HomeMy WebLinkAbout1001 W 8 St - E08-000751 - OUTSIDE PANEL UPGRADEApplication # : , v — 0 S
Job Address: 01 —
Parcel ID:
CITY OF SANFORaPERMIT APPLICATION
Zoning:
Submittal Date:
Value of Work: $ / Qc )1 Oo
Historic District:
Description of Work:' 6.hftriCf i
Square Footage:
0.....................
Permit Type: Building [3, Electrical Mechanical Plumbing Fire Sprinkler/.A, larrmm Pool Sign
Electrical: New Service — # of AMPS Addition/Alteration 13 Change of Service t 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 Commercial
Occupancy Type: Residential Commercial Industrial Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
Property Owner: I { ( 9"C' )U LL / (T Contractor: 11 .dam
Address: ( IL) Address: d r
Phone: E-mail: Phone:?State License Number:
Bonding Company: Mortgage Lender:
Address: Address:
Architect/Engineer: Phone:
Address: Fax:
Plan Review Contact Person: Phone: Fax: E-mail:
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. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. 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 that I will notify the owner of,the
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:
Date
rida Lien Law, FS 713.
314-
ature ofContractor/Agent Date
Cvntmctor/drxent's Name
Date Signature
UTIL: FD:
Florida Date
i`%: DEBBIE,BLANTiOM
MY COMMISSION # DD629096
OF EXPIRES: Febntary 25, 2011
Ld{M13-NOT Y FI. Notary Discount . Co.
Contractor/A tv
Produced If e_
ENG: BLDG:
Special Conditions: <0 0
Rev 07.07 a