HomeMy WebLinkAbout600 Upsala RdCITY OF SANFORD PERMIT APPLICATION
Permit No.: / -7 6 Date: t,t,h , DOy Job
Address: 600 U AS i kL scanl FL- - ;) -7-? Parcel
No.:'33-1 q - ,36 ` S-n F 0 000 !0 300 (Attach Proof of Ownership & Legal Description) Description of
Work: Q LK t4j(,L (1 DaK0 fa S Pevejao 1'b Plt 4' Type of
Construction: a e•I r XFlood Zone: Np Valuation of
Work: $ i0J 000. Occupancy Type: Residential Commercial Industrial Number of
Stories: Number of Dwelling Units: Zoning: Total Square Footage: Owner: S
0 e n'10. KE r(.. C0 !1 S Jt=R L_; a 11 Address: City:
6SG'
rl'tRJState: F-- zip: 3oZ_2 7 Phone No.: q 0 -
7 Fax No.: 140? 3,—1 ;k 0 Contractor: Sy10P_/» . na, + w
cc A t v, (,d, 7rnC _ Address: D 0 U .
fy' S" P T City: a/t!{ State:
Zip:3 0 l'77 State License
No.:
C aQ C 0S'D J y0 Phone No.: 7 0
7 - Q- 3 / 0II 3 Fax No.: Y0 % 3,.) — / of 0 Contact Person: _ D ea
11 110 C/YCt-Q Phone No.: q6 Y 30) D Z Title Holder (If other
than Owner): S&2M P Q SQ%d ve_- Address: Bonding Company: n
M-
Address: Mortgage Lender: Address:
Architect:
IG(., T
Q
P, ZZ ISO Phone No.: 1 +67 65+ 8-7;3 Address: i Z 2
i R.F&CccA S P-04 OfL. - GAr<I i;1: Fax No.: $A Mf4,_- Application is hereby made
to obtain a permit to do the work and installations as indicated. 1 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 of her/Agent
Date gighfituFel6f ntractor/Agent ate Agent's Name Signature
of Notary-Stath
of Florida PATRICIA A. MANN MY
COMMISSION 0 CC
men EXPIRES: April 5, 2002
Bonded Thru "I"y
n!! l ! un,"Mo s Owner/Agent is _ Produced
ID Date Personally
Known to
Me
or neaA Jhcvfiral e Pr'
ontractor/Agent's
Name Signature of Notary-Stat
of Florida Date R;M.- Contractor/AgentICIA
A. MANNSSION
i CC
721828S: Aprils, a mP" UndArrwtph Contractor/Agent isI/
Personally Known to Me or Produced ID APPLICATION APPROVED
BY: Date: -
k 3 - O 'Z Special Conditions: Q fi( *
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