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HomeMy WebLinkAbout2408 Lake Ave (2)Permit # : ©� -�) l �v ` Job Address: a'i 0� ui� k J(� CITY OF SANFORD PERMIT APPLICATION Date: D% 6S - Description of Work: �e�l°`« S�w� `� Nk ro ^^ Qr.��i \-J Gsl Historic District: Zoning: Q.FS Value of Work: S SW "' Permit Type: Building Electrical Electrical: New Service - # of AMPS Mechanical: Residential Non -Residential Plumbing/ New Commercial: # of Fixtures _ Plumbing/New Residential, # of Water Closets 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 Line . ` Plumbing Repair - en or CommercialSyd`��\ 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 #: (Attach Proof of Ownership & Legal Description) Owners Name & Address: Phone: Alin (QW�a X`}\1 Contractor Name & Address: Phone & I Bonding Address: Mortgage Address: Architect/ Address State License Number: CFLCa� 1?a1 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 Print Owner/Agent's Name Date Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID APPLICATION APPROVED BY: Bldg: 4-.J' Zoning: (Initial Special Conditions: Lien Law. FS 713. Print p i+j ; WA DS Date S!Anatglecof NKMW AfWTDbHAVC Date MY COMMISSION # DO 164280 ¢ EXPIREQmbef 12, 2006 tarl C'dct8c/A Ail�IsonallyKnrtt5 g�rsonally Known to Me or Produced ID Utilities: FD: (Initial & Date) (Initial & Date) (Initial & Date)