HomeMy WebLinkAbout2350 Beardall Ave 09-181 IrrigationCITY OF SANFORD PERMIT APPLICATION
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Application N: 0 / - / i Submittal Date:
.:lob Address: .2B.5 0 �- ��1�rt_r_ �Z($/�� Value of Work: S 1:A / WI
Parcel ID: Zoning: Historic District:
Description of Work: /_—)SSA 4-d— / /�T /�iG� OJT Square Footage:
Permit Type: Building ❑ Electrical ❑ Mechanical ❑ Plumbirig �L 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 Cale. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
PlumbinglNew Residential: # of Water Closets Plumbing Repair -Residential ❑ Commercial ❑
Occupancy Type-. Residential ❑ Commercial ❑ Industrial ❑ Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FENIA form required)
. ... ............../...,. ........�.7...................... ................. ......... ...............................
�- Property Owner: �}�LD [ Jo[5 /E9r�5 � r • • • • •. • • • Contractor: C: L4 I tiTc%
f _address - 55 v 'address: � ��' \
V e: .
Phone: E-mail: Phon tLicense Number
Bonding Company:
Address:
Architect/Engineer:
Address:
Plan Review Contact Person:
Nfortgage Lender:
Address:
Phone:
Fax:
Phone: 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 %kith 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 ofthis 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 o the prope y of the requireme is tFa ZLien w . FS 3.
?//7/�6
SignatureofOwTter /Agent Date S' atureofContractor. /A ent Date
Print Owner /Agent's Name Print Contractor /Agent's Name
Signature of Notary-State of Florida Date tga VotarvsStattmt fdoridte Date
F,u,{�Y P "DEBBIE BLAN`FOIV'
MY COMp,ISS10N # DD629096
'9w�c)do EXPIRES: February 25,2011
Or _N FI. Notary Disco= A_oc. Co.
1- 81NF3- NOTARY
Ji. fk <? fa.•aL2 Ga�4 .1'1f'J:.Y'1.51iZP1�a2i'i,Ft/is 7f'11'')
Owner /Agent is _ Personally Known to Me or
Produced ID
APPROVALS: ZONING: -- UTIL:
Special Conditions:
Rev 07.07
FD:
Contmctor /Agent is Pers na Icy Known to Me or
Produced ID � '��Jk4
ENG: BLDG: