HomeMy WebLinkAbout411 Wylly Ave (a) (2)-
/ C(TY OF SANFORD PERMIT APPLICATION RECEIVED
I_q_A- ._.__��++ date: FED V 2 2007
Address: ...)
AAi Forzo
5� . y � c, ro vE
cription of Work: !t?r�t > ~- � ���;i•� t3� h
--- ---- _------ „- Total Square Footage f�
toric District: / — 'zoning. ( G.: � 2+ Vaiuc of Work ��d��
mit Type: Building c/ Giectrical Mechanical v Plumbing Fire Sprinkler/AI<uut Pool
etrical: New Service - # of AMPS _ Addition/Alteration Change of Service --_ Temporary Pole
chanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
mbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
mbing/New Residential: # of Water Closets po' Plumbing Repair -- Residential or Commercial
:upancy Type: Residential Commercial W Industrial
istruction Type: \5— —# If Stories: # of Dwelling Units: Flood Zone: _ (FEMA form required )
Aft
Name & Address: 1r "_" V�vP/L^-PIPJ ju�S 1.r�
tractor Name & Address: '
-- -- State License Number
ue & Far:
Jing Company:
ress.
tgagc Lender:
ress:
litect/Eagineer
ress
Contact Person:
Phone.
Fax:
icatiou 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
ace of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. t understand that a separate
it must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BO(LERS, HEATERS, TANKS, and
CONDMONERS, etc.
IER'S AFFIDAVIT: t certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
ruction and wring. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT M YOUR PAYING
-E FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING. CONSULT WITH YOUR LENDER OR AN
3RNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
ICE: In addition to)ale t oquir f Utis permit, there may be additional restrictions applicable to this property that may be found in the public records of
ounty, and there ,jnn jl 1 bead tional its r aired Eom o" govemmental entities such as water management districts, state agencies, or federal agencies,
prance o is veriF tion I will tfy the o the pro erty of the requirements of Florida Lien Law, FS It 3.
Sign eof t O e Signature ofConuactor/Agent Date
Z A/C) ePf T`
ntOwnerlAgent's Name t -,-\ - Print CoattactorlAgent"s Name -�
4 ature of Notary -State of Flortda Date
z��r ;butt^ JO ANN k
JOHNSON
* MY COMMISSION # DD 285622
EXPIRES: March 23, 2008
()weed ent i°srF`oR\�pPers"odr�iajjy4151@IYLe@lr
.OVALS: ZON�
of Cortditrott5:
312006
Signature of Notaty-State of Florida Date
>nttactor/Agent is _ Personally Known to Me or
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