HomeMy WebLinkAbout4250 Bloom Ln- CITY OF SANFORD
FEB 18 20 3 BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: Documented Construction Value: $
Job Address: c Lei > r Historic District: Xcs ❑ No lam"
Parcel XD: ] ��,�,�CrC) -Ci jt �!"?Jl) Zoning:' 1,
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Description of Work: Cor)c C:' =f' ),v-kI n R 4,
Plan Review Contact Person:
Phone:
Fax:
E-mail:
Property Owner Information
Title:
Name e -C - E'C'cc }. LA-rke- Phone:
Street: '"fa 6166V-4 V-4 tY),'_'_ Resident of property? • i `� �_
City, State Zip: &_%4=01
Contractor Information
Name
Street:
City, State Zip:
Phone:
Fax:
State License No.:
Architect/Engineer Information
Name: : IC A. `0 - C ✓1 1—n C'a Phone:
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Street: r2 rhe t �, ► N y�� t; -F l�'�r�. Fax:
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City, St, Zip: �r L 371�-7190 E-mail:
Bonding Company:
Address:
Building Permit ❑
Square Footage:
Mortgage Lender:
Address:
PERMIT INFORMATION
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:
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