HomeMy WebLinkAbout1002 Gemstone Cove 06-2256 (low volt security)Permit # : 00 AC4 ✓'`"
Job Address: I
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Dater
Q aoUue
� O«fl-G2. 5_?C,� Total Square Footage
Zoning: Value of Work: $ ��. 00
Permit Type: Building
Electrical V
Mechanical Plumbing
Fire Sprinkler/Alarm Pool
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: # 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
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
Owners Name & Address:
Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender: _
Address:
Architect/Engineer:
Address:
Contact Person:
Phone: q
State License Number:
Phone:
Fax:
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 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 m be found in the public records of
this county, and there may be additional permits required from other governmental entities such as water management distri s, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien LWS 713_
Signature of Owner/Agent
Print Owner/Agent's Name
Signature of Notary -State of Florida
Owner/Agent is _ Personally Known to Me or
Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 03/2006
Date Signature of
is Name
t
Date
Date Sigwve Votary -State of Florid TAW PM&SM OF FWRIDA
Kenya K. Lindsay
Commission # DD541618
Expires: APR. 18, 2010
Contractor/Agent is O�' Personally WVjMjW atlantic Bonding Co., Inc.
Produced ID
UTIL: FD:
ENG:
BLDG: