HomeMy WebLinkAbout1908 Holly Avej
CITY OF SANFORD PERMIT APPLICATION
Permit No.: Iy Date: s,; - -
Job
Address: D -J n I I:g- V e • J Permit
Type: Building Electrical Mechanical Plumbing Fire Alarm/Sprinkler 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: ZResidential Commercial _ Industrial Total Sq Ftg: Value of Work: S Z o oo , ad Type
of Construction: Flood Zone: Number of Stories:_ Number of Dwelling Units: Parcel
No.: 3 6 - ! q .- 3 o S". b I S-/ C (Attach Proof of Ownership & Legal Description) Owner/
Address/Phone: fj -g l `/c_sDiti i : / 31t - S"j coj" -Frfj-011 32
3 - !9-8 3 -9State License Number: GBCId 99 $F Contact Person:
0&.14411 apoo-,-r -e=PMnu 3&yArrPhone & Fax Number: _ s.y, G 195 A Av vt_ Title Holder (
If other than Owner): Address: Bonding
Company:
Address: Mortgage
Lender:"
Address: - --: •' • Architect
Address:
Phone
No.:
h b "2T Z qS3.S- 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 Twill notify the owner of the property of the requirements of Florida Lien Law, FS 713. G oZ
Signature of
Owner/Atent Date >Ignature of Contractor/Aitent e Owner/Agent'
s Nme I '- FS1,
E'l" Signatureo
o - tate of Florida Date CURnS & ELLERBE
Commisaton 2
CC 39&M ZRO• Sep
22, 20M Bonded Gen?
ins. Co. Owner/Agent
is Personally Known to Me or Produced ID
APPLICATION APPROVED
BY: ENyb- Contractor/Agent'
s Name 422=nn
h--) s ture ofNotary_
State ffOorida Date PAY JO
ANN
M. JOHNSON Afr COMMISSION #
CC 921808 EXPIRES: March
23, 2004 ded Toni
Budper WlAry Services Contractor/Agent
is Personally Known to Me or Produced ID
Date: 5-
6 -0 2- Special Conditions:
4
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JOB No. 114 CHK
BY. UPDATE
No. SCALE:
1/8'- V-0' DATE.
4/12/02 SHEET
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