HomeMy WebLinkAbout2429 Princeton Ave (2)Permit #
Job Address: ��aZ
Description of Work: �
Historic District: ` `
Zoning: Value of Work: $ '`ad -
Permit Type: Building Electrical /," Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service – # of AMPS SSD Addition/Alteration Change of Service—
Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Cald. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair– Residential or Commercial
Occupancy Type: Residential 40"- Commercial Industrial Total Square Footage:
Construction Type: # of Stories: / # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Name & Address: Sly/iy L��
Laa 0 3a
Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
a -
(Attach Proof of Ownership & Legal Description)
-PI). /fin y 6 c) a l .
�f ^ Phone:
3a �3g State License Number.
1 a
Contact Person: /kle/'T ltr 11 G
Phone:
Fax:
Z27 -2-5-7-6/-7P
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 ofthe 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 rN VOU7. 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 roti a owner of property of the requirements of Florida Lien Law, FS 713.
Signature of Owner/Age ate Signature of Coor actor/Agent Date
Pri wner/Agent's Name
Si n taIat of Florida Date /
DEBBIE BLANTON
COpfily;1SSION # DD 1g�o
wner t is EXr'° PpttoP4HKJ rn 0 M or
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Print ContractodAgent's Name
Signature of Notary -State of Florida Date ---
Contractor/Agent is _ Personally Known to Me or
_ Produced ID
APPLICATION APPROVED BY: Bldg:11 C
(Initial & Date) (Initial & Date)
Special Conditions:
Utilities: FD:
(Initial & Date) (Initial & Date)
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