HomeMy WebLinkAboutPERMIT APPLICATION::. J
offioeuse oni Master# .�pZA�O Permit# 2
JI,HIVIVL=L� S23oovu�MA County Lucie nue .�g �s6 g
BY Tel. 561-462.1553
•�t I iwip rmint,
APPLICATION FOR MEECHANICoAL/HVAC
Date: �5T T�
1. Location/Site Address:
2. Parcel ID Number.
3. DeseriPflon of Project or.
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Activitd•�if%�21ii/�/ � !P�°�Lr�CE �'O/1/�n�5i�/cl-�
List KW Rating for Heat Strips:
4. Owners InfOrmatiOU
Name:
Address:41 Q7 A/. NWV A iA
City: er / F"ecb State:
Phone: Zip-
6. Value of Construction: $ k200-
& contractors Information
FL Reg/Cert #: t'qC� tp
county Cert#: / 7 IK3
Business Name: L c iag&
Fees Due:
Receipt#
OWNER'S AFFIDAVIT, 1 Omft that W of the mlamiatioa coateieed in Gus application is carted and that ell wcwk wiU be done in Compliance
with all applicable laws regulating C=M ctian end Mdut.
it Yl.a a
QUA RMIRSIOWNERS NAME S LET TUBE OI AUFIEBlOWNRR
STATE OF FLORIDA. COUNTY OF�a � -�w^ �—
A WLEDGBD BEFORE ME THIS DAY OF WHO IS PERSONALLY
TO TIE WHO HAS PRODUCED f . _ As IDENTIFICATION.
J I1�Ati fi ��� Victoria Conrad
ommissionMD218897
MTU4=1?Np1ARy TYP£ORPRINTNAMEOFNOTARXt�_ xpires:Jun02,2007
,ram-l1t 'oie?. Bonded Thru
TITLE: NOTARY Y PUBLIC COMhDSSION NummER � a � '� '�'t•�, �. � � Ai!antic Bonding Co., Inc.
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OP COMMIENCEMENT MAY RESUI T IT YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. B: you IIA`rCr M TO OBTAIN FINATCINO. CONSULT WITH YOUR
LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
F3IFd1'Wr. ArC-HEAT REPLACEN[E T W1TH CONTRACT UNDER$5.000.
St. Lack C=* Au CaaAldatdng Perim, Application