HomeMy WebLinkAbout1807 Holly Ave (2)Job Address: _
Description of Work:
Historic District
J t
,
CITY OF SANFOKI) PERN11I' APPLICATION
RECEIVED
I `eo7 - UQ i c,i ,-Are NOV 2 q 2005
Zoning:
__--. _-"l•gtal Square Footage
1q
Value.a Work;. 'r
LEM
Permit Type: Building / - Electrical .._._— Mechanical - .T- Plutubing __--. Fire Sprinkler/Alarm fool ---
I
Elects ical: New Service -it of AMPS — Addition/Alteration Change of Service __-_— Tempohary 1'ulc
..lechauical: Residential _ Nott-Kesidential _ Replacement New_ (Duct Layout & Energy Calc, Required)
I' Plumbing/ New Commercial: ii of Fixtures It of Water & Scwcr Lincs_____ _ 11 of Gas Lines
Plumbing/New Residential: It of Water Closets PInanbing Repair - ltesidcutial or Commercial
Dccupancy Type: Residential _ Commercial industrial
Construction "hype: � It of Stories: _ f# of Dwelling Units: _- Flood. Lone: -_ (MMA form rcquircd )
Jwucrs Nxute - Addr 's: l�p Cl L up �� 2 r Y� cC P Z, _ --._. �j
f O( LI- rice Y)-FC`J C - l'hinte:_ 1vt_
-'onlractor Naure & Adt cess:
Statc t.hccuse Number:
?Irorte & Paz: -- - —. -- _._ Contact Person:
3uuding Company: ---
Itortgage t.endcr' ------ - -- -- - -- ._._ Y ...—
\ddress:
II \rchiI a/u rgiuccr:
lddress: -_ -- Fax: _. -- --
�pplicatiou is hereby nude to obtain a permit to do the work and installations as indicated. I certify that no wwk- or iaslallatiou has coauncuccd prior to tile.
ssuance ofa pennit and that all work will be pct-Git ned to nice( standards of all laws regulating construction in this jurisdiction. I uudctstand that a separate
n;amit utast be secured for ELEMICAL WOKK, PLUMBING, SONS, WF.L.LS, POOLS. FURNACES, BOILERS, HEATERS, TANKS, and
Ult. CONUITIONEWS, e(c.
)WNEWS AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicadle laws regulating
ottstruction aid zoning. WAItNINQ TO OWNER: YOUK FAILOKE TO ItFCORD A NOTICE OF COMNIENCEMENT MAY RESULT IN YOUR PAYING
: WICE FOK IM['KOVEMEN-1'S "f0 YOUR PROPER-IY. IF YOU INItiND TO 013 -CAIN FINANCING, CONSULT W IT[( YOU It LENUI31t Olt AN
VITORNEY BEFORE ItECOKIJ NG YOUK NO"fiC.[3 OF COMMENCENtEN'f.
40TICE: lu addition to rice requirements of this permit, there may be additional restrictions applicable to this property that utay be found in the public records of .
his courtly, and there utay be additional permits required from[ other goverumcutal entities such as water management district, state agencies, or federal agencies.
Wceptanccc of peralit is verification that [ will notify the owner of the property of the requirements of Florida Lien Law, F'S 713.
Sigoature urowlter/Agent Date Siguauu c of Contractor/Agcut -- — � Date
c�--CGS :'��--�-1 t-- 7~�aGFr�J�zz_ ------••-------
Pfint�t mer/Agent's Naut' / Print Contractor/Ascot's Name
- lam__ -5 / l (� 0 Co _.. -
Signature of Notary -Stale of FI a , Date Signature of Not.uy-Stale Of Florida Datc
\\Ok-Aliiti�rrii��
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Omer/Agent ice_ , PC mlill fidull'to Me dr � Contractor/Agent is _ Personally Known to Me or
— Produced to 7` �';�¢ ,. `4r�_ Produced FD --_ - -
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,��' rz .
&IKOVALS:'LO IN Uri FI). FD: ENCi: SLUG:
pecial Conditions:
acv 0312006
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