HomeMy WebLinkAbout104 Spanish Hill Ct 04-307 Spa svcr-
04
CITY OF SANFORD PERMIT APPLICATION
Permit # :_ Date: i ;/ G U 7
Job Address:
1)
61V 1J y r l O— ZI . / Description
of Work: (/ _ f-etyi rn ,912,25-i' 0 v-) Historic
District: Zoning: Value of Work: $ OG_O Permit
Type: Building Electrical -/ Mechanical Plumbing Fire Sprinkler/Alarm Pool 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 Wa losets 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 #:
Owners
Name & Address: i
Contractor
Name & Address: Phone &
Fax: _ Bonding
Company: Address:
Mortgage
Lender: Address:
Architect/
Engineer Address:
7
Contact
Person: Attach
Proof of Ownership & Legal Description) Phone: /
G/o / l State
License Number: 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. II
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. 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. y
haonnuowAcceptanceofpermitisverificationthatIwillnotifytheownerofthepropertyoftherequirisofFloridaLienLaw, FS 713." ' oy Signature
of Owner/Agent Date ign re of Contractor/Agent Date a
x o Print
Owner/Agent's Name r /A e t Name' ig r'
o %D y' rn ra
Signature
of Notary -State of Florida Date <,n
gnature
of Notary -State of Florida Da 9 "• CD 4t: aq
0
O0 ON
W Owner/
Agent is _Personally Known to Me or Contractor/Agent is Personally Known to Me o Z w Produced
ID Produced ID APPLICATION
APPROVED BY: Bldg: Special
Conditions: Initial &
Date) Zoning:
Initial &
Date) Utilities:
FD: Initial &
Date) (Initial & Date)