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HomeMy WebLinkAbout301 Larkwood Dr (3)//�� CITY OF SANFORD PERMIT APPLICATION Permit # : 0S n Date: _Job,Address:_ �! �q r K Lc') nC� ��1 LJ r ;Description oof _Work: M 00 r n-9 IC n {. P Yt Y'9 �J 4 Historic District: Zoning: Value of -Work: S S 6 0 0 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. Requited) 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 #: (Attach Proof of Ownership & Legal Description) / � _--Owners-Name & A_dd_reis: C� A 4r Y- �/ / �yJ j / A I h _ i 2Jg%'l i.L 2 S / CJ /c / I r �2 S ,, 3 ~4 �? r % Cy to � r , �Ud1 r G l / 2' "knorie: ��©7 - C� crib' �i/S3 / Contractor Name & Address: State License Number: Phone & Fax: Bonding Company: Address: Mortgage Lender: . Address: Architect/Engineer Address Contact Person: Phone: Fax: ne: 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 requirements of Florida Lien Law, FS 713. ,Signature o wner/Aggeent l / Date Signature of Contractor/Agent BWNTO U O I.' ignto I�or� fL, ot}a}P=9IaY�bFlbfiflaV # DD 18 491 Date EXi°HES: February 25, 2007 1-800-3-NOT,'Y RY FL ?letcry Discount Assoc. Co. Owner/Agent I _ P�cs�n y Know r Mfr Produced ID �� V � 7 Print Contractor/Agent's Name Signature of Notary -State of Florida Contractor/Agent is _ Produced ID _ APPLICATION APPROVED BY: Bldg.Zoning: o I t a ate) (Initial & Date) Special Conditions: Utilities: Date Date Personally Known to Me or FD: (Initial & Date) (Initial & Date)