HomeMy WebLinkAbout3653 S Orlando DrS'WO
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Application 4: Submittal Date:
Job Address: 3653 South Orlando Drive Wal-Mart
Wal-Mart Store #0857 Value of Work: S 22.400
Parcel ID: jv��,' ,l h PLYmk � *0'7 �q gl-fi Zoning: Historic District:
Description of Work: Install Delav Egress on existing fire exit doors Square Footage:
........................................................................................................................
Permit Type: Building ❑ Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm X Pool ❑ Sign ❑
Electrical: New Service — # of AMPS Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
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 Plumbing Repair — Residential ❑ Commercial ❑
Occupancy Type: Residential ❑ Commercial X Industrial ❑ Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
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Property Owner: Wal-Mart Stores, Inc. Contractor: Ferguson Cabling Corp. Contact: Mark Ferguson
Address: 1105 S.E. 5" Street Address: 203 Orange Street
Bentonville AR. 72716-0610 Palm Harbor FL 43683
Phone: 800-530-9924 opt. 3 E-mail: Phone: 727-786-9473 State License Number: ES0000416
Bonding Company: Mortgage Lender:
Address: Address:
Architect/Engineer: Phone:
Address: Fax:
Plan Review Contact Person: Phone: 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. 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 laws regulating
construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY: A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. 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.
ptan pe erificati that I will notify the owner of the prope f the qui ents of Florida Lien Law, FS 713.
Signature0f er/ gen Date 9iiiiature of Con r/Agent Date
Own!�rr/Agent is -
#I" Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 07.07
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