HomeMy WebLinkAbout402 W 19 StPermit #
—.Job Address:
OS - - a, D
02 W
r Description of Work: ' C
CITY OF SANFORD PERMIT APPLICATION
S 4'4 S_'4.2str
E
Date: -� - Z a S
Historic District: Zoning: Value of Work: $_�
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm / V 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 Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:II SC `` (Attach Proof of Ownership & Legal Description)
4 Owners Name & Address: e- : A � . rw 1—y--,
,bntractor Name & Address: M
Phone & Fax: y 6 7
Bonding Company: _
Address:
Mortgage Lender: _
Address:
Architect/Engineer: _
Address.
Phone:
// State License Number: L'fL O 3&� 0 3
- 3 ry b Contact Person: t n -*,o 1' -1 Phone: _ y n l 3
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 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 l will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
Signature of Owner/Agent Date Signature o3Contractor/Agent Date
/ � \/IMUS VJ. Ll -\o —)
Print Owner/Agent's Name Print Contractor/Agent's Name
Signature of Notary -State of Florida
Owner/Agent is _
Produced ID
Personally Known to Me or
Date Signature of Notary -State of Florida
APPLICATION APPROVED BY: Bl gv ` Zoning:
(Initial & ate)
Special Conditions:
Date
Contractor/Agent is _ Personally Known to Me or
_ Produced ID
Utilities:
FD:
(Initial & Date) (Initial & Date) (Initial & Date)
r r e
CITY OF SANFORD, FLORIDA
PERMIT NO DATE 7 -; s 6S
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO INSTALL THE FOL-
LOWING PLUMBING WORK:
OWNER'S NAME a�oA2
ADDRESS OF JOB Gi' o 2— � �p fA_—
PLUMBING CONTR. Res. _ Comm.
Subject fo rules and regulations of Sanford plumbing code.
Residential: I Number
Amount
Alteration, Addit' n, Re air i
I
_
_
New Residential:
One Water Closet
�)
_
_
Additional Water Closet
Commercial:
�I
Fixtures. Floor Drain, Trap
—
Sewerr
Water Piping
Gas Piping
Factory -built housing
Mobile Home
Application Fee
_
_
Minimum Commercial Permit: $25.00 Total
Master Plumber
COMPETENCY CARD NO
05 3a
CITY OF SANFORD, FLORIDA
PERMIT NO DATE 7 ' a S ' 6S
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT TO INSTALL THE FOL-
LOWING PLUMBING WORK:
OWNER'S NAME �4'�`
ADDRESS OF JOB �� ° 2_—
PLUMBING CONTR. G�a.��_ Res. _ Comm._ _
Subject to rules and regulations of Sanford plumbing code.
Residential: j Number
Amount
Alteration, Addition, RRepa )
New Residential:
One Water Closet
�I
Additional Water Closet
_
Commercial:
it
Fixtures. Floor Drain, Trap
I�
_
_
Sewerr
Water Piping
Gas Piping
Factory -built housing
Mobile Home
Application Fee
_
Minimum Commercial Permit: $25.00 Total
Mester Plumber
COMPETENCY CARD NO. a
a
.. s