HomeMy WebLinkAbout2921 Orlando Dr 04-1287 SignCITY OF SANFORD PERMITAPPLICATION
Permit # : r) (A "' 'd 6 Date:
Job Address: (9 �A.I 091-!9 NAD DP_ .5le i ✓^-� cf- //0
Description of Work: 4; _— "& \ 0
Historic District: Zoning: Value of Work: s
Permit Type: Building Electrical Mechanical Plumbing Fire Spriukler/Alarm fool
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: It of Fixtures # of Water & Sewer Lines /t 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: (F'ENIA form required for uthee than X)
Parcel #: (Attach Proof of Ownership & Legal
Owners Name & Address: L1_-A ef{-1/ L hR e p< b 1-n a
Phone:
Contractor Name & Address:
State LIcyennse Number: _
Phone & Fax: C txc 1' r'on: � 11 h I I , n l'Imac:
Bonding Company: tiNjr i ]KI I
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Address:
Mortgage Lender:
Address:
Architect/Enginccr- Phone:
Address: ri r— ^ f�l I 1 I Fill M Fax:
Application is hereby made to obtain a permit to do the work and install ti !rt�,.s t jetted I er ify h no work or installation has commenced prior to tyre
issuanceofapermitand thatall workwill beperformed to meet standarxxallaws regulating cons ruction in this jurisdiction. I understand that it separate
permit roust 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 RESULTIN YOUR PAYINtx
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY, IF YOU INTEND TO OBTAIN FINANCING, CONSUL'!' WITH YOUR LENDER Olt 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.
of permit is
that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
0- (< =a Li
Signature of Owner/Agent
Prktt Owner/Agent'l ant
S
Signature of Contractor/Agent
Print Contractor/Agent's Name
otary-State of Florida Date Signature of Notary -State of Florida
Date
Date
Owner/Agent is _ Personally Known to Oe or Contractor/Agent is _ Personally Known to Me or
'11roduced ID S"'s -(-1 �� (i`� Produced ID
APPLICATION APPROVED BY: Bldg :l R�,� l -o c! Zoning: G g i' Ls- oa/ Utilities:
(Initial & Date) (Initial & Date)
Special Conditions:
FD:
(Initial & Date) (Initial & Date)
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etitrat 'Florida lChildrens Home
* CLOTHING 2�2I
S. ORLANDO DR. THRI T DE OT
* FURNITURE SUITE I 10 "per.-1 BN-
* HOUSE HOLDS Centrit. T,orida Childrel dome
* APPL:"ACES