HomeMy WebLinkAbout2811 S French AvePermit #: d 5' 3"
Job Address: aB
CITY OF SANFORD PERMIT APPLICATION
Date: 5 -17-05
Description of Work:..%ZQl(t&a
Historic District: Zoning: Value of Work: $ 4360-.00
Permit Type: Building Electrical X Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration Change of Service TemporaryPole
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 X Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Owners Name & Address:
� ntractor Name & Address: L LC c r(A(C- 6 il
F� "\b0X' x-700 rd , i ngm e /a��, FL_ 3j,? 3 0
Phone 8( Fax: yU / — —_ (p l� Contact Person: _
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
(Attach Proof of Ownership & Legal Description)
Phone:
License Number: 2e�/ /�
Phone: ,qo7 R3 Ll q0
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 nermits required from other governmental entities such as water management districts, sate agencies, or federal agencies.
Acceptance of permit is verification that 1 will notify the owner of the property of the requirements o tori Lien L w,Y13.
713.
Signature of Owner/Agent Date Signature of Contractor/Agent D e
N, ZE L- 4-
Print Owner/Agent's Name Print Contractor/Agent's Name
3Ukl 8 • R4KU= 5-17-05
Signature of Notary -State of Florida Date Signature of Notary -Sat ff Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Special Conditions:
Zoning:
Contractor/Agent is X Personally Known to Me or
Produced ID
Utilities:
FD:
(Initial & Date) (Initial & Date) (Initial & Dale)