HomeMy WebLinkAbout100 Willner Cir 05-16651, _ .may. ..,`t. ,,, . ,rT1tf r� � T,,}•`t_4 c �..ti
CITY OF SANFORD PERMIT APPLICATION
Permit # : D V �(lilU .� Date:
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Job Address: %t./ill�� .dT /2 /%Ors ioo1+ alazt-e L,,Z. !Z //A//%S r7/,/ /l/ y-%�/.�o'�,�� A�
Description of Work: 9%verc�- �-- r—c WOOL) ttz.fntr iv:w5�icec; ��i7yw,vL! Pc�r9irr �,v,,.�T
Historic District: Zoning: Value of Work: eg. ei'J _
Permit Type: Building 1 Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration Change of Service TemporaryPole _-
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: 42 - # of Dwelling Units: Flood Zone: (FEMA form required for otlwr flcao X)
Parcel #: J. L - A - 30 -- u0•-;i(i- U00 a (Attach Proof of Ownership & Legal Description)
Owners Name & Address: ,Lei WE A�,1/2,u: C-C% ,2N5 1-0/ 5 Ale w VORK d s11 /.N7-,ER
Contractor Name & Address: f ial�cn',4y Ji- rr r�55CC' Tiv' (r)u [ 'IyAI Vi 4iGhhit M
/O /, /• 1 /% ')c,L L rife D];I- State License Number:
Phone & Fax: /C'J- %%O Of7/ !_ %f0 D % r%/ Contact Person: FEE re i? l2Ar w/,4 u J1= Phone:_ yo,)_ 4G/c ' 3'7/Lf
Bonding Company: /2/1I4
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address: 933
Phone:
Fax: • 4.0
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has comme.nc:ed price' 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.
OWNFR'S AFFIDAVIT: 1 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 YO►Jlt 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 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 t 1 will notify the owner of the property of the requireme f Flori ien Law, FS 71
Signature of OwU/Ant Date Sign re Contractor/Agent
(16l,._.,
Print Owner/Agent' Name nt tractor/ gent's e
Signature of Notary -State SEvkswetE`- "' - d nature of Notary -State
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01 m t►000075242O ner/Agent is Me 6A ontractor/Agent is _
Produced ID _ Produced ID
APPLICATION APPROVED BY: Bldg f— Z Z 1 O T Zoning:
(Initial & Date)
Special Conditions:
Utilities:
(Initial & Date) (Initial & Date)
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