HomeMy WebLinkAbout4395 St Johns Pkwy 08-2698CITY OF SANFORD PERMIT APPLICATION
Application #: �C1 — (.09 c Submittal Date: _
Job Address: 03 S ST zDM5 fti wifY Value of Work:
Parcel ID:
12.400. pO
Zoning: P—Z' ( Historic District:
No
Description of Work: F'0MC-e f;G �4I (0,6141-x, Square Footage: W/A
FEE
Permit Type: Building lla' Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler /Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service — # of AMPS Aj/T Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
Mechanical: Residential W f A Non - Residential ❑ Replacement ❑ New ❑ (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of FixturesAJ/#A # of Water & Sewer Lines Q A- # of Gas Lines _0A�
Plumbing/New Residential: # of Water Closets NA Plumbing Repair —Residential ❑ commercial ❑
Occupancy Type: Residential ❑ Commercial ❑ Industrial G3,' Occupancy Use Group(s): iJ
Construction Type: ?J A # of Stories: Olt # of Dwelling Units: N .4 Flood Zone: N° TEMA form required)
............................................................................ ...............................
Property Owner: P—EELTYA1e MAgIeSTIkV, !95P.%C4S We-
Address: d3dIS_ ST Ib4N5. P/ft_W"
QWFW_te , FL- 32771
Phone:
E -mail:
Bonding Company: 11A
Address: P) A
Contractor: COWRO D CONSmVG110 i
Address: Sit CENTRAL f WV_ DANE
SMFOQa, FL 32771
Phone: 330,37.36 State License Number: CSCOSS«g
Mortgage Lender: )414
Address: A114
Ater: WITNE2 SUleyyo 4 Phone: J07'37.2 -2000
Address: _ R0.80K 823, SMF kr>.9 VIL 32772 Fax:
Plan Review Contact Person: STEVE: Phone: 330'323? Fax: 9445 E -mail:
Application is 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
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 laws regulating
construction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. 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 federal agencies.
kLccepta o permit is nfication that I will notify the owner of the p op of the requ' eme s of Flor' Lien Law, FS 713.
`1.2R •o$ 9 •Zq•oC>
Sig ture of Owner /Agent Date Sign re of Contractor /Agent Date
<4W F-4 co�1QAA
LUCY L. HISE - (�
tMIZ V.
ly Commission Expires Jan 24, 2011
Commis N l
ano Noa ySAssn.
Bonded By a
Owner /Agent is _ Personally Known to Me or
Produced ID ��GG
APPROVALS: ZONING: TJ� UTIL: _
Special Conditions: / i2 I
Rev 07.07
FD:
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91?fft.4 Co,IMID
Produced ID
NOtetY Public a
Iy Commiss on ._
Personally Known to Me or
L!/.2 / 8
BLDG:
IF
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AGENTS AUTHORIZATION
To Whom It May Concern:
Stephen Conrad is, authorized to act as my agent and on our behalf in all
matters concerning submittals, permitting and construction for 4395 St Johns
Parkway, Sanford, FL 32771. Parcel ID #:28- 19- 30 -5JB- 0000 - 0350..
Signatwre: s Date
Print Name:
State of Florida
County of Seminole
Sworn to and subscribed before me this day of 200_ by Stephen
Conrad (name of person acknowledged) who is personally known to me or who has
produced KRDWJ,i (Identification)
Notary Public.. f 'y-�jl ;$�jRY pvi, April Honeycutt
u" ? COMMISSION IDD785M
Commission expires: Lol2—
fly •; W�WWRAARONNOTSARYcolm
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