HomeMy WebLinkAbout144 Carmel Bay Dr (2)Permit # : 3
Job Address:
Description of Work:
Historic District:
Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date: v� 0
Value of Work:
Permit Type: Building Electrical Mechanical // Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential _,__--Non-Residential Replacement ✓ 'New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Name & Address:
(Attach Proof of Ownership & Legal Description)
Phone:
Contract me & Address:TI'2/
7 State License Number:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer
Address:
—3 --�Tr Contact Person:
Phone:
Fax:
Application is hereby made to obtain a pen -nit 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
pen -nit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: 1 cenify 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 pennit is verification that I will notify the owner of the property of -the requireme"-of r w, FS 713.
Signature of Owner/Agent Date z7re
of Contractor/Agent Date ((((((
Print Owner/Agenrs Name
Signature of Notary -State of Florida
Owner;/Agent is Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg:
( Initial & Date)
Special Conditions:
Date
Priv ntWor/A'gnt'sNanie
Signature ofNotaiy-State of Florida Date
_.�-..-..rte-•�..1...
l I s s
Cor ttac(f r/<A'gent is Pe ,ora M or
Produced lDl`f i` MON
91scount Assoc• Co.
1.60d•3d��,, '.: i
Zoning: Utrhties"' "' FD:
(Initial & Date) (Initial & Date) (Initial & Date)
Permit # :J ' 0
Job Address: cj Clc-f-1i
Description of Work: wti, <—
Historic District:
Zoning:
CITY OF SANFORD PERMIT APPLICATION
e_
Date: I/ / / 0 S
f �
Value of Work: $ 07, doo oe
Permit Type: Building Electrical V Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS /So Additio Alteration Change of Service NO TemporaryPole i C S
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Name & Address:
(Attach Proof of Ownership & Legal Description)
Phone:
Contractor Name & Address: aw a.r• < /c U.tJ) I 'r, C.- 4 s a,{ k1,✓ s 4 S 1
/A�N4 S 0 rrµt State License Number: c, (306 )SS -0
{� M q0-2- y�7-
Phone &Fax: Contact Person: c...� oy L i Phone: 0
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer: Phone:
Address: 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
Signature of Owner/Agent
Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Special Conditions:
Zoning:
Law, FS
C,•
Print Contr6ctor/)&e6n-Nc Name
I (II t IQ
Signature of Notary -Sia et of Florida Date
tt;vOE A. DE GRAVE
'OMMISSION # DD 164280
a . 7 'IRES November 12, 2006
Contractor/Agent fsPetsoRally, KYmknlM e o'8,\ -o
Produced IDTV"\o CC) -",9 ' (DO "
Utilities:
FD:
(Initial & Date) (Initial & Date) (Initial & Date)