HomeMy WebLinkAbout1303 French Ave 05-2458 (mech)CITY OF SANFORD PERMIT APPLICATION
Permit #: M5 • *1qS p Date: �lll t'iti , Z,�rj
-Job Address: 1303 IP04WW
Description of Work: QZSCo.04 T %Aw%TS.Q1rngVFMM Qbot AuZ MQCWMrCC AFrr<st. ROOF i3 OCG
Historic District: Zoning: Value of Work: $ a U
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
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 Gras Lines
Plumbing Repair - Residential or Commercial _
Industrial Total Square Footage:
Construction Type: I # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel M
Owners Name & Address:
(Attach Proof of Ownership & Legal Description)
Phone:
.—Contractor Name & Address: A �Ffi�� T AzAe�Gtt��Yd3i>�C�St3C
�U�, SP ,�sGVs6w M. SA, Q,; s XL' !3y 13 State License Number: C14C l
Phone & Fax: `qm 36,L'1.4t81, l41laU $7+y•usti Contact Person: AN4CfttY LA)XIL%Af*U Phone: 41ftWZ��L'7 tti1.$�
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Phone:
Fax:
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 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. 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 require is of Florida ien Law, FS 713.
1
Signature of Owner/Agent Date Signature of Contractor/Agent Date
1I�N i.JSus
Print Owner/Agent's Name t Co tor/ is Name
S
Signature of Notary -State of Florida Date SignaturerofNotaryf NEEI$ GRAVE. Date
1401"*. MY COMMISSION # DO 164280
EXPIRES. November 12,2006
,
0onded Thru Budget Notary Services
Owner/Agent is Personally Known to Me or C ntractor/Agent is _ PersWally Known to Me or `,
_ Produced ID Produced 1D\ , 4 cJ '(��'�-'7'��1) `�
APPLICATION APPROVED BY: Bldg: Zoning: Utilities: ` FD:
(Initial & Date) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions: