HomeMy WebLinkAbout100 Willner Cir 05-1667_ e - .. . t� �tA ::J^ 'r :t' .•�.�. �> 4- 4NU `t�,t Lisa
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CffY OF SANFORD PERMIT APPLICATION .,++
Permit #: I O� /tsi`,� 7 Date:
Job,Address: _lit.✓it/�� .vrr2 i�D loot%/irr=i7 (2117 92-171 /�,C1)'417 YA117-5
Description of Work: _Pe,w g 5%verc, E�/7l•r►C-E WC) w5%.rrcj3!(Z7+��
Historic District: Zoning: Value of Work: S _;b Coe, go
Permit Type: Building 1 Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool ^._-_...
Electrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary Po)e,---
-
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: -V12— # of Dwelling Units: Flood Zone: (FEMA form required for o0w)• thin X)
Parcel #: J�- - / 11- 31) -- 00.--;iG'- C900 i7 (Attach Proof of Ownership & Legal Description)
Owners Name & Address: 14 /lt /%n1/20r_ 455e C'r L P C/O i//�S SD/ S AICW �/nRK dAE. ►✓,NT.R /,1t?I(
Contractor Name & Address: Pr1 T-! J4%1 0 a v 14 550 Z" -
1 /W 0RL 3,J Y/7 State License Number.
Phone & Fax: //G j- %U 03t/ he Z%/0•• D Z j/ Contact Person: PF Tt R R .v,4 u Or --Phone:
Bonding Company: //11A
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address: 9.33
T
Phone: C/0�%- 5!5 - 3_00V�
Fax:
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commrmt:erl 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 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 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.
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 verifrc 'on tha
Signature ofUwner/A ens
u, J
=aAgent's Nmer
Signature of Notary -State o
i
Owner/Agent is _ Perso
_ Produced ID
APPLICATION APPROVED BY: Bldg:
Special Conditions:
notify the owner of the property of the r
7 1 / Nf
Date
VP
Me or_
K— Z -2 10 r Zoning:
(Initial & Date)
of Floryia)Lien Law, FS 7
OWature of Notary-Stati,
Contractor/Agent is
_ Produced ID
Utilities:
(Initial & Date)
(Initial & Date)
(Initial & Date) r Jr
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