HomeMy WebLinkAbout611-636 Willner Cir Bldg 6 (fr sprnklr)0
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CITY OF SANFORD, FLORIDA
APPLICATION FOR BUILDI PERMIT
(Ql I—(.Q3cp_,W► On 'P
PERMIT ADDRESS
Total Contract Price of Job
Describe Work -
Type of Construction WWI
Number of Stories
Occupancy: Residential
Number of Dwellings
Commercial
-.1
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PERMIT NUMBER �tl1`1`�
Total Sq. Ft. ICMA . R.
Flood Prone (YES) (NO)
Zoning
Industrial
LEGAL DESCRIPTION (please attach printout from Seminole County)
TAX I.D. NUMBER
OWNER I
ADDRESS
CITY i
TITLE HOLDER
ADDRESS
CITY
BONDING
ADDRESS
CITY
ARCHI
ADDRE
CITY
(IF OTHER THAN OWNER)
COMPANY J //A
STATE
STATE
ZIP
ZIP
MORTGAGE LENDER
ADDRESS
CITY
STATE
ZIP
CONTRACTOR �2 1 I -� E 11ZP) l ) 2r- 10 K -J 1 r(S PHONE NUMBER � � 1-333
ADDRESS rel ST. LICENSE NUMBER
CITY STATE FL ZIP L 1
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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, PLUMBING, MECHANICAL, SIGNS, POOLS, ETC.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that
all work will be done in compliance with all applicable laws regulating construction
and zoning. A COPY OF THE RECORDED COPY OF THE NOTICE OF COMMENCEMENT WILL BE POSTED
ON THE JOB SITE WITH PERMITS NO LATER THAN SEVEN (7) DAYS AFTER THE PERMIT HAS BEEN
ISSUED. FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
THE 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, state 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, FS713.
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S' nature of Owner/Agent & Date Signature o Contractor Date
Lpil M.
�t wner/Agent Name pe or Print Co ractor's Name
ure %: ferry & Date S' ature of -Notary & Date
) (Official Seal)
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FEES: Building (-01-00
Radon
..
JOY 1. 80UCHARD
Notary Public, State of Florida
My comm. expires Oct 23,1995
Comm. No. CC154761
Appl ical?.'OW"Approved BY:
Date:
FEES: Building (-01-00
Radon
Police Fire
Open Space
Road Impact
Application
PERMIT VALIDATION: CHECK
CASH
DATE ( Q BY
ORIGINAL (BUILDING) YELLOW (CUSTOMER) PINK
(COUNTY TAX OFFICE) GOLD
(CO. ADMIN)
**** THIS APPLICATION USED'FOR WORK VALUED $2500.00 OR MORE
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