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HomeMy WebLinkAbout2650 S Mellonville Ave (3)t CM OF Sl"aNF15RD PERMIT APPLICATION Architect/Engineer:. FJ., Address: Plait Review Contact Person: Phone; Fax: Phono: tax: _ E-moih Application is hereby made to obtain a pemrit to do lite work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of permit told Urat all work will be performed to meet standards of all Iaws regulating construction in this jurisdiction. I understand that a separate permit must W secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES. BOILERS. HEATERS, TANKS} and AIR CONDITIONERS, cte. 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 MAX RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY, IF YOU II;ITEND TO OBTAIN FINANCING; CONSULT WITH YOUR MAY. ORAN ATTORNEY 13EFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NO"fICE: In addition to the requirements of this permit, there may Ire additional restrictions applicable to this property that may be found in thu public records of this county, and there may be additional permits required from other govemmcrdul entities such as water marragcumit districts, state agenolw~, or federal agencies, Aceeptruwo of Parrott is �eriftcation that I wilt notify the owner of the property of the requirements of Florida Licit L;u 'S IM ,,. ri.,,,. 0 , otp-116 - 07 ��4-13-07 Signature of Owner/Agent Date Signature of Contractor! ent Date �Kane (..rpw-< Vi c t - p s icU.4 o-� &M MEAN 1144, t Miif� PrintgorlAgent'sNamo / �� �ip�„� � Pr �p raelor/Agenl'sN c (/ DIANA M. D / ' fN ar -Slat fFloridn%% Date r�•ti -State ofFlorida ate Signature o of y e o L�L MY COMMISSI00MR51 EXPIRES: OCT 02, 2009 Bonded through 1st State Insurance Owrter/Agent is• LPcrsunolly Known to Me or Contractor/Agent is 6 Produced ID Produced ID _ APPROVALS: ZONING: A, A— UT1L: Special Conditions; Rev 02/2007 `^IIl%/ % , PATRICIA A. MANN MY COMMISSION # DD 520661 EXPIRES: April 5, 2010 6ogd1d Thru Notary Public Underwriters /v l� SLDG: i � aA Submittal Date: Application 0 � Joh Address: �o 056 � MP I (Mvi 1 tc• Nom• .x>ll&d1 L- 3217.3 Value of Work; SL%P i3©U. rid. Parcel ID; oily' Zd " 1 ! " 3 oy - 001©"'00 Zoning: _ — Historic District: Description of Work; ZnialtOf root l C0rsS4r Ly__4 i Square T+ootage: N,1A •.....1..1....♦\e.♦..\.\.Y\1......\\1..............Y......1...\.......... •\\........... ................ YY 1.... Y.........♦ Permit Type: Building e Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm C{ Pool Cl Sign ❑ Electrical: New Service—H ofANIPS Addition/Alteration Q Change of Service q 'temporary Pole ❑ Mechanical: Residential ❑ Non -Residential Q Replaecment ❑ New Cl Q)uct I� tyout & Energy Cala Rcquirod) " Plumbing! Plow Commercial: 0 of Fixtures , N of Water & Sewcr Lines'_ W of Gas Lines PlumbiaWNew Residential: #! of Water Closets Plumbing Repair — Residential D Cc ercial ❑ Occupancy Type: Residential R Commercial ❑ industrial ❑ Occupancy Use Croup(s): -_ Construction Type: N of Stories: It of Dwelling Units: Flood `Gone: N/A CFEh1A form required ) ... ............... ..\..................... ...\..\............... ►\.\.\I................ ....................... .:....... C�7r�S'�• Property Owner: �ln{bt'(�R'�runr`i Auer►�y Contractors,i'{O��%��•1�1 Address: QD C12 it yd, 1 Address:. Ise _ �rn�arC� F!_ 3��ti3 �1.�}ta�r�Ki�; ' �'G.-• 32.?7�.. � l �`� ]Phone: -�#DD2 ]& rrrail; Aet ewS () 0S M, iter Phone 322" )03 State license Bonding Company: 'li1 Mortgage lender: Address: Address: Architect/Engineer:. FJ., Address: Plait Review Contact Person: Phone; Fax: Phono: tax: _ E-moih Application is hereby made to obtain a pemrit to do lite work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of permit told Urat all work will be performed to meet standards of all Iaws regulating construction in this jurisdiction. I understand that a separate permit must W secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES. BOILERS. HEATERS, TANKS} and AIR CONDITIONERS, cte. 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 MAX RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY, IF YOU II;ITEND TO OBTAIN FINANCING; CONSULT WITH YOUR MAY. ORAN ATTORNEY 13EFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NO"fICE: In addition to the requirements of this permit, there may Ire additional restrictions applicable to this property that may be found in thu public records of this county, and there may be additional permits required from other govemmcrdul entities such as water marragcumit districts, state agenolw~, or federal agencies, Aceeptruwo of Parrott is �eriftcation that I wilt notify the owner of the property of the requirements of Florida Licit L;u 'S IM ,,. ri.,,,. 0 , otp-116 - 07 ��4-13-07 Signature of Owner/Agent Date Signature of Contractor! ent Date �Kane (..rpw-< Vi c t - p s icU.4 o-� &M MEAN 1144, t Miif� PrintgorlAgent'sNamo / �� �ip�„� � Pr �p raelor/Agenl'sN c (/ DIANA M. D / ' fN ar -Slat fFloridn%% Date r�•ti -State ofFlorida ate Signature o of y e o L�L MY COMMISSI00MR51 EXPIRES: OCT 02, 2009 Bonded through 1st State Insurance Owrter/Agent is• LPcrsunolly Known to Me or Contractor/Agent is 6 Produced ID Produced ID _ APPROVALS: ZONING: A, A— UT1L: Special Conditions; Rev 02/2007 `^IIl%/ % , PATRICIA A. MANN MY COMMISSION # DD 520661 EXPIRES: April 5, 2010 6ogd1d Thru Notary Public Underwriters /v l� SLDG: i � aA