HomeMy WebLinkAbout811-836 Willner Cir Bldg 8 (fr sprnklr) (2)a 3
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CITY OF SANFORD, FLORIDA
APPLICATION FOR BUILDINGRMIT
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PERMIT ADDRESS � ~ I ' � � . S uiic.� D PERMIT NUMBER
Total Contract Price of Job O 5;
Describe Work 7-T/Is 46/t 57Q,- .'^ f� ems
Type of Construction
Number of Stories 3 Number of Dwellings
Occupancy: Residential Commercial
Total Sq. Ft. 14�?691 LX
_ Flood Prone (YES) (NO)
Z c0 Zoning
Industrial
LEGAL DESCRIPTION (please attach printout from Seminole County)
TAX I.D. NUMBER
OWNER- C..kC 0%/1e0C Ar >: o
ADDRESS / e> f> nd4r. Pr
CITY j Mom ,S' ; S
TITLE HOLDER (IF OTHER THAN OWNER)
ADDRESS
L•s/K.VCG( A 9, 4 -. PHONE NUMBER
STATE' F_ L, Z I P 3 ZZ O/
CITY STATE
BONDING COMPANY
ADDRESS
CITY
STATE
ARCHITECT F,,
6 Pr
ILO
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ADDRESS -Z-57!5_—S:
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CITY L.J
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STATE
MORTGAGE LENDER
ADDRESS
CITY
STATE
ZIP
ZIP
ZIP -7 Z% 4197
ZIP
CONTRACTOR� 9C l � F," Spr) . - k �,�/"s ?� _ PHONE NUMBER
c/ 3 3 33 3 cj
ADDRESS ZO d("•" C* /'Z $ ST. LICENSE NUMBER
CITY A bl-G/Yl 0/1 41 S:Orsk-r- C STATE Joe ZIP
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
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WILL NOTIFY THE OWNER OF THE PROPERTY OF
THE REQUIREMENTS OF FLORIDA LIEN LAW, FS713.
*****#**************************************** ****** *************#************
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gnature of Owner/Agent & Date
Signature of Contractor & Date
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or Print Or/Agent Name
T pe or Print Contractor's Name
x B
ary b Date
1g ture o Notary & Date
T(Official
(Offib Seal)
Seal)
— : my Comm. Expires '
-
JOY 1. BO.LICHAnD
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March 19, 1995
SA- No. CC187574 `z
Notary Public, Stats of Florida
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My comm. expires Oct 23,1995
Comm. No, 00154761
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Appl'Yfiintd*W Approved BY:
FEES: Building
Open Space
Date:
Radon Police Fire
Road Impact Application _
PERMIT VALIDATION: CHECK CASH DATE 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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