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HomeMy WebLinkAbout403 Mattie StCITY OF SANFORD PER r9T APPLICATION Permit No.: S- ` V / Date: Job Address: LI © 3 Mik-rT i 1= slwi Permit Type: Building Electrical Description of Work: A! F of Mechanical Plumbing Fire Alarm/Sprinkler ti " laA' t. Additional Information for Electrical & Plumbing Permits Electrical: Addition/Alteration _Change of Service Temporary Pole New AMP Service (# of AMPS ) Plumbing/Residential: Addition/Alteration New Constrim'aon (Ore Closet Plus Additional) , Plumbing/Commercial: Number of Fixtures Number of F;'ater ,.1k. Sewer Drainage Lines Number of Gas Lines Occupancy Type: Y Residential Commercial _ Industrial Type of Construction: 060a Flood Zon :'Ala Parcel No. • 6 c- - Z o / — O r_ Owner/Address/Phone:—rveoM.9 P m i, ew ) Contractor/, a Total ,q Ftg: U Value of Work: S Nuiabar of Stories:_ Number of Dwelling Units: n Z-( 2ZS/ a IL Attach Proof of O ership & Legal Description) yam Faso t v J State License Number: Contact Person: ;v h ftri 14. ! " ,,,`' LIC/r- Phone & Fax Number: Title Holder (If other than Owner): 'tc- Address: Bonding Company: t Address: Mortgage Lender: f/oA/ S 64AI r— " Address j /0 6 a-r-t Al vol /D r L Tc/M( Architect/Engineer Phone No.: Address: Fax No.: Application iu heraby made to obtaYn s rermit to do the work and insinhations 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 O`XINER: 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. t Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713. Sipadre of Owner/Ag t Date •:1atir, a of Contractor/A t Date AAol. eve, R<,,— cPrWOwmer/ Agent's Name Prmt Contractor/Agent's Name z fM 4te 2Signature ofNotary- tate of Florida Date Signature of Notary -State of r orida sKWyo, i Melissa Cameron DONNAMORRI3c -Commission # DD079915 MYCOMMISSIONaCC9214834s? EXPIRES March 23 2004 pp` EXPiM Dec. 20, 2005 o :...... d' ' dF. Bonded Thm 7 01 , aonded Triru Notary Public Underwriters 1 OFFS nm` Atlantic Bonding co., inc. 0% 3a/Agent is P sonally Known to Me or Contractor/Agent is Personalll Known to Me or Produced ID _R iCrilJ I L- 1 O- Produced ID Y)/ b0y3/ iKJS'O APPLICATION APPROVED BY: r Date: v Special Conditions: - 4