HomeMy WebLinkAbout1404 S Sanford AveCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: Documented Construction Value: $ 400
Job Address: kw -:S" At" Historic District: Yes 0 No 0
Parcel ID:
Description of Work:
Plan Review Contact Person:
Phone: Fax: 4:*
Zoning:
E-mail:
Title:
Property Owner Information
1 — dName7-ai;Allvf Phone:
Street: //'a, Resident of property?
City, State Zip:
Contractor Information
Name Phone:
Street: Fax:
City, . State Zip: 4LI a2ac State License No.: 1ZLm 1';4'
Name:
Street:
Arch itect/En g i neer Information
Phone:
Fax:
City, St, Zip: E-mail:
Bonding Company:
Address: .'
Mortgage Lender:
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SSa 0a 11912P,10 M03Ma33 'S INFORMATI
Building Per
Square Footage:
No. of Dwelling Units:
Electrical U't'__
New Service — No. of AMPS:
Construction Type:
Flood Zone:
Mechanical E3 (Duct layout required for new systems)
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satoa 33 W 110,22,
Plumbing 13
No. of Stories:
New Construction - No. of Fixtures:
Fire Sprinkler/Alarm El No. of heads:
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 understa-fid that a separate permit
must be secured for electrical work, plumbing, signs, wells, pools, furnaces, boilers, heaters, tanks, and
air conditioners, etc.
I
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 pen -nit fees when the
permit is released.
Signature of 0-w--nerTAgent Date
Print 0/,genrs Nirrie
Signature of Notary-S e DEB131h bb
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y larte of Fl r iodlA - state of FloridaN47olaryPubficgr
0* or gni2 5MyComm. Expires Feb40
Commission # EE 60182
I REM Bonded Through Natival NOWY Assn
Owner/Agent is Personally e or
Produced ED Type of IDYM ft1o—"1-T-/QrJJ r
APPROVALS: ZONING: UTILITIES:
ENGINEERING:
COMMENTS:
W-1 =
0 - - //
MBBIE BLANTOV'-
Notary Public - State of Florida
My Comm. Expires Feb 25. 2015
Commission # EE 60182
Boaded Through National Notary Assn.
Contractor/Agent is Personall Kno%lvm to Me or
Produced ID — Type of ID . IlVle
WASTE WATER:
BUILDING:
Rev 11.08