HomeMy WebLinkAbout1150 Albright Rd 07-3127 SprinklerCITY OF SANFORD PERMIT APPLICATION
Application # :! 1 ,f_f_!. Submittal Date?�'lt.� `jI� � 1rD'`-"' r
Job Address: f l5 L� n t b1 ��- , i t�1 �(1 Value of Work: $ I 1 O �5 ' QQ
Parcel ID: LConinl;: f, p Historic District:
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Description of Work: � �R%I,�r��Z�-�)Dn ekD I e}��i5firr-�,-") IYP✓ 3CXI' l 6�.-lp.Square Footage: 'YFp a r 2nn;"
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Permit Type: Building ❑ 0ectrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler Alarm In Pool ❑ Sign ❑
Electrical: New Service - It of AMPS __ Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
Mechanical: Residential ❑ Non -Residential ❑ Replacement ❑ New ❑ (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: It of Fixtures # of Water & Sewer Lines It of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair- Residential 13 Commercial ❑
Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑ Occupancy Use Group(s):
Construction Type: # of Stories: It of Dwelling Units: Flood Zone: (FEMA form required)
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Property Owner: i�C 1'1 lam' �r� _ Contractor. �t"'1 e -dojo '•-I'rCL lIr ICI l bl %
Address: i - o f� %� t'1 t� r�Gi . r� f'
I � � Address:' i00 I l�' it �Y`(,l ,�- � Gt:1� l�,�Y"i
;Ct rt arr�.l t t `� `rl IIr ,:,k ,.-:�-1
Phonel(U 1,' U _ U14) E-mail: Phone [LRTA 'l lotc-State License Number:
HondingCompany: Min, Mortgage Lender:
Address: Address:,
Architect/Engineer: Phone:
Address:
Plan Review Contact Person:
Fax:
p G'SFtit�a a -r e(;' r,,
Phone Ul',r 'i Fax j��"? x'��'"j(08 E-mail: (�re��r,l-Pf-F;c,r,tGncqq
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 it 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.
Oj�I TIt E: 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 Floridp-L{en Law, FS 713.
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
Owner/Agent is ______ Personally Known to Me or
Produced 1D
APPROVALS: ZONING:. ___ U'IIL:
Special Conditions:
Rev 02/2007
Signature of Contyfic tor//
Print Contractor/Agent
Sagnat 11-6 ofNot A Statt
Contractor/
Produced ID
FD: _ t N". ENG:
Date
Name
of Florida Date
A$MLEY E GATEMAN
MY COMMISSION It D0647613
AXPIRFiS March 06, 2011
BLDG: