HomeMy WebLinkAbout1101 Bunhart RdPermit #
Job Address:
Description o
Historic Disci
a
CITV OF CANFORn PRRMIT APPLICATION i
Permit Type: Building )<__ Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
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 or Commercial
Occupancy Type: Residential Commercial < Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
40wners Name &
�Centractor Name & Address:
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Phone & Fax:
Bonding Company:
Address: (0
Mortgage Lender:
Address:
Architect/Engineer:
Address:
(Attach Proof of Ownership & Legal Description)
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_ Phone: LIO
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State License Number: R
F/ 3 19 �
s 3 - t!o S s5 Contact Person: � K.
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Phone:
Fax:
Application is hereby made to obtain a permit 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. 1 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. 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 roe that may be found in the public records of
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this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
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Acceptant t is verificatitin that 1 will notify the owner oft a property of the requi encs o FloLin, FS 713.
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Si ature of Owner/A e t Date ature of Cont Date
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to rrA _• rA Signature of Notary -State of Florida to Signature of Notary -State of Florida ate
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tv 0% Owner/Agent is Personally Known to Me 9[ �.�.{ Contractor/Agent is P,f�rsonal�Y KnowJ� to Me o
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APPLICATION APPROVED BY: Bldg: -Zoning: Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions:
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Date trusted at
APPUCATION Teh&
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CONCERN NO.
_.1_C�.21j07?-W--,t'-W=-.3 Ave.
6 90
F 306.1 Tarhua'.i: 4 P -t a. J 3 6 04
is to c!-,iiy '11V the m E e r a 1 s - d es, -"-ib ed on this ce-liflcve have peen /,'amc-
*re_=-,e_dor 2l-9 inhere.,7rly-nonilc171'fj-tE''D'ie.2nd were supplied x: A
N^1 IM Ten: Renmzl Co. ac.'. ..'AT 2102 W. W;--,a-zs Ave.
C,1STATH T -Florielz 23604
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Ger7ification is hereby made thE
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7,-,e E,-i--jes described on this with a flarne-retar-lan, a-orovo?-�
c iem. ical'and the application of done in ccniorman, ce with'F'edera!
Soe-_,;ficz;jon
MeT,cd of a)piic=tjon:
--,anne of flarn. fabric Or rinate'rial use.d.. Scs Shcu-c44e Cu&Tcme
Cheri. Rer
,. No = 306.1
Ifie '-'Jarne Ret_=rdant F,rocscss Used`_ Hl.!:N, Ot- Be, Reirnoved By Washing
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d. is rood for the Hie of e fabrid.! ehe'wal C6rk"ifi cation 'Onnecessary
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Color we;ght of fabric:
Description of item certified: 30 tent
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Name 0/ Appfi=V'ar Pmdtj=ict7 Superinrendent Caivin C. 01"
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