2874 Sanford Ave 08-1518CITY OF SANFORD PERMIT APPLICATION
Plumbing /Nett Residential: # of Water Closets
Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑
Plumbing Repair - Residential ❑ Commercial ❑
Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
.............. .... ......................................................................................................
Property Ottner: i'C// / /����'lii 6- ,�CZf/ Contractor: f�/' &i
%ddress y {L J Address:4 /
Phone: E -mail: PhonZZWState License Number:
Bonding Company: Mortgage Lender:
Address: Address:
- %r-chiiectr Engineer
-Xddress.
Phone:
Fax:
Plan Review Contact Person: Phone: Fax: E -mail:
�ppllcatiun a hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
;,,__nee 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
pernut must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
:%IR CONDITIONERS, etc
OWNFR'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 regulaur.g
construction and zoning.
%� %R\ING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING 'IA6ICc FOR
IMPRON'EMFNTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE 'I HE
FIRS I\SPEC'DON IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDI \G YOLK
NO iCE OF CONI:�IENCEMENT.
NO I ICE. 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 count\, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies
Acceptance of permit is verification- that I will notify the owner of tea ro j of the
Signature of Owner/Agent Date
Print O% +ner,Agent's Name
Signature of Notary-State of Florida Date
Owner :agent is _ Personally Known to Me or
Produced ID
APPRO \'ALS ZONING.
ipec:al Cond:uons
ire% j U-
UTIL:
FD:
Tentsorida Li lay✓ S 713.
ot00'?
Agent Date
Pri nt ontr ctcW gent'„
Signature of Notary-State of Florida ate
L -i �yy± B .`SON;
1.74'
c' r -`' t C':9�11SSIDN rf DD620096
e .
t; •`r:;- y�i'iRLa: Fcbnmry25.2011
F1. Notary Discount Assoc. Co.
,p 1- 8Cf1- 3•NOTARY
6oal�jt ,lµtuefl�'YAf'u'i.Y"tii��' ,
Con[rProduc gent is ersonally Known to � /l
_Produced ID __ 1, L
ENG:
BLDG:
S�(�
S f O ADC'
Application # V
Submittal Date:
Job .address: _ir%
/tJ,43Q'2L) 1614"
/E'G Value of Work: S
Parcel ID: / °a(D"J��
J'OC� `� %Ci
-CSC Zoning:
Historic District:
Description of Work: `��?�%rOCi/�(y
%
/ 2U
/
/ EYl1Jl'2i� <r$G il��/s� e <T/- �Ifuare Footage: J L l�7- J�
.........................................................................................
Permit'I' pe: Building ❑
Electricals Mechanical ❑ Plumbing
...............................
❑ Fire Sprinkler /Alarm ❑ Pool ❑ Stgn ❑
Electrical: New Service - # of
AMPS
Addition/Alteration E
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 /Nett Residential: # of Water Closets
Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑
Plumbing Repair - Residential ❑ Commercial ❑
Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
.............. .... ......................................................................................................
Property Ottner: i'C// / /����'lii 6- ,�CZf/ Contractor: f�/' &i
%ddress y {L J Address:4 /
Phone: E -mail: PhonZZWState License Number:
Bonding Company: Mortgage Lender:
Address: Address:
- %r-chiiectr Engineer
-Xddress.
Phone:
Fax:
Plan Review Contact Person: Phone: Fax: E -mail:
�ppllcatiun a hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
;,,__nee 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
pernut must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
:%IR CONDITIONERS, etc
OWNFR'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 regulaur.g
construction and zoning.
%� %R\ING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING 'IA6ICc FOR
IMPRON'EMFNTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE 'I HE
FIRS I\SPEC'DON IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDI \G YOLK
NO iCE OF CONI:�IENCEMENT.
NO I ICE. 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 count\, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies
Acceptance of permit is verification- that I will notify the owner of tea ro j of the
Signature of Owner/Agent Date
Print O% +ner,Agent's Name
Signature of Notary-State of Florida Date
Owner :agent is _ Personally Known to Me or
Produced ID
APPRO \'ALS ZONING.
ipec:al Cond:uons
ire% j U-
UTIL:
FD:
Tentsorida Li lay✓ S 713.
ot00'?
Agent Date
Pri nt ontr ctcW gent'„
Signature of Notary-State of Florida ate
L -i �yy± B .`SON;
1.74'
c' r -`' t C':9�11SSIDN rf DD620096
e .
t; •`r:;- y�i'iRLa: Fcbnmry25.2011
F1. Notary Discount Assoc. Co.
,p 1- 8Cf1- 3•NOTARY
6oal�jt ,lµtuefl�'YAf'u'i.Y"tii��' ,
Con[rProduc gent is ersonally Known to � /l
_Produced ID __ 1, L
ENG:
BLDG: