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HomeMy WebLinkAbout1518 S Sanford Aver' CITY OF SANFORD PERMIT APPLICATION r Permit No.: V i I V/ ` I Date: b " .7 j'• 0 Z Job Address: % ,%ll .r fAW/04 Gt - Permit Type: V Building Electrical Mechanical Plumbing Fire Alarm/Sprinkler 1y7DescriptionofWork: .dam 1^J/X - ?-"tTd'I, t,/ 'v ti-tGA„ 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 ob Occupancy Type: _/Residential Commercial _ Industrial Total Sq Ftg: OU Value of Work: S 2/ 001 Type of Construction: Flood Zone: Number of Stories:_ Number of Dwelling Units: / - Parcel No.: Contractor/Address/Phone: T Contact Person: Title Holder (If other than Owner): Address: A Attach Proof of Ownership & Legal Description) CI State License Number: Phone & Fax Number: i0 % • ./Z Z - f',r fe Bonding Company: /V f`i Address: Mortgage Lender: Address: Architect/Engineer o 4 Phone No.: Address: Fax No.: 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. Sf&aturc of Owner/Agent DAe Signature o ontractor/Agent Date UZ_ 4' My Commm wn CC985425 ya adE' Expues pecembel 09 2004 Ua, QL_ oe Ow; ng ent is ersonally Known to Me or CCon or/Agent isl, Personall Kno rProduced —PWoduced ID f/ 3 63 •/6/73- / U y O APPLICATION APPROVED BY: Date: Special Conditions: