HomeMy WebLinkAbout217 Bellagio Cir 08-2088 (mech)O n f% CITY OF SANFORD PERMIT APPLICATION
Application # : �1 _ Submittal Date: *P
Job Address: G��% �,Z i��0 G!/1dG(i � ,t( %k/! JCG 31771 Value of Work: $—/,A frw
Parcel ID:
Zoning:
Historic District:
Description of Work: ul�JG. f�c(�7!¢GL 5 4- �- 7''0'/1 �� %(J d QC/Gr1 --" Stare Footage:
.......................................................................................... ...............................
Permit Type: Building ❑ Electrical ❑ Mechanical X Plumbing ❑ Fire Sprinkler /Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service — # of AIMPS Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
Mechanical: Residential ❑ Non - Residential ❑ Replacement ❑ New g (Duct Layout & Energy Cale. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential ❑ Commercial ❑
Occupancy Type: Residential ❑ Commerciale Industrial ❑ Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
.......................................................................................... ...............................
Property Owner: Contractor:
Address: Address: C -4,5;r %%/t (vt
Phone: q-0 7 U;-qM E -mail: SAI > DF.S ,V X(A, // /,/+CT Phone: State License Number: C& ay-s s-e
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer: (DIl.i14 /: !f`G� Phone:
Address:
Plan Review Contact Person:
Phone: Fax:
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 ofa permit and that all work will be performed to meet standards ofall 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.
Acceptance of permit is verification that I will notify the owner of the
Signature of Owner /Agent Date
Owner /Agent's Name
Signature of Notary-State of Florida Date
Owner /Agent is _ Personally [Grown to Me or
Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 07.07
UTIL: FD:
Contractor /Agent is
Produced ID
ENG:
3
,410N I Y///
ale ow'� t� vtc op;> .� �.