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HomeMy WebLinkAbout1700 W 13 St 03-2793 fire supression system.'1 - /- �, ;.�, f'.:M, ay oy 32 r F�4t "at s;.� y i .F ! { Y -k x t .� �.B t :-�4 r �' _ CITY OF SANFORD PERMIT APPLICATIO t fi C�; Permit # : `✓ b Date Job Address Description of Work: M1 V-IV-E SOMK95610 �® . Historic District: Zoning: Value of Work: $ .� Permit Type: Building Electrical Mechanical Plumbing Fi�re� ''� ��' Pool 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 Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial Occupancy Type: Residential Commercial Industrial Total Square Footage: Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: d, 1 4 1 2 (Attach Proof of Ownership & Legal Description) Owners Name &'Address: J<k N E�' Q I Vyt✓ k 0 9ff- b U 0 g7 9 I 0 a ( u 4'( , Jil tJ �U`�, t' (� )t/`d'1 1 Phone: L V 31,3 j -7 ® V Contractor Name & Address: 06 T7t _ , . - JZ 1 State License Number: A&A6S=i5V=R4 Phone & Fa W4- i (Acq)azk-© Contact Person: Phone: ) Bonding Company: Address: Mortgage Lender: - Address: Architect/Engineer: Address: Phone: Fax: 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 rclsN3tin construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULTFNT "YOUR P Aff hI(''r TWICE FOR 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. Acceptance of permit is verification th I it notify the owner of the property of the requirements of Flo da ien Law, FS 713. Signs `M of Owner/Agenk Date Signature of Contracto /A nt Date U04L s Name, S'Prt Contractor/Agent' a �11 �nt ""0 &idol a w �& State of Fl ida� Date Signature of Notary -State of Florida Date l�\J Owner/Agent is ✓ Personally Known to Me or Contractor/Agent is Per onaliv Known to Me or Produced ID Produced IDS . APPLICATION APPROVED BY: Bldg') ffi FZoning: Utilities: FD: (Initial & Date) (Initial & Date) (Initial & Date) Initiate l & - Special Conditions: 413 OD