HomeMy WebLinkAbout114 W 1 St 99-0622 (int alt)ZONE DATE (,a-_ I —q
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ADDRESS
PHONE # (A 2 2- 2.�l1 T `3-2'?q
LOCATION
OWNER
ADDRESS
PHONE #
PLUMBING CONTRACTOR-'-) -5
ADDRESS
PHONE #
" ""ELECTRICAL CONTRACTOR ', -{� ,
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ADDRESS
PHONE #
' MECHANICAL CONTRACTOR
ADDRESS
PHONE#
MISCELLANEOUS CONTRACTOR
ADDRESS
SEPTIC TANK PERMIT NO.
SOIL TEST REQUIREMENTS {__}
FINISHED FLOOR
ELEVATION REQUIREMENTS
ARCHITECTURAL APPROVAL DATE:
PERMIT '# t�
JO Lu
COST
FEE $
STATE NO.
FEE $
FEE $ `
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FEE $
SUBDIVISION:
LOT NO.
BLOCK:
SECTION:
SQUARE FEET.-
MODEL:
EET:MODEL:
OCCUPANCY CLASS:
INSPECTIONS
TYPE DATE OK REJECT BY
FEE $ ENERGY SECT.
CERTIFICATE OF OCCUPANCY
ISSUED # J DATE:
FINAL DATE f
EPI:
CITY OF SANFORD, FLORIDA
APPLICATION FOR BUILDING PERMIT
PERMIT ADDRESS 1 %T (/V • ,e/IQJ S/,p� i> A
Total Contract Price of Job jaw a
Describe Work //y 725(i 04 C, T6( A 'y
Type of Construction S �/C.
1
PERMIT NUMBER -qq-G'(AO\
Total Sq. Ft. lot .,% ir%(�
Flood Prone (Y
Number of Stories Number of Dwellings Zoning
Occupancy: Residential Commercial Industrial
LEGAL DESCRIPTION (please attach printout from Seminole County)
TAX I.D. NUMBER
OWNER oRq&&4A1V Q 0 I 09L. AW06 PHONE NUMBER g'%? -41&9
ADDRESS 6VY C v G /
CITY 4V LAN Ob STATE ZIP 7 Lt0 /"
TITLE HOLDER- (IF OTHER THAN OWNER) IY1,}
ADDRESS
CITY STATE ZIP
BONDING COMPANY
ADDRESS
CITY
STATE
ZIP
ARCHITECT TjG GG% c�, I G►N DV/0
ADDRESS f�' wo0409* r -/C OLO0
CITY t9R[ANtln STATE /G(. ZIP
MORTGAGE LENDER Iy 1A
ADDRESS
CITY STATE ZIP
CONTRACTOR CN N r -C K AfrO G/ e,s 0 AG • PHONE NUMBER
ADDRESS 5 O!/v 7' C7. ST. LICENSE NUMBER
CITY w/n% STATE ZIP
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, PLUMBING, MECHANICAL, SIGNS, POOLS, ETC.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that
all work will be done in compliance with all applicable laws regulating construction
and zoning. A COPY OF THE RECORDED COPY OF THE NOTICE OF COMMENCEMENT WILL BE POSTED
ON THE JOB SITE WITH PERMITS NO LATER THAN SEVEN (7) DAYS AFTER THE PERMIT HAS BEEN
ISSUED. FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
THE IMPROVEMENTS TO YOUR PROPERTY. 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.
3\ ACCEPTANCE OF PERMIT IS VERIFICATION THAT I WILL NOTIFY THE OWNER OF THE PROPERTY OF
THE REQUIREMENTS OF FLORIDA LIEN LAW, FS713.
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Signature of Owner/Agent & Date
Signature of Contractor & Date
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Type or Pr' t Owner/
gent Name
Type or Print C tractor's Name
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Signature of tary ate
Signature of Notary Date
(Offici 1 Sea
(Official Sea )
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INOI C;i AEL f RUZ114KY
Public - StWe of H6ft*
My Commission Expires Oct 15, Z01
Commission # CC689016
FEES: Building l
Open Space
PERMIT VALIDATION: CHECK
MICHAEL PRUZINSKY
Notary Public - State of FlorWo
My Commission Expires Oct 15, 2901
Commission # CC689016 i.
Radon ' � Police Fire
Roa Impact Ap lic tion _
C.iSH DATE BY
ORIGINAL (BUILDING) YELLOW (CUSTOMER) PINK (COUNTY TAX OFFI E) GOLD (CO. ADMIN)
**** THIS APPLICATION USED FOR WORK VALUED $2500.00 OR MORE
20
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CITY OF SANFORD
FIRE DEPARTMENT
FEES FOR SERVICES
PHONE #: 407-302-1091
DATE: L �/ 7 * PERMIT #:
BUSINESS NAME: c kt�6"C -Jt * c 1/ „ P`�VF—(C .
P
ADDRESS: W. 1= t t2'5,
PHONE NUMBER: (
PLANS REVIEW TENT PERMIT
BURN PERMIT ❑ REINSPECTION
TANK PERMIT ❑ FIRE SYSTEM
AMOUNT
COMMENTS:
❑
❑
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Fees must be paid to Sanford Building Department, 300 N. Park Avenue, Sanford,
Florida. Phone # 330-5656. Proof of payment must be made to Sanford Fire
Prevention before any further services can take place.
& � 6 1 A'j? & -
Sanford Fi Prevention
I certify that the above information is
true and correct and that I will comply
with all applicable codes and ordinances
of the City of Sanford, Florida.
Applicants Signature