HomeMy WebLinkAbout1500 W Airport Blvd 16MAY 12 2011 CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: I ( Documented Construction Value: $ / Sid .ryo
Job Address: -v yn, ; ( Ly J # Historic District Yes No 1
Parcel ID• Zoning:
Description of Work: cam_ z-t& Gew%sa' / 0 42/7'Z,a eye / u_ JIQ Z ego lrlVd
Plan Review Contact Person: S VtP w ry -IrNAQ-cL-V110,ti Title: 14,
Phone: S Z - Fax: E-mail:
Property Owner Information
Name P ry C D CQz GowaogsS C Phone: L-\ 'off Street:
f :' Qo Resident of property?.: _ 'e S City,
State Zip:t- Contractor
Information Name
3Phone:._b Street: ?_b
1N Slk- PtLOZA zzT Fax: City, State
Zip: L 3Z r 3 State License No.:z oo 2y Architect/Engineer.
Information Name: Phone:
Street: Fax:
City, St,
Zip: E-mail: Bonding Company:
Address: Building
Permit
Mortgage Lender:
Address: PERMIT
INFORMATION
Square Footage:
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 0 No. of heads:
Application is hereby made to obtain a permit to do the' work arid`` nstallations 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 work, plumbing, signs, wells, pools, furnaces, boilers, heaters, 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 Florida
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.
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Rev 11.08
UTILITIES:
1`_
Signature of Contractor/Agent Date
2)6Z.t/rt/'s, /L /h -f 2iZ2
Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING: