HomeMy WebLinkAbout230 Kay's Landing DrCrrV OF SANFORD PFRMIl APPLICATI N
Permit
Job Address. lip
Description of Work*
Historic District. %;glue of Wr'
Pe,rmit'rype; Building Plumbing Fire SprinkleTIA)aM
Electrical: New Somme - # ofAJMPS AWiti(mAllwation --- Change of Service Temporary Polt
1�r�
MechMechanical:Residential — 'Non-Resideatial _._ Replacement ___ New --. (Du CH .a YOut & Calc. Required)
Plumbing/ Now Commercial: # of Fixtures - # Of Water &- Sewer I.ines- 4 of aw Lines -
PlumbingtNew Residential: 4 of WSW 00wq Plumbing Repair ... Residential or Commercial
Occupancy Type: Residential -- C0V1rnefcW -- Industria! Total Square Footage: ----
Corstruction, Type: of Stories: # of Dwelling Units: Flood Zone:. MA form retlolred for other than X)
parcel# ;.Attach proot of Oweenlillp & Legal Dese-AP0011)
0-^ners Name &
Address:
Picone:
Contractor Name &Add,,,,: C
State Lirenst Number. "r -JI
I�-
Contact Person: Phone & For --y-,9Q-= 3-1j�-1=L---
Bonding Company:
Additesi -
l.krty,sge Lendti
Address: C V
!Phone:
Fax: C'.
Address a,5: �
kp9lication 5 hereby Made CO Obtain 4 Permit to do the -*.Ork and 'Aqtii"Atiouti at indirsa". i that np work or justallaLion has commenced peal" ti the
ss ,e of a permit and that all work 14 -ill be performed to meet standards%`-alllaws rogulatilig contirtuction in this jurisdiction. I undet stand that a separate
permit must be secured for ELIECTPICAL WORK. PLVMBrN<'-, SIGNS. WELLS, FMIAM. BOILERS, HEKTFRIS. TANKS, and
AIR CONDITIONERS. etc.
atK �, '* that all -umtO a:id that all work will be done in corrpliance with all applicable laws iegulating
kfEj?Ay T: I certify - or the forcgoing informati0l., is Q0.
L
c*nstniclion and zoning. WARNING TO OWNER: YOUR. FAIL,VRE TO RECOPr) A NOTICE OF C0,1,AMENCEMENTMAY RESULT [N YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PkOPER.TY. IFYOiiiNTENC)TO()B'Ailql-',NANCtNG,CONSULT WITH YOUR L,ENDEROR. AN
ATTORNk Y 8 FFORF R_FCORDjr4G yOUR NOT'ICE r)F CoMmENC FM RN T
NQ e icquiremmas of this permit, then may be additional msuvtion.� applicable to this property that may be found in the public record' 0;
Tk�;�: In addition 70 the fhjs cojory, and there may be additions!nal permits required fronk ottxi we-governrital entittzi such As waver management dLitrictl, state agencies, or federal agencies
A,;cewance of permit is verification that I will notify the owner of the .property of the teilti"m e 16 Lien Law, F S -Z; 3
Signature of Ow neriA gent Date ign Lure o'Contractoc/Agent Date
Print L)I;.—. 1-1—Sent t Name Pr 'tcontmcto eni*
ofty it
Date
Signature of Notary -State oft lorlda patef
EXPIRES: November 12,200E
Gordeffh�rulud NltarvService!;
OwneriAgent is Personally Known to Me or C.)ntrartiinA anally Known to Ale or
Froduced ID prodlic.-d
A PFLIC A T ION NPPROVEL) BY: BkiF liming:
(I n; t I a I (initial & Datt) ({Initial dt Date)
Speciai Condltil;-ns: