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HomeMy WebLinkAbout4585 St Johns Pkwy (hood) + (a) (4)Ill. p CITY OF SANFORD PERMIT APPLICATION Permit # : 0 CJj - I ;; Date: 9l-Z/ o RECEIVED Job Address: 't+SBS "• poVLVfq f San 1L dc SFp 2 3 2005 Description of Work: Historic District: Zoning: Value of Work: $ ;000 ` Permit Type: Building Electrical Electrical: New Service- # of AMPS Mechanical: Residential Non -Residential Plumbing/ New Commercial: # of Fixtures Plumbing/New Residential: # of Water Closets Occupancy Type: Residential Commercial Construction Type: # of Stories: Parcel P: Owners Name & Address: Mechanical 3<' Plumbing Fire Sprinkler/Alarm Pool Addition/Alteration Change of Service Temporary Pole Replacement New (Duct Layout & Energy Calc. Required) of Water & Sewer Lines # of Gas Lines Plumbing Repair - Residential or Commercial Industrial Total Square Footage: of Dwelling Units: Flood Zone: (FEMA form required for other than X) Attach Proof of Ownership & Legal Description) Phone: Contractor Name & Address: c -T-A-0- Adc %n' _ i*o o Qom,— Dkjd *(l(d- 9-_ ,u•5-7r4 31 " Z. •-&.-Stale License Number: d14C 0 (3S'o4.1 f Phone & Fax:y rel %4 Cr Contact Person: a e-v% 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, ctc. OWNER'S AFFIDAVIT: I certify that all of the foregoing infonnation 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, stale 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 S 713. i Signature of Owner/Agent Date Signature of Contractor/Agent Date Rr6'lex5 Print Owner/Agent's Name Pri ontractor/Agent's Nam Signature of Notary -State of Florida Dale Signature of Notary -State of Florida C 13f,ANTON Owncr/ Agent is _ Personally Known to Me or ContractC/Aent-is_.PersonallyAnomeyn P ;*Rr Produced ID P"—n;•eournmsoaCo• APPLICATION APPROVED BY: Bldg: -Mit-Zoning- Utilities FD: Initial & ate) (Initial & Date) (Initial & Date) (Initiall&at`) Special Conditions: J q 0 CITY OF SANFORD FIRE DEPARTMENT FEES FOR SERVICES PHONE # 407-302-1091 * FAX #: 407-330-5677 DATE: © PERMIT AQ-0 U BUSINESS NAME / PROJECT: ADDRESS: U3 A --I, PHONE NO.: ( acvg FAX NO.: CONST. INSP. [ ] C / O INSP.:[) REINSPECTION [ 1 PLANS REVIEW [ ] F. A. [ ) F.S. [ ] HOOD [ ] PAINT BOOTH (] BURN PERMIT [ ] TENT PERMIT ] TANK PERMIT [ ] OTHER [ ] TOTAL FEES: $ 4- C-3 (PER UNIT SEE BELOW) COMMENTS: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. H. 12. 13, 14. 15. 16. 17. 18, 19. 20. 5- -S-f - . =0 Address / Bldg. # / Unit # Square Footage Fees per Bldg. / Unit Fees must be paid to Sanford Building Department, 300 N. Park Ave., Sanford, FI. 32771 Phone N -407- 330-5656. Proof of Payment must be made to Fire Prevention division before any further services can take place. I certify that the above is true and correct and that I will comply with all applicable codes and ordinances of the City of San ord, Florida. M. 712M f - REVISION 1 PERMIT # O - ag C DATE PROJECT ADDRESS qSUS &L -,\,, CONTRACTOR \ f PHONE # 3 ' og FAX # DESCRIPTION OF REVISION R qN2 UTILITY DEPT lj WFIRE PREVENTION PLANNING BUILDING