HomeMy WebLinkAbout1253 W Airport Blvd 08-2359 antennas & grnd equip to owerCITY OF SANFORD PERMIT APPLICATION
Application #: ^ Ow, Submittal Date:
Job Address: II Q 'S W • 1 rar+ e 1j yd .��1 Value of Work: $
Parcel ID: 0 0 - go-So- Soo - 034,4 - V oo Zoning: � 1� Historic District:
Description of Work: Add.. ad enrias � Q rou -equ I P 4 y Aotz) Square Footage:
Permit Type: Building ❑ Electrical Mechanical ❑ Plumbing ❑ • • • •Fire Sprinkler /Alarm ❑• • • • • •Pool •❑ • • • • • •Sign ❑
Electrical: New Service - # of AMPS goo Addition/Alteration ❑ 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/New Residential: # of Water Closets
Occupancy Type: Residential ❑ Commercial Industrial ❑
Construction Type: I I - & # of Stories: # of Dwelling Units:
Plumbing Repair - Residential ❑ Commercial ❑
Occupancy Use Group(s):
Flood Zone: (FEMA form required)
•Property Owner • • I ' � �U t I ................. ..................Contractor:.. . CT W 17 .....0 ..r l.... ..... ; ... .
T -7I
Address: 311 I r. ►YI a �-� i n u 1° r l n r. B l vd flddress T
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m p . FL_ 9&o* L 42&lo
Phone: - r E-mail: n Phone. 13 3W6909tate License Number: FC 0001 UI -T3
Bonding Company: N A Mortgage Lender: 1J 1A
Address:
Address: O(UUT W -
Plan Review Contact Person:
Address:
T9; �er %ti Phone: S 13 -154- 914:g-
Phone: Fax:
G 3 Fax:
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 to4his 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 wat� management districts, state agencies, or federal agencies.
of
of p3p6yis verification that I will notify the owner of the property,
Date
C_ Z� C2 . tm� nL 8l ce
=8-01 eEofrlf4itg6Jlori a Date
rr++ ISSION # DD807880 S March 20, 2011 allotaryService. om
Owner /Agent is _ Personally Known to Me or
Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 07.07
UTIL: FD:
, FS 713.
Ntgn -ature of Contractor /Agent Date
% a -6( CV. S'c% /,emln)er
Prt ontractor/Agent's Name
8 /g /a8
Signature of Notary-State of Florida Date
4Pe5 E ANDERSON
ISSION # DD807880
S March 20, 2011
Contractor /Agent is allotaryservice.com
Produced ID
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