HomeMy WebLinkAbout11 Garrison DrCITY OF SANFORD PERbffr APPLICATION
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Permit No.: b2,.LY Date o Z
Job Address:
Permit Type: Building Electrical Mechanical Plumbing Fire Alarm/Sprinkler
Description of Work: r,v- f i cr l ' o `w u S
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Additional Information for Electrical & Plumbing Permits
Electrical: _Addition/Alteration _Change of Service Temporary Pole New AMP Service (# of AMPS )
Plumbing/Residential: Addition/Alteration New Construction (One Closet Plus Additional)
Plumbing/Commercial: Number of Fixtures Number of Water & Sewer Drainage Lines _ Number of Gas Lines
Occupancy Type: _Residential Commercial _ Industrial Total Sq Ftg: , Value of Work: $ Q-
6
Type of Construction: Flood Zone: Number of Stories:_ Number of Dwelling Units:
Parcel No.: 3S•i4.3e. 20- a ROO -a,200 m'kPR R334e(Attach Proof of Ownership & Legal Description)
Owner/Address/Phone: Rolw Ait.2_®.46
P4
State License Number:
Contact Person: al"i'rQ?"327'{L o Phone & Fax Number:
Title Holder (If other than Owner):
Address:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer
Address:
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 perm it'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 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
Sighiturie of Owner/Agent Date
FiPr' t Owner/Agent's N
Signature o tary-State f Florida Date
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1*_&; wo
Signature of Notary -State of Florida Date
Melissa CammII
ROMI)m Ann
aCbmmt:on D00079956
Hooded 1bN P.
o„Atlantic Bonding CD. a=
Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID Produced ID Vl 3 ZG -9Z6 - — r,: 0
APPLICATION APPROVED BY: Date:
Special Conditions: