HomeMy WebLinkAbout809 Scott AveCITY OF SANFORD, FLORIDA
APPLICATION FOR BUILDING PERMIT
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PERMIT ADDRESS yD C' SL 6 T TO ICJ.
Total Contract Pr'ce of ob _ . .3h0"h
Describe Work pf- JA,kTypeofConstructionQ
Number of Stories
Occupancy: Residential
Number of Dwellings
Commercial
PERMIT NUMBER d 2 — (,67 W
Total Sq. Ft. 200,40
Flood Prone (YES) (NO)
Zoning
Industrial
LEGAL DESCRIPTION please attach printout from Seminole County)
TAX I.D. NUMBER
OWNER fvy Q' //(7G•P/',S PHONE NUMBER yOyS{11t d'
ADDRESS2A 2f
CITY a: 77 STATE ZIP
TITLE HOLDER (IF OTHER THAN OWNER)
ADDRESS 1 ,
CITY STATE ZIP
BONDING COMPANY
ADDRESS
CITY STATE• ZIP
ARCHITECT
ADDRESS _
CITY
MORTGAGE LENDER
ADDRESS
STATE ZIP
CITY STATE ZIP ,
CONTRACTOR A r6r, V,5PHONE NUMBER a%d ZL `%f
ADDRESS `Z AV-L ST. LICENSE NUMBER GCLD X J%rP/
CITY A,p STATE ZIP
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, PLUMBING, MECHANICAL, SIGNS, POOLS, ETC.
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that
all work will be done in compliance with all applicable laws regulating construction
and zoning. A COPY OF THE RECORDED COPY OF THE NOTICE OF COMMENCEMENT WILL BE POSTED
ON THE JOB SITE WITH PERMITS NO LATER THAN SEVEN (7) DAYS AFTER THE PERMIT HAS BEEN
ISSUED. FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOU PAYING TWICE FOR
THE 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 surer'16 water management districts, state agencies, or federal agencies.
ACCEPTANCE'. N RMIT IS VERIFICATION THAT I WILL NOTIFY THE OWNER OF THE PROPERTY OF
THE REQUIREMENTS OF FLORIDA LIEN LAW, FS713.
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Signature ooffOwner/A Date Signatur of CCoontr Date 0 aOe/
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Type or Print Ow er/Agont Name Type Pri actor's Name v x
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Signature of Notary & Date ignatu a No a & Date
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Y_ _(official Seal) _ _ _ _ _ Offic 1)
App 13
FEES: Building Radon
Open Space Road Impact
PERMIT VALIDATION: CHECK CASH
or undaA ing
l My Commr wn =90128
i r, ExW@s December 09 2004
Date: 2
Police Mre
Application
DATE BY
ORIGINAL,(BUILDING) YELLOWu,(CUSTOMER) PINK (COUNTY TAX OFFICE) GOLD (CO- ADMIN)
THIS APPLICATION USED FOR WORK VALUED. $2500;.00 OR MORE
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