PLBD1410-0188-ApplicationPERMIT TREE
City of Parkland
PERMIT NUMBER
PLBD1410-0188
PERMIT NO
SUB -PERMIT
SUB -PERMIT
SUB -PERMIT
PLBD1410-0188
PERMITS
1
PERMIT TREE
PERMIT TYPE
STATUS
FEES CHARGED
JOBVALUE
WATER HEATER
APPROVED
$56.88
$2,043.00
TAL Of ALL FEE
DESCRIPTION
APPLIED ISSUED
FEES PAID BALANCE DUE
OWNER
2 HOT WATER HEATERS
10/24/2014
$0.00 $56.88
RICHMAN,JEFFREY &
FEES CHARGED FEES PAID BALANCE DUE JOBVALUE
Printarl• Tuperlav 7R Clrtnher 7fld
$56.88
$0.00 $56.88 $2,043.00
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City of Parkland
Building Permit Application
Contact Person: uyli
www.citvofparkland.or
Phone #:
4-13 E-mail: �,C/ ff ID- 1
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ALL OF THE FOLLOWING MUST BE FILLED IN BY APPLICANT, ACCORDING TO F.S. 713.135
Company Narne_ ,..; u,1 IUs
Business Address
City
it" ton
J
.4I.1 kp I 1 r
wig
Property Oinrrier's Meme
1. ,.11 •.
IOwner's 5treetAddress;.: i s t\+ o, ��
City State - Zip` Phone#
Master IrermWCNurriber
Date ,.
Canstrcidfian :Value
Engineer's' Name
Engir►tser's License #
{ ,/�/'� ` 2t� Y Arciifect's Name
ry 1 c (!it it, � I ) ' 10) 01 S 4. 0.1(J4Architect's Ucense4t
Job Site Address (i)),A Kw (mikr RtL) Block J Phone# - .
I Work Descriptions �'�t�.�1 lOj e t�V"] Dr (2) F'C) c aj on •-)-BJ 1
1.44o ._61W -W/
Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or Installation has commenced prior to the Issuance of permit
and that at work will be performed to meet the standards of all laws regulating construction in the City of Parkland, Florida. I understand that a separate permit may be
secured for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, BOILERS, TANKS, AIR CONDITIONERS, ROOFING, SHUTTERS, ETC.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCMENT 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
Co:n.tractor-
Notification E-mail: ,.11 Lk.)��PP ? u as Y? air •e
P/r.' t Name of Qualifier Builder:aWri—
License Cmber:--� ^
�� 1 f�
Signature of Qualifier:
Notification E-mail:
Property Owner
If 1 an ()61Q tOg1ISIV•'
Print Nam 4f - Property Own rl
lwner's %+'Dress:
Notary Public • Stan of Florid 8 l() c a ' UI � m meui
My Comm. Expires Aug 25. 201 Il )/ r j
1;ommismoa 9 H 131bn mIgnature of PropertylOwner:
On this •',day of ,''1 , 20 before me, the undersigned
notary Puhlic f therktate of Florida, personal appeared
`\;"01C1- /3.1.(11'• +,4nd w Ose name is subscribed to and within
the instrument, and he/she acknowledges the/she executed it. •
Al.
NOTARY PUBLIC, STATE OF FLORSpA
..i.f _ . �. .7 ..r+, !C.
PRINTED NAME OF NCTAIR/ P BL
rl'Personally known to me
0 Oath taken
NOTARY PUBLIC SEAL OF
OFFICE:
Application Approved By:
Permit Officer
d identification' • .'IESAK
otta?enar : .» ••. State of Florida
.. .ssion * FF 137629
e
On this :7-.'") day of . / ') . 20 yam' , before me, the undersigned
N_ ublic of the,Sta of Flori� personally appeared
• 5 ��c �.• per ' Not,
name Is subscribed to and within the
instrumenbd he/she acknowledges that he/she executed it. j
.r+.- / -`
-NOTARY PUBLIC, STATE OF FLORIQK) )
7 6, i%-/ C':;"
PRINTED NAME OF NOTA) PUB
{.'
O Personally known to me
❑ Oath taken
NOTARY PUBLIC SEAL
OF OFFICE:
Date:
ed Identifc>y LESAK
tHitery P*ic -State o1 Florida
a '.S 2QTI
Conlmlalfon # FF 137629
1