HomeMy WebLinkAbout175 Woodridge Trl (2)Permit #: V `�
CITY OF SANFORD PERMIT APPLICATION
Date: Q if /05 -
Job Address: I" 'S tobod R1d4P IAA; L SF?4FoA0 , FL
Description of Work: Ch�,� , ,$'kA a4�- }'1,Q,v� b h) y 0&e1 Q,Q,tt4-W jlszll.j /f1 --/-POJ
Historic District:
Zoning:
Value of Work: S 4 `l'V0,
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 l/ 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: 2 t44 iP
pos�co
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel#: aA -N-An - 56,5-owo- a
Owners Name & Address: -t "
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Co ractor Name & Address:
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Phone & F' x. qo1- Jaa— 7y�
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
(Attach Proof of Ownership & Legal Description)
Phone: �� �% - �3 - a
—State License Number: 64COOy Z d 1
Contact Person: R10tO FgCl°i1'Ktf{ Q Phone: qO'7
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 suchas 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 m Flo a w, FS 713.
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Signature of Owner/Agent Date Signature of Contractor/Agent Date
&AJl 41 Fft nw e R
Print Owner/Agent's Name Prin ontractor Agent's Name
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date
�% L -tNE BLANTON
DD 188491
Owner/Agent is _ Personally Known to Me or Contrac r/A' P' ;Personally;K�}� �qor
Produced ID _ Pr ur
APPLICATION APPROVED BY: Bldg: 611 1Zoning: Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions: