HomeMy WebLinkAbout1303 Sanford Ave 09-469CITY OF SANFORD PERMIT APPLICATION
Application # : %) _ V � � Submittal Date: / . & q
Job Address: 1 3 o3 `) a(1'Ti -. r6 a V e. -, Value of Work: S �DOO . l RECEIVED
Parcel (D: 3 I MI "' J I - 50 (P ` O AOO -- OO on�g: Historic District: nln i /_% 2008
Description of Work: R L P to L A-CO M I N t- j-A-% 2 I e- Square Footage: 3 O
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Permit Type: Building ❑ Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler /Alamt ❑ 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
Plumbing/New Residential: # of Water Closets �/�
Occupancy Type: Residential ❑ Commercial K Industrial ❑
Plumbing Repair -Residential ❑ Commercial ❑
Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood "Lone: (FENIA form required)
............................................. ............................... d r e-
Property Owner: T I m 0THI Lu A- Contractor: 'FIBS( L N I 12 CL lS r -S n Q al. f,a,
NQ Address: t'Cp Se E D L 2� Address: 1 L ,
3 _D _71 G� C[JFL A 32- -73 2
1 - Y�o -7 - 3 y-q -
Phone: m3' (st3 33 E -mail: f b LJq dd) e- a � 1 60 Phone: c� t State License Number:
l \4 0,, t' e O �-
Bonding Company: Lt, CS4Cf t� Std / e Fi _0 Mortgage Lender:
Address: QVl vtr,eKa_ka, . S Ah Fa (Ls S,), Address:
Architect/Engineer:
Address:
Plan Review Contact Person:
Phone: Fax:
Phone:
Fax:
E -mail:
Application is hereby made to obtain a pemtii 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, [[EATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVrr: l cenity that all of the toregout, intomration 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
V%IPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE TI IF
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSUL -r 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 of the prop e of the requirements or Florida Lien Law-- FS 713.
'Z( /7� a
Signature of Owner /Agent Date �ignatuxe of ContractocAgent Da e
Print Owrier/Agent's Name Print Contractor /Agent's Name
Signature of Notary-State of Florida Date Signature o - +ary tat i F t
Iv1EY COMMISSION # DD6290
2 X011
c�. XPIRES: February 5,
�°F Fl-° FI. Notary Discount Asso^. Co. .
1- Swid- �OL1RY
, n �. r�.^ eta. ndan� +ltiAV�AJYbllti'erti�i- 'dl�''.
Owner /Agent is -_ Personally Known to Me or Contractor /Agent is Personally Known to tMe or
Produced ID _ Produced ID
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APPROVALS: ZONING- I Z/3/63 UTIL: FD: ENG: BLDG:
Special Conditions: 11 n
Rev 07.07 O1L l� Vr'L$�w`1�i Cca r.o�t, 5%q�► t✓ 1 �� SS 4t-1% t(g CoVcJ- tS / ,- for 4A 17 /1
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