HomeMy WebLinkAbout2315 Park Ave; 11-1891; RE-ROOFApplication -No: H — 1291
CITY OF.SANFORD
BUILDING &FIRE P:RE/ENTION
PERMIT -APPLICATION
Documented .Construction Value: $
Job Address: ? sr-S r) kYl ? a Histon.c District: Yes No M Parcel
ID: 2c, n La - n\ Zoning: SA -- Description
of. Work: 2 `- 11 Q-5 Plan
Review Contact Person: t C , C11CZIc it a: 1f Ylt' A ST Phone:
C Vli-l-= Fax: Property Owner
information Name Q -
Phone: Street: 25N
LL-La Resident of property? City, State
Zip: L-Lr EL SZ- 10 Contractor Information
byame \ I
Phone:. 64M)`"1 Stree . _ Fax:
City, State
Zip: _ State License No.: C—Bcf5I AlchitectlEngineer information
Name: Street:
City,
St,
Zip: Bonding Company:
LA Address: Building
Permit
IR Phone: Fax:
E-
mail:
Mortgage Lender:
l/ Address: PERMIT
INFORMATION
Square Footage:
Construction Type: No. of Stories: No. of
Dwelling. Units: Flood Zone: Electrical 0
New Service —
No. of AMPS: Mechanical 0 (
Duct layout required for new systems) Plumbing 0
New Construction -
No. of Fixtures: Fire Sprinkler/
Alarm O No. of heads:
l' .
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. 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 COMMENCEMENTMUST-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 property of the requirements of Florida Lien
Law, FS 713. The
City of'Sanford requires payment of a plan review fee. A copy of the executed contract is required in order to -
calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the plan
review fee based on past permit activity levels. Should calculated charges exceed the documented _ construction
value when the executed contract is submitted, credit will be applied to your permit fees when the permitisreleased_ Signature
of owner/Agent Date e of Contractor/Agent Date Print
Owner/Agent's Name Signature
of Notary -State of Florida Date Owner/
Agent is Personally Known to Me or Produced
ID Type of ID APPROVALS:
ZONING: COMMENTS:
t
Contractor/Agent's Name QEB13TEBLANTON --
Notary
Public - State of Florida My
Comm. Expires Feb 25, 2015 Commission #
EE 60182 Bonded
Through National Notary Assn. Contractor/
Agent is Personal own to Me or Produced
ID Type of ID e/ UTILITIES:
WASTE WATER: ENGINEERING:
FIRE: BUILDING: Rev
11.08