HomeMy WebLinkAbout2200 Country Cluib Rd 08-2244 plumbing new showerCITY OF SANFORD PERMIT APPLICATION
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4ppli�atioii # : � V •� 1� Submittal Date:
Job Address: - 9 0 Q ` (ZU,}�r � L(,(t �� W Q Vatue of Work: S
Parcel I[V" Al / L) Zoning: �/A historic District: t(/A
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Description of Work: 7y 5 1 4 PCy p, f 7- �C n Square Footage: n/
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Permit Type: Building ❑ Electrical ❑ Mechanical ❑ Plumbing III Fire Sprinkler /Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service - # of AMPS 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 P
Plumbing/New Residential: # of Water Closets Plumbing Repair - Residential ❑ Commercial L9�
Jccupancy Type: Residential ❑ Commercial fl Industrial ❑ Occupancy Use Group(s):
construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
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'rop" Owner- C- i—en 1 no tkiP% S Contractor_ >4 //Lo 4,4, a. /- S,- S
kddress: Address: ,0r
�a P,-L FLT 3 32^
'hone: E -mail: Phone: ��� ��t1 iLs I State License Number: (AC 0-S 79
3onding Company: Mortgage Lender:
\ddress: Address:
\rchitect/Enginecr:
kddress:
'Ian Review Contact Person: Phone: Fax.
Phone: _
Fax:
E -mail:
kpplication 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
ssuance 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
crinit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
SIR CONDITIONERS, etc-
)WNER'S AFFIDAVIT: 1 certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
onstruction and zoning-
YARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENT'S TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
IRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING. CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
IOTICE OF COMMENCEMENT.
IOTICE: 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
tis county, 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 th r�rty of the equirements of Florida Lien Law, FS 713.
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Signature of Owner /Agent Date Signature of Contractor/Agent'-
,l Date
Print Owner /Agent's Name Print ntractor /Agent's Name
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$ignatura of Notary -State of Florida Date Signature of Notary-State of Florida Date
Owner /Agent is _ Personally Known to Me or
Produced ID
TPROVALS: ZONING-
pecial Conditions:
cv 07.07 .
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Contractor /Agcy is.,
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