HomeMy WebLinkAbout818 Sanford Ave (a)U alrva...t it L- 4W
JUL 2 6 2009
CITY OF SANCORD PERMIT APPLICATION
Permit # : `-' 1 _ t Qx :s _ 71 -1/v
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Historic District. Zoning: aluc,of, rk;..5t .� CJGIC>r
Permit Type: Building �t(— Electrical Mechanical Plumbing Firc Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary Pole
Mectlanical: Residential Nott -Residential Replacement New (Duct Layout & Energy Cale. Required)
Plumbing/ New Commercial: # of Fixtures _ # of Water & Sewer Lines it of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair - Residential or Commercial
Occupancy Type: Residential Commercial'T Industrial 'Total Square Footage:
Coustruction'1'ype: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than A)
Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
f of Civncrship & Legal Description)
A- 14 Phouc: -7
Contact Person:
State Liccuse Nutuhcr
f hu uc:
Fax:
Thune:
Application is hereby made to obtain a pennit to do the work and installations as indicated. I certify that nu work or installation has commenced prior to the
issuance of a permit and that all work will be performed to rnect 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 cumpliauce with all applicable laws regulating
construction and zoning. WARNINU TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPER'T'Y. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LIiNDER OIL AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NO'T'ICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that nuty be found in the public records of
this county, and there may be additional permits requited from other governmental entities such as water management districts, shite agencies, or federal agencies.
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:�u its ve i�fication that 1 will notify the owner of the property of the require�tn�' ttp�ti oaf Florida LielL,[,aw, F.' 713.
ute_wrier gent Date Signature of Contract / Agent Da
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��ner grflt�l`1ar�e- Print Contractor/ gcrmt's Name71, 051
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ure of Nota -State loric Date Signature I� Rotary-frtate o F on a ��1�ONDate
�aaYear s67 Vf'� 1. JOHNSON Uc13�31= B
• c r r, hIuSIOPI !; DD 18891
MY GOMMI�ION # DD 285622 tiv c;0,. , 2v 200-1
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TION APPROVED BY: B
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Special Conditions:
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