HomeMy WebLinkAbout215 S Sanford AveCITY OF SANFORD PERMIT APPLICATION
Permit # :— KDU Date:
�.Tob Address:
"escription of Work: 45U-0 b % AL 5 r U ( CF e
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Historic District: Zoning: alue of Work: S 1000
Permit Type: Building Electrical X Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS 2-0 G Addition/Alteration
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential Commercial
Replacement
Change of Service _>�'— Temporary Pole
New (Duct Layout & Energy Calc. Required)
# of Water & Sewer Lines # of Gas Lines
Plumbing Repair — Residential or Commercial
Industrial Total Square Footage:
Construction Type:
# of Stories: # of Dwelling Units:
Flood Zone:
(FEMA form required for other than X)
Parcel #:
(Attach Proof of Ownership
& Legal Description
Owners Name & Address: c
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Phone:
Contractor Name & Address:
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State License Number:
C— C_ 0Ae,,:"gPP l g
Phone & Fax:
Contact Person:
Phone:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
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, s e agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the require nts f Florida L L 3.
Signature of Owner/Agent Date Signature of Con�tractor/Agent Dat�
Print Owner/Agent's Name Prin Contr cto� g n 's Name
�tpRY 9,,
Signature of Notary -State of Florida Date Signature of ; otary $tate of Floctda :got ;.`.. ,bio EMRENCE A. Ut GHAVE
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MY COMMISSION # DD 164280
rEXPIRES: November 12, 2006
Owner/Agent is Personally Known to Me or Contractor/Agent is _ PersonallyQwrl�toMe Banded Thru Budget Notary Services
_ Produced ID Produced ID 'i,N
APPLICATION APPROVED BY: Bldg: Zoning: Utilities: FD:
(Inti & Date) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions: