HomeMy WebLinkAbout129 Aldean Dr 04-343 RoofI Y .. ..
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CITY OF SANFORD PERMIT APPLICATION
Permit # : 0
Job Address: _ e
Description of Work:
Historic District:
2 L/3
Zoning:
Date:
r _ Q sC
Value of Work:
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 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 #: 3 _ — d s tR — ff01S" (Attach Proof of OOwne h' Legal Descr
Owners & ess: C. +
SEI
on)
1
Phone:
Contractor Name & Address: 7 11
Phone & Fax: --L
Bonding Company:
Address:
Mortgage Lender: .
Address:
Architect/Engineer:
q
OG State License Number:
Contact Person: Phone:
Phone:
Address: 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 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 maybe additional restrictions applicable to this property that may be fa in the blic records of
this county, and there may be additional permits required from other governmental entities such as water management district encies, o federal a cies.
Acceptance of permit is verification that I will notify the owner of the property of the requir is /FIa Lie w F
Signature, of Owner/Agent Date ure of Co ctor gent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
Print Contractor/Agent's Nalne
Signature of Notary -State of Florida Date
DEBBIE BLANTON
MY COMMISSION # DD 188491
Contra for EXFAawnai*tYaw25t 29Ne or
P OgVSM 96TARY FL NotaryDiscount Assoc. Co.
APPLICATION APPROVED BY: Bld Wak 1, 100 Zoning: Utilities:
Initial & Date) (Initial & Date)
Special Conditions:
FD:
Initial & Date) (Initial & Date)