HomeMy WebLinkAbout1800 W 1 St 05-362 RoofCITY OF SANFORD PERMIT APPLICATION / /
Permit #: S
Date: e
Job Address:
Description of Work: Aw / ,^,
llHistoric. District: Zoning: Value of Work: $ U V t d v
Permit Type: Building lectrical Mechanical Plumbing Fire SDrinkler/Alarm Pnnl
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#;7_ ^f y ~C) `-~t/ "w — ( C) / 0
Atch Proof of Ownership &Legal P)escription)"') Art
Owners Name- `& Address:
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Contractor Name & Addr
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Phone:
Number: U
Phone:
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 theissuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. 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, regulatingconstructionandzoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR. LAYING
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 that I will notify the owner of the property of the$ents ofLF a Li 713. %
Signature of Owner/Agent Date An.yture of Co tractor/Agen Date
Print Owner/Agent's Name Pript.,Contractor/Agent's Name
Signature of Notary -State of Florida Date Sig re of 'o -State of Florida Date
DEBBIE BLANTON
Owner/Agent is _ PersonallyKnown to Me or MY Coe "
Contractor/ ge Pe o a1. "AWA14 RPM8491Produced [D _ Prod dtl
t E rr 1t3c8: February 25 2rx17
FL "Jot" DiscountAssoc. Co.
APPLICATION APPROVED BY: Bld '—,t=# ( 19 jbqning: Utilities: FD:
Initial &Date) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions:
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