HomeMy WebLinkAboutSPECIALTY PERMIT APPLICATIONCity:
Zip:
6.V
Oil
ALM
Fee Due: Recef t# hermit #
Planw mg & Deyelopulent Servi&ai • SCANNED
Building, & Code Regulations Division'
2300 Virgfluia Ave.', BY
f St. E� u
Fort PieTee, FL 34982 'i� Cau my
(972)462-1553 f
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�. SPECTALTYPERNM Ai'PL•,YCA ON•• . .
tries,l ❑ Plumbing LSO HVAG ❑ Fence
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See Age 2 fot inMuct vm avid &4*10nalAperworkreq�rn,ed forspe '
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m/Site'Ad�: 41
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ID Numbere 7-7
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7Powrivhip, Raaytp TSapF+�ge zoning L9ed�Tee. • i�tNals
O,Q7Ce ilsF Section '
Only i ;.: • • .
:te De
scntion of 1'roiect or work'ri�ri/Pf1F
rS Lifosa6tlon 5. Conts actors InformaHoio
all 111M.
FL RegiCert'#:
. Z d2� '• CouantyCert#: �. • •L
Business Name:,
_ f• ._._ phoAe: ;�� . � 492LO Phone >7
of Construction: S �l. Lp 5
OWN AFFM,AW: I certify that all of tkl0 mfmmmdaa cm aivad in this sppIicatian is =reot
compliance ovitli all app&cable•iaws reguhting comstruetibn zoning_
OR;C • CTDR NAME SIGNATURE OF OWNER. Ok
SATE UFLOMA, COUNTY OF
ACKNO I UMGED SSfFORE ME Tfgs AY OF ioTL-L BY t f
WFIO IS NAI:LY KNOWN TO NM_jL OR WHO HAS PRODUCED
I
•',S CATION. ,
r CRYSTAL MARK CRUZA00
A- LAA-Au
(� �= M13910N8EE1$7483
SIC*NA OF NOT TYPE q PRINT NAME OF NOTARY i ��XMES Jum 26, 2018
COMMT SONNUAlBER� I f4d1)sse otsa �pMMt► apn
NOT! O Ol ]FAILURE TO IIECORri ANOTTCR OF COMVFXCEM7M MAY RM I,T IN YrO)OR PAVMG TRICE FOR
E"ROVBdV ENTS TO YOUR PROPERTY. 1P YOU MTEND TO OBTAINANCINGj CONSULT MM YOUR
LENDER OR AN ATTORNEY BEFORE RECORI)UgG YOUR NOTICE OF CO CEMENT,
M". A/4HEAT RRPLAC1EMIgNT WFM CONTRACT UNDER $7500.00
Revis /26/2010 '
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ZO/ZO 39dd dIV HOV3E N3SN3f ZOZEVEEZLL 06:VT VTOZ/ZZ/80