win a ndry the owner of the properly of ibc requsemeds of F#ida Lm Law, FS 713.
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Sigralum of OwnerlAgrml Dag Sistaaue of ConI;=k 1Agent Date
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Print Owne
r/ Name �, Print Coctract is Name
6 4606
Si of lc S' me of NatMT Sri, f Florida Dat
`�yf.�,. PETER DANIEL SIMON
e r PETER DANIEL SIMON . MY Cb�O�MrrMISS�It Ap37A132
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Contractor/ ersonalcxPl�tES: Ma
Y g. 2010
is . 10 ►start' SerMcaoom
(s07) 3flg Q153 Ronde NOWY Savicaoom
APPROVALS: ZObWG: UM_ FD: I3`G: BLDG -
Special Conditions:
Rev 03rMN