HomeMy WebLinkAbout220 Towne Center CirPermit #
Job Address:
Description of Work:
Historic District:
Zoning-.
CITY OF SANF(e)RD PE` IMIT APPLICATION
BVCENED
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0
Value of Work:
Permit Type: Building Electrical Mechanical Plumbing . Fire Sprinkler/Alarm –X— Pool
Electrical: New Service - tF of AMPS Addition/Alteration d Change of Service _^ Temporary Polo_
Mechanical: Residential Non -Residential Replacement New(Duct Layout &Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets.-- y Plumbing Repair - Residential or Commercial _
Occupancy Type: Residential _-- Commercial A' Industrial Total Square Footage:
Construction "Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Name & Address:
Contractor Name & Address: .DIM
(Attach Proof of Ownership & Legal Description)
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Phone:
State License Number:
Phone. &Fax:__ )07 Z �,� `//00 t/!)7 `235 //Sy Contact Person: I <?\1e i7 /-Vll IC —Pltone:
Bonding Company:
Address: "
Mortgage Leuder:
Address:
Are hitect/Gngineer: Phone:
Address: 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 separate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
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 Taws regulating
construction and zoning, WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMEN`1' 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.
NOTICE: In addition to the requirements of this permit, there may 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 requirements of Florida Lien Law, FS 713.
Signature of Owner/Agent Dale SignactureVoutrxetor/Agent Date
IC...............
Print Print Owner/Agent's Name PrintCor ntra/ct r/Age/nt's ,Name MISAEh ALICEA
y �/A�yr�a�rr�"oy Camm# OD0291408
!!� /. s? Expires 21IW2000
Signature of Notary -State of Florida Date Signature of Notary -State of Florida 2 Sonded thru (800)432-4264:
Florida Notary Assn., Inc
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Owner/Agent is _____ Personally Known to Me or Contractor/Acent is Personally Kno n to Me or
Produced ID 1-1 Produced ID
_— ,, ++� ,,fi�rr— 114113m, _....--- .
APPLICAI-tON APPROVED BY: Bldg �°�C's+L.,,.q - Zoning:
(Initial k Date.)
Special Conditions:
Utilities:
(Initial & Date) (Initial & Date)
FD:
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LEGEND
0
EXISTING 1" OUTLETS
0
-1" PLUGS
G
NEW TYCO %" 155° TY -FRB SHR PEND
23
O
NEW TYCO 1/2" 1550 RFII WHITE CONC PEND
9
NEW TYCO 155° TY -FRB UPRIGHTS
16
TOTAL
48
EXISTING PIPE — — — —
NEW PIPE -
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IDRAWN BY:
CHECKED BY: �p
DATE:
6, 2006
DRAWING NAME:
SILLY MONKEY
SCALE:
1/4�, _ 11
_05
7
PROJECT No./ PROMPT No.
FILE LOCATION:
SHEET: - 1 of 1
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