HomeMy WebLinkAbout401 W Seminole Blvd (23)d0 1- a 0:
pecei�-ed,:Fa � ..- 6 W�� Se s°15�2t705 E':73AM�'*'-.�Fax��Station.:.•�: DenmaniGrou �Tnc��_g... .a. � `3�s2 _ ��° :� �� ��:�: _- :�.�� �3.�.
Sep 15 05 09:o9a
Permit #:—
j ob Address-
Lexcar
CITY OF
. 7
PERMIT APPLICAT1oN
Date:
P.2
Description of Worl:: '
Historic District; Zoning: Value of Work: S ,
Permit Type Building Electrical Mechanical _ Plumbing Fire Sprinkler/Alarm Pool
Electrical.• New Service– # of AMPS Addition/AherationChan a of Service Temporary Pole
Mechanical; Residential Non -Residential Ra�lacetnrnl New
8
Plumbios/ Nen, Comarne rcial: # of Fixtures (Duct 'out & Energy.Calc. Required)
K of Water & Sewer Lincs # of Gas Lines
Plumbing/New Residential- a of Water Closets Plumbing [tepair – Residential orCommcareiat
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction Type: R of Stories• q of Dwetlink Units Flood Zoite:
( FEMA form re"Ired for othrr than ; C)
30 -300 —op?p =_QDon
/ Attach Proal of Owserslrt & [Azal Description)
n, Address 14C.i �1 e_ /fY1,,.iC... M I : L.. 't' _ n. _ F
Contractor Name Address; — ph"O:
-
Phone & Fax: _
Conding Compaa}-
Address:
NfortcaEe Lender:
Address:
.McbitccUEgAncer:
Stale Urense Number.
Catrlaet
Address. Person Phone:
/IQ�
Fax:
Appikation is hereby mode a obtain a pemit to d n the wci* aad inst nmkms as indicated. 1 ecrtify that nes work or inaaprtion has commenood
issuvtce of a prnnit and"nil Mork an71 be peeonned to rnel-h staadarrts oral) taws rLIulatiag constnx? ion in Ibis jurisdiction. I undxastand Iluc tsepante
AIRPennilC NDITI sccu?vdNERS for ELECTRICAL WORK PLUMPING. SIGNS. WE.LS, POOLS, FURNACES. BOILERS, HEATERS, TANKS and
AIR CONDITIONERS, ac,
tER'S AFFIt)AV fT: 1 artily ttmt all of the farigpinE infixrration is aceurmc and thu all work sri11 be done in eotnpiiance rvitlt all apptica6k hws rccuhtir►g
construcFOR IMPK
d aaroV WARNING TO OWNER VOUR FAILURE TO RECORD A NOTICE OF COMMENCEMEN MAY RESULTIN YOUR PAYING
TWICE FOR BEFDpEEMENTS TO YOUR PROPERTY. IF YOU INTEND TO ORT FINANCING, CONSULT WITH H YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
i'MIC : In addition toy m ditionnee of this pcntnit. t herr may be odditionai tasnrigt ions applicable to this property that may bo found in the public merds of
th"s ctwtgy, and that may be addiuorul prnnitc reCtuir -d fmru other Eovernmrntal emit its such as water otanageatrnt rGstriets, state
J=;–V76–r�
�7q.�%��/fes.orfedcralagtncirs.
/C -j S J.�d1�3 ✓n �lii�� .f�,iSU /t- a
— Pmduccd
Da1r
IISSIRDD 465628 aa1Q
September 11, 2009
Notary Public Underwriters
11 1- s 1:
Rece�e2i Fa`.+'�: Sc 15'2065 8:73Atd Fax Sta.ion:;- Ceriman'Grou inc:. _ � 3 ,_:
Sep 15 05 09: oea Lexcot- p.3
AFFIDAVIT
REGARDING ,ROOF DRY -IN AND FLASB ING INSPECTIONS
Company: _ Rck fiUT Int U t PA14'5` C J. -7e?�Q
License #:
at 3 ixltr:� .,J,0,)
,, �1 iF g
7-AMA 4i-)Pi�04_33&0q
Project Information
Owner: 140.1 �� L(. LfC_bi5
Pexmit #:
AMC I- .
'V VVt t'y1 J e IR_.�(A
Subdivision:
address .
lot M
plianc
want, hereby affirm that I am the duly licensed
contractor of ecord fbr the above referenced permit, that all the foregoing information is true
and accurate, and that the dry -in, flashings at the above referenced address or lot has been
installed in accordance with the applicable codes and standards.
Contractor:
Ad V
printed name`/
STATE OF FLORIDA i
COUNl'Y OF �
This instrument was acknowledg efore me 8,1155- day of i 2p�: b the
above referenced individual, ' y
duly licensed contractor with o ackno ledged that he/she is a
he/she was authorized to execut this document. He/she4�iden
er•personal I o wn to me or ed that
produced as ' on.
WITNESS my hand and seal this day of 20��
DD 465628
N 11, 2009
ThN