HomeMy WebLinkAbout225 Kennel Rd (2)Permit #
Job Address: �s C
Description of Work: —
Historic District:
CITY OF SANFORD PERMIT APPLICATION
/?,o 4,0 A
— 2%- cJ f
Zoning: Value of Work: $ 5 060-._-f_�
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)
� ��T er
Owners Name &Address: � i
Phone: l�l�
Contractor Name & Address:
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` ,SSttate License Numbeerrp ,�/ ,�x�
Phone & Fax: 47 ��7 �3 l Contact Person: (: �6C �%7r wf Phone: Yf07 51t3 V -o
Bonding Company:
Address:
Mortgage Lender: C-rif�
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 addja!
requi rom other governmental entities such as water management districts, state a ies, or federal agencies.
Acceptance erificabify e o net of the property of the requirements ofJ59rida Lien Law, FS 713.
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Signatu f Owner/Agent Date Signature Contractor Agent Date
Print O�dAzant' i/ Print C n ' e
of Florida Date
C68M_# DD 129
11JAKi,ee or
APPLICATION APPROVED BY: Bldg:
Date)
Special Conditions:
Utilities:
FD:
(Initial & Date) (Initial & Date) (Initial & Date)