HomeMy WebLinkAbout155 Towne Center CirIll
RECENUD
b/) CITY OF SANFOI60 PERMIT APPLICATION / D E 06
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Permit # : - _ Date:.._ V Lt�+ V
Job Address: _�� `O—G4-�_�J�►� t (. � �..__ �_._._
Description of Work:
Historic District: ,.—„_ T Zoning: Value of Work: S--P--Y&y
Permit Type: Building_— Electrical Mechanical I'luntbiug _ Fire Sprinkler/Alarm _ X Pool
Electrical: Now Set -vice -- # of AMPS Addition/Alteration . Change of Service __ Temporary Polo—.--
Mechanical:
OI .Mechanical: Residential Non -Residential Replacement - New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines 11 of Gas Lines
Plumbing/New Residential: 9 of Water Closets m Plumbing Repair- Residential or Commercial
Occupancy Type: Residential -_ Commercial n Industrial 'Total Square Footage:
Construction Type: —.” # of Stories: -- # of Dwelling Units: _,-,.,v, Flood Zone: (FEMA form required for other than X)
113reel #: _--.—•
Owners Name & Address:
(Attach Proof of Ownership & Legal Description)
Contractor Name&Address: 3761 A%•-TO�YI
- /0 6 Qyo� ouI
/' 7_r /7� 5Guc License Number: e.t� Yz�r.�,�___
Phone & Fax: 7072 1 o _ G% 23 XJD Contact Person: r1 n I� I'hone: Z i ZA„ ^ Is�l'tjp
Bonding Company:
Address:
Mortgage Lender: .
Address:
Archfte.ct/Engineer.
Address:
Phone:
Fax:
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 scharute
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, IWA-TERS, TANKS, and
AIR CONDITIONERS, etc.
O\VNER'S AFFIDAVIT: I certify that ail 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 COMM I,NCEMEN'r 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 COMMENCEMENT.
NO I*ICH: In addition to the requirculcnts of this permit, there tray 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 I will notify the owner of the Property of the
Signature or Owner/Agent
Date
Print Owner/Agent's Name Print
Signature of Notary -State of Florida Date Signature of
13
Daw
Date
Owner/Agent is Personally Known to Nle or Contractor/A;;cnt is — 1, rally Knowt� 3110A
Produced lD _ Produced ID_
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APPLICATION AI'I'ROVED BY: Bldg: 6+ zoning: Utilities: _
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(lmlial Gate) (initial &Date) (initial &Date)
Special Conditions:
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X 101
MI$AEL ALICEA
Comm# DD0291403
Expires 2/16/2008
`s Bonded thru (800)432.4254;
Florida Notary Assn., lac
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