HomeMy WebLinkAbout699 Aero Ln (2)CITY OFSAIWi`ORD PERMIT' APPLECATXON
Application # : t ✓ / Submittal Date:
Job Address: _%? CCL%/y C �� h e- Value of Work: S-_ __� •"�'_
Parcel CD: 6,qC_ ROCU G'CoC) Zoning: S/ Jarmla>cQ _ Historic District: _ NO
Description of Work: Lr�c�t!� 5 /�, i act i loin - r�zcfY<c Square Footage: rP ! c�o-i c5, ,
u..i...... 1�::.:� . ............................................................................
Permit Type: Building ❑ Electrical ❑ Mechanical ❑ Plumbing 13
Electrical: New Service - # of AMPS _- � �� Addition/Alteration. GJ
Mechanical, Residential ❑ Non -Residential Z
Replacement ❑
Plumbing/ New Commercial: # of Fixtures ter & Sewer Lines
Plumbing/Mew Residential: # of Water Close s
Occupancy Type: Residential ❑ Commercial ❑ Industrial 11
Fire Sprinkler/Alarm 0 Pool 0 Sigr
Change of Service ❑ Temporary Pole ❑
New 13 (Duct Layout & Energy Calcul tGEPYED
# of Utes Lines _
,lltfr p07Plumbing Rep:dt - [residential Q o erci<m
Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: �__Flood Zone: (FFNIA form required)
•............................................................«....................«...................«9....«........
Property Owner: & ero Gcrn LC Contractor:.�t'�C�� 1U �....�?lc �? JY C • _
Address: /Ow y ea') Lezne_ Address:, �)0,Y 4015076__ _
c C r7 orrQ li . too `ao-7 C
Phone:
E-mail:
Bonding Company: !
Address: LA
Architect/Eugincer: X 1 ��
Address:
Plan Review Contact Person:
Pon C
Phone:
0 7-Zj3-535 tcenreNail cr: 0eL-alb
Mortgage Leader: I co If
Address: _ P__ w —.
Phone:
Phone: Fax:
Fax:
E-mail:
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. 1 underskmd 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 turd that all work will be done in compliance with all applicable laws regulating
construction and zoning. WARNINGTo OWNER, YOUR FAILURETO RECORD A NOTICE OF COMMENCEMENT MAY RESULT 1N 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 tcdcral agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Liar Law, FS 713.
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Signature of Owner/Agent Date "Signa uraa'
Contr al r/AAguat Date
asp �� r 1, d C'
Print Owner/Agent's Name "'k -Print Contractor/A nYs Name
Signature of Notary -State of Florida Date Signature ot"Notary-State of Florida �Dule
Owner/Agent is — Personally Known to Me or
_ Produced ID
APPROVALS: ZONING: r b_ jq 617/4UTIL:
Special Conditions:
Rev 02/2007
FD:
lorid
Iry oo NotaryPublic State of Fa
;� Wanda S Clary
� 4 My Commission D0605158
actur/Agent is 1'ersc nall'yu rtrtlin to f�f 10/2512010
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PROJECT# 05-328