HomeMy WebLinkAbout117 Palmetto Ave (2)qt
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ermit #
Job Address:
Description of Work:
Historic District: f%2S Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date:
O /4
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Value of Work: $
Permit Type: Building Electrical
Electrical: New Service - # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential Commercial
Construction Type: # of Stories:
Mechanical Plumbing Fire Sprinkler/Alarm Pool
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Calc. Required)
# of Water & Sewer Lines # of Gas Lines
Plumbing Repair - Residential or Commercial _
Industrial Total Square Footage:
_ # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: ,,++ ,, (Attach Proof of Ownership & Legal Description)
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Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender: .
Address:
Architect/Engineer:
Address:
State License Number:
Contact Person: Phone:
Phone:
Fax:
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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
pennit 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 infonnation 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. 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 pennits required from other govemmental entities such as water management districts, state agencies, or federal agencies.
Acceptance of unit is erifica on that I will he owner of the property of the requirements of Florida Lien Law, FS 713.
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Signla/ture of Ow Agent a - 545v re- Date Signature of Contractor/Agent
Print Ownersge -s Na a oPr :5.16 re Print Contractor/Agent's Name
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Signa ure of Notary- to o lorida Date Signature of Notary -State of Florida
FLORENCE A. DE GRAVE
h9Y COMMISSION # DD 164280
r' �B o M e \_ V
APPLICATION APPROVED BY: Bldg:\ Zoning:
(Illitia Nkt
e)
Special Conditions:
Contractor/Agent is
Produced ID _
Utilities:
(Initial & Date)
Date
Date
Personally Known to Me or
FD:
(Initial & Date) (Initial & Date)
CITY OF SANFORD HISTORIC PRESERVATION BOARD
APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS
P.O. Box 1788, Sanford, FL 32772-1788
Phone: 407 330-5672 Fax: 407 330-5679
TO: THE HISTORIC PRESERVATION BOARD OF THE CITY OF SANFORD, FLORIDA
Downtown Commercial Historic District Residential Historic District
This application is filed in response to a notice from the Code Enforcement Department
ADDRESS OF PROP
Property Owner
Signature: Print Name:
Mailing Address: -,�55oCC o�
Phone: O Fax:
A licant/A
Signature: Print Name:
Mailing Address: v�
Phone: Fax:
I certify that all info a' c ined i pplication is true and accurate to the best of my knowledge.
Applicant/Owner: Date:
Please use the attached criteria c ecklist as a guide to completing the application. Incomplete applications cannot be
reviewed and will be returned to you for more information. You are encouraged to contact the preservation planner at
407-330-5672 to make sure your application is complete.
Description of Proposed Work/Application Category: (Check all that apply)
❑ Site Improvements/driveway/walkway ❑ Storage shed ❑ Moving structures
pReplacement windows or doors ❑ Underskirting ❑ Awnings
❑ New construction/additions Signs ❑ Demolition
❑ Roofs/gutters/downspouts ❑ AC/Mechanical ❑ Fences/Gates/Pergolas
❑ Replacement siding/flooring/porch ❑ Paint WOther
Completely describe the entire scope of work: all changes in material, color or location to the exterior of the building,
where on the property the work will occur and how the work will be accomplished. For large projects, an itemized list is
recommended. Attach additional pages if necessary. ,
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A Certificate of Appropriateness is valid for six months unless otherwise noted
OFFICIAL USE ONLY
Historic Preservation Board Me ing Date: Staff Review Date:
Application is Approved Approved with Conditions
Conditions:
Signed:
Date:
Denied
***This Certificate must be prominently displayed on the building when work is in progress***
Put in wall with 3" concrete screws
VOLTA
Vintage
Clothing *Jewelry
Furniture *Decor
More!!!!
48"
117 Palmetto Ave.
42"