HomeMy WebLinkAbout2605 Park DrApplication No: J ( — 3G(o
CITY OF SANFORD
BUILDING & FIRE.PREVENTION
PERMIT -APPLICATION
Documented Construction Value: $ 1909)
Job Address: % 0 S Ag)eK ZV I V E Historic District: Yes No
Parcel ID• Zoning:
Description of Work: RE't.fieMJ6 6 L QdK Irk,} L L SAT Wj s Woe_MED Z)OwIVLuc: TV Plan
Review Contact Person: AE11W D'y>9 yC- Title: ftft
Phone:
q0 % - ZZ l - g SG3 Fax: 407 - 32 0 - 07 0 (o E-mail: ONIREVOCKS Mleg O L - (OT Property
Owner Information Name
EVIN bet eg Phone: _y07- oSRl-(pf03 Street: _
RK PAlVE
Resident of property?: NO d 0/YM(ne'(- (6t City,
State Zip10'0la FL 3,-277 Contractor Information
Name Phone:
Street: Fax:
City, State
Zip: State License No.: Arch itect/
En.gineer Information Name: indemunn .
I enf2onl ueK g`ni mg`90 Phone: 3 1-2 - 2 4 2 - O'1 O O Street: To.
G o X 121 DSO _ Fax: 3 S2 - 2 L{ 2` 0 3 d 2 City, St,
Zip: C e((VIonT FL_ 3 712 E-mail: VAN W, Bonding Company:
Mortgage Lender: Address: Address:
PERMIT INFORMATION
t ' Building Permit
S/ - Square Footage:
Construction Type: No. of Stories: No. of
Dwelling Units: Flood Zone: Electrical Plumbing
New'Service -
No. of AMPS: New Construction - No. of Fixtures: + " Mechanical -(Duct
layout required for new systems) Fire Sprinkler/Alarm No. of heads: s
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 property of the requirements of Florida
Lien Law, FS 713.
The City of Sanford requires payment of a plan. review fee. A copy of the executed contract is required in order
to calculate a plan review charge., If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released.
Signature of Owner/AgeyU Vj Date
L D
Print Owner/Agent's Name
Signature of Notary -State of Florida Da
otter BAF AAC.FAGAN
DD 79W
EXr1AE
tuY SW" BadedTAru8ud0et Io
Owner/Agent is x Personally Known to Me or
Produced ID _ Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
UTILITIES:
Signature of Contractor/Agent, Date
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of M
WASTE WATER:
BUILDING: 1 Z o
Rev 11.08
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