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HomeMy WebLinkAbout104 Brushcreek Dr 07-1589Application #: G-7 5 Submittal Date: Job Address: JOC(t Valae of ark: S 500 Parcelw. '�3— 17—so— 5')(,— ��� t9jc�00-67 , »� riel: Description of'WoriL d e:cc t l -R + U!'h (R k q io , jjtj FqzA Square Footage: _AQ ......................................................................................................................... Permit Type; Building O Electrical ' Mechanical O Plumbing 13 Fire SprinldedAlarm 13 Pool 13 Sign 13 Electrical. -.New Service-9ofAMPSt, 4aOO Addition/Alte tion;, Clinttge of'$"vivo 0 TornporaryRole Mechanical: Residential, EF Norr:itesidential Replacement New ID (DUctLayout& Enem Cale Requiwd) Piullib DS/ NON CutnnlVMUI: # of Fixtures #0 Water & Sewer Lines_ # ofCas Lines PlumbfitOow 14sidcnlia'l: # ,of Water Closets Plumbiinu itepair — Residential b Commercial 0 Occupancy Type: ResidentIOX commotew a mallow a�e4tF�ttlttC� 90�rtltl�f��i .: Cot Mt1Qa r K.- _ # of'Storles oil as lIitt FTtllft fit`4 Virgo O(WW, i litkwegttf> 4k, ........................ 0................ .. ......................................................`...................:. Property Owner: Q46' b e, Ra (i mond D tQ�,t�y'� m Contractor. Flffdo ll � Eledle't : Address: &U.SLced Or Address: l6 a h k -c Or &,ta,t[ rL r " 3; 2 Phone, y a, 30 -� Fo-Mi at E'hone W—S%ie Li0O4 NutttbOt c-&V--OLU 2 Bonding Company.: It�u age:> ettdetr„ Address: Adder Archttect/Engineer: Fligtto. Address: Pian PATI w'Contact Person: Phone: For., Appli&anon is hcrey madf to obtaitr aperrttitt© tRe wcnk nttci iastnllottons ittdl l crti A$trtooF ctr ttlstolt#ttlett} itas sontats pYtc tE> rite issuatcceofapennit`andtlratcli�wotkwillEt�pGifatuttittisstt�ist�rtd"�urdsofallla��s.is�t►lstiit�c�tt5tttt�tiditittt}is•.��tfis�lt�ti®ttATERAtuiclst3tst`t�.ii�ats<s�ai�, POW MOO bo ted for EU I tICA3 yy{OU, PLUM161NG, SIONS, NEW, OWLS, TUI�NACE-S, DOJI<ERS, S, TANKS, and AIR 10ONWIONM, etc- (}yF!N tF' IDAVIt! C cceti y fat oilF o Utc lot ctutp tni�ottxtstiott, it. sc ktt4 id dotll *0 *tli be Otte itty OffiPliAw with Olt ApOlic 010 l4*.& t lUo0 c�nstractionr and zoatng. GJAltNllVf'r f+6i 3VJNi R 044A%Lt RE44AKOIAD A ii lli L t?p fJM1t 1Cplti f MA'Y" l�l✓sw)u Il 'I �/iC� �c�il ItvIP�UIviEN T�7 �'�ltlt PJ�S�J?�It'�Y. �' ��� I'iNi� Tc��l�wAl� I=IN,/�NCIfiiC, C�ntSUl„T vI'3'R'�QUJi l.Elt 1311 APi ATTOitWY BET'() RECORIDINC YOUR NOTICE 4I' OO MWNCEMEW. NOTICEIir addition to the nacttrirCitients oftllit porttnt ,that l •sdditi6psl t itttottoot o niioot(,� to titit ptootwN that ivio bo foimtt i,# tlio-t�Etolte t_#.'d s this count), and there agcy bo additional pertrtits a yNiied &€t tr pt(tetptS� nim ltot. t�ti suGi t ', of f tient dint s t�; stat a er trq : a� # il4 i i s Acceptance of peaiiit is xeritTcatiod Istat 1 will notify owner of the property of #te reuu' f FloraIa Lien Law, 713. Signature ofOwner/Apat I3at� S. a rp4act fAg _ hate Print (3wnsr/Apnt's bia e Sigaftr OfNOUJrg-State of Florida Dar, vv �µNoupi ntd�.�...... . 1 !' Notary Pubk - Sis1e of Florida • -my= Ltd May 30.2011 C 0 W 557470 annded By Natural Notary Assn. Owftor/Agft is P smaiiy Xwwn to W or Conlan"/.pit is ✓P�sonally known td _ Produce ID P�� ID. APPRG VALS: ZONMG 1311L: Tilt ENID. SF.IJiG , Special d-tlons: Rev 0=007 POWER OF ATTORNEY Date:�/)/47 I, t�oW i ►,, �, , do herby authorizef ffi�"/ _ to pull the b.1—permit for 1 O 13rLL_LI-°C •e Type ofpemut. job address A, yj L.. igllsiUte �!TOiaFy Personally known to me r verslice r o a, nun fon_�y of 20 '�ti ��N I�ABM +�8 DaWbA .a�'�S•���2 Omss 00 A a� 9 =L� G -s "PRA 10 inan . ^.1 m Awn . �^d Alli �o,;• JAN ItIbN