HomeMy WebLinkAbout2249-2269 Brookridge Trl (2)06/28/2013 FRI 15:30 FAX Quality By Design 0001/003
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: jo— )D—1
1 Documented Construction Value:
Job Address: ,r2c211Q —off jm2t:K 1 C.'i'aQ
rt
1 l Historic District: Yes No
Parcel ID'D'M r514 —6000 — 6-7 242 Zoning.,
Description of Work:
Plan Review Contact Person; ',j rr i. u Title: uLror
Phone• - Fax -00 a L E-mail: r . r^orl
Property Owner Information
Name Phone:
Street; Resident of property?:
City, State Zip:
Contractor Information
Name F'T nn I j:X,&Ahone:
Street,.M25 VI& cYrrtlFag: L
City, State Zip: State License No.:
Architect/Engineer Information
Name: Phone:
Street: Fax;
City, St, Zip:
Bonding Company;
Address:
Building Permit 13
Square Footage:
No. of Dwelling Units:
Electrical 0
E-mail:
Mortgage Lender:
Address:
PERMIT INFORMATION
Constructions Type:. No. of Stories:
Flood Zone:
New Service — No. of AMPS:
Mechanical 0 (Duct layout required for new systems)
Plumbing 10
New Construction - No. of Fixtures:
Fire Sprinkler/Alarm M No. of heads;
4rt a+iuy-
06/28/2013 FRI 15:31 FAX duality By DeSign 10002/003
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 prion 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, heater's, 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 Morida
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.
pp 6-
Signature of Owner/Agent Date - SI aturo of Contractor/Agont Date-
Print
ata
Print Owner/A gent's Name
Signaturc of Notary -State of1~lod& bate
Owner/Agent is Personally Known to lute or
Produced ID Type of ID
Print Contraotor/Agent's Name
Sign - to offlorida
K1MREALYA.PH1WP8
MY COMMISSION @ EE 077469
n
EKPIRESpp dl A, 2015
Bonded Trou Nol y Vuhtc Undarwrltors
Contractor/Agent is 'Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING-.
COMMENTS:
Rev 11.08
FIRE: BUILDING: