HomeMy WebLinkAbout1311 E 2 StPermit # : C1
Job Address c
Description of Work:,
Historic District: Zoning:
s ��r �' � a r �r "ed r ? � r. to "�'•�'� daY kt'g 11 Yds ryeru � �. �1
.� � Y• � t x ii r f� �� ���.� 3�1tn r '� l � .
SANFO4?.'.a'/.
Value of Work:
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm PoQI .
Electrical: New Service — # of AMPS A�ddition/Alter Change of Service Temporary Pole
Mechanical: Residential Non -Residential V Replacement New (Duct Layout & Energy C•a1E. Required)
F... _
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 4"*' Industrial Total Square Footage:
Construction Tyne: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Name & Address-
13116.
ddress:1311E. J-i�_
Contractor Name &"'Addref�:
C?/e I -) 3 d(
EA,
(Attach Proof of Ownership & Legal Description)
.1.1, — �r_s�
V4 -411,C 17c. �/
State License Number: C _ /'1/P,C403 6
Phone & Fax: 42.33-3- 25/2 Contact Person:
Bonding Company:
Address
Mortgage Lender: .
Address:
ArchitecuEngineer:
Address:
Phone:
Fax:
hone:
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. 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 la\vs mg;tii_ating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT 1N YOUI� 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 fedeml. agencies.
Acceptance of permit is verification that I %will notify the owner of the property of the requirements of Florida Lien Law FS 713.
. 7;e 09 g
Signature of Owner/Agent Date Signature of Contractor/Agent ( Date 's•+,Ho
Print Owner/Agent's Name Prin0ont��'me
I',�'2,q ;,•'oe:
Signature of Notary -State of Florida Date Signal e o7o:ary- tate of Florida Date ,�• � ,.._,
Owner/Agent is Personalh Knokcn to Me or
['reduced ID
APPLICA] ION APPROVED BY: Bldg:
Specie! Conditions:
rn
�• CA
n
Coil tractor/Ag,e : is _ Personal"% Known to Me or Q s N d
ProduceC .D O
N O �
Zoning:
[Initial & Date) (Initial & Date)
ult. ies: FD:
(Initial & Date) (Irwial & Dat;