HomeMy WebLinkAbout1020 Laurel Ave 03-2332 Gazebo:; << CITY OF SANFORD PERAI'PLICA'1'ION
MIT'
Permit No.: ` Date:
--
dob Address: °` L
Permit Type: Building Electrical Mechanical Plumbing Fire Alarm/Sprinkler
Des'etipt on, of Work: e e � �--
Additional Information for Electrical & Plumbing Permits
Electrical:. Addition/Alteration Change of Service ,Temporary Pole _—New AMP Service (# of AMPS r�
Plumbing/Residential: Addition/Alteration New Construction (One Closet Plus Additional)
A;.
Plumbing/Commercial: Number of Fixtures Number of Water & Sewer Drainage Lines Number of Gas Lines
Occupancy Type: Residential Commercial _ industrial Total Sq Ftg: Value of Work $
Type of Construction: Flood Zone: Number of StoriesA �0 A Number of Dwelling Units: _
Parcel No.: (Attach Proof of Ownership & Legal Description)
Contractor/Address/Phone: PO
Contact Person: -'
Title:Holder (if other than Owner):
Address:
Bonding Company:
Address•
Mortgage Lender'
-R7
R 11��,t`ii'�``ytk%e�L cE!T�ts1le NJu�cR9n�ber: Lam' �C/!a, �1
kw1 y
Address-
Architect/Engineer - - /tiv I L~ % 1P C. Phone No
Address: jDb c� (_ �' �. 5 % 2 : C �� �j,�.1 tip : N ,!X Z , Fax No. f %�3'" `�2 7
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. 1 understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS,
POOLS, FURNACES, BOILERS, HEATERS, TANKS, and.AIR CONDITIONERS, etc.
OWNER', 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 A i"TORNEY 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 regords 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 requi - nts of Florida Lien Law, FS 713,
Signature of Owner/Aged .Date S' of Contra or/Agent t e
0 1. �)21 e_,
Owner/Agent is _
Produced ID
orida Date
' M. R0"' SON
MY COMMISSION # CC 970117
EXPIRES: December 16, 2004
Flooded Thru Notary Public Underwriters
Personally Known to Me or
Contractor/Agent
of Florida ! Date
'i KIM M. Rohr RrsoN
6,%0�*= MY COMMISSION # CC 970117
Z EXPIRES; Uecembar 16,2ow
nUornWd Thfu Notary Public Underwiten G
APPLICATION APPROVED BY:Date:
Special Conditions:
ally Known to Me or