HomeMy WebLinkAbout118 Circle Hill Rd - P08-001088 (WATER HEATER REPLACEMENT) DOCUMENTSCITY OF SANFORD PERMIT APPLICATION
Permit # I V00Date:
S—Dp Job
Address: 11 9 0-n12 ( L F AI I &L Pc l Description
of Work: b .1 y G LC% {Q+ C A> l`+ Pt p-tF i
Historic District: Zoning: Value of Work: $ 5V '4 d Permit
Type: Building Electrical 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 Residenti or Commercial Occupancy
Type: Residential Ll"" Commercial Industrial Total Square Footage: Construction
Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required toy other than X) Parcel
tl: OY 'ofU" :% Owners
Name & Address: Contractor
Name & Address: Phone &
Fax: Ij V Bonding
Company: Address:
Mortgage
Lender: Address:
Architect/
Engineer: •- Phone:
Address:
Fax:
Application
is herebymade to obtain a permit to do the work and installations as indicated I certify that n0. work or. installation has commencai prior to the issuanceofa'permit and that all work will be perfotmea to meet standards of all laws regulating construction in this jurisdiction. [ understand Ibai a separate permit
must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIRCONDITIONERS, etc. yeeg—
9/t>o (Attach
Proof of Ownership & Legal Description) LL
t\ Phone: S ,
t t
e ` Aa0C J r :7/ T State License Number:_01 at 0 s% Xontact Person:
127 AR- l< InAi-T /yl Phone: V.,7-77(1 G(d9s J OWNER'S
AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will I. be
done
in compliance with all applica1131c If?: f: rcrtrlating construction andzoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY REWL: f I)N )' (1I ))t PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LEND)111,) 01" 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 ltabl is t".Ords 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 [will notify the owner of the property of the requirements of Florida Lien Law, FS 713. 0 At,,,
eAZ41_ 3 Signature of
Owner/Agent Date Signature of Contractor/Agent Date Print Owner/
Agent's Name Signature of
Notary -State of Florida Owner/Agent
is— Personally Known to Me or Produced ID
APPLICATION APPROVED
BY: Bldg: Initial & Date)
Special Conditions:
Print Contractor/
Agent's Date Sign
Conn Zoning:
initial &
Date)
p6 ittido;
Mefor `'I.; i _ Utilities: FD:
Initial & Date) -
Initial & Date)