HomeMy WebLinkAbout114 Aldean Dr (3)r w
CITY OF SANFOI:D P&MIT APPLICATION
Permit #: 1 Date:
Job Address: 1 \ Li u kay-- --Z)Y
Description of Work: Ne.W -5yA Y h ne-
Historic District: Zoning:
Permit Type: Building Electrical
Electrical: New Service - # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential Commercial
Construction Type: # of Stories:
Value of Work: $
Mechanical Plumbing Fire Sprinkler/Alarm Pool
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Calc. Required)
of Water & Sewer Lines # of Gas Lines
Plumbing Repair - Residential or Commercial _
Industrial Total Square Footage:
of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: (Attach Proof of Ownership & Legal Description)
Owners Name & Address: -1-e_t( r u Ox- cA Sur n^l • ` t5 Yl$PX1
II H AICIeC.r, Phone: _L407-3a2 - I685
Contractor Name & Address: \.]D.X VA tM - OC14r 1 CV — k- )OX f`k ¢A,t S 1 11nrr bt n a
Phone & Fax:(
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
State License Number: K _
Contact Person: I Q71rrI e._l Phone: (Z)UP)6(0849gi
Phone:
Fax:
Application is hereby made to obtain a pennit to do the work and installations as indicated. 1 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, ctc.
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. 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 propeny 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.
1 9 I 23 04
Signature of OwneriAgent Date V SiNature of Contractor/Agent Date Print
Owner/Agenl's Name Signature
of Notary -State of Florida Date Owner/
Agent is _ Personally Known to Me or Produced
ID APPLICATION
APPROVED BY: Bldg:' Zoning: _ Initial &
ativ Special
Conditions: Print
Contractor/Agent (s m Z
Si
afore - liot- t tc o Florida Date ANN
M. JoHNSM MY
COMMISSION I DO 28MW EXPIRES: MarRff?,
Contractor%1 nli5 IondpocarProducd IDMfg i • 'j2 5 LI Initial & Date)
Utilities: FD:
Initial & Date) (
Initial & Date)
POWER OF ATTORNEY
Date: i-a3-0ko
I, 130' nw, 4eg4r" u- , do hereby authorize iGn e, G •—eG+,v c-1
to pull the of wxmb'i rya permit for 114 RIcy e.ar• -\r • S0.--'Eora
type of permit address
1
Notary
Personally known to me or drivers license #
State of Florida, County of V 0,.K -,.t ,
IANA R. NARRISON
MY COMMISSION # DD 219M
EXP%S: June 5 2007
n,!t Ow4ed rn.:; :.wlen unPkundeiwAon
ASr+ day of