HomeMy WebLinkAbout1204 W 20 StCITY OF SANFORD PERMIT APPLICATION
Permit $1:- 2 Date: eh&)0(0
lob Address: r Dom) k/. d 0t1L J ,_ xe j� 0P
Description of Work:1 t.J \ �e ��ci S'h\ r4 .s �` Total Square Footage 1:2100
Historic District. Zoning: Value of Work: S .57to 00,
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Permit Type: Building Electrical r/ Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS 15 d
Addition/Alteration
Change of Service
Temporary Pole
Mechanical: Residential Non -Residential
Replacement
New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures
# of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets
Plumbing Repair - Residential or Commercial
Dccupancy Type: Residential Commercial
Industrial
Construction Type: # of Stories:
# of Dwelling Units:
Flood Zone:
(FEMA form required)
:)waers Name & Address:
Phone:
�oatractor Name & Address:? —er F ee.,r L
L L C l yq
�v � J t o, .St-
p
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State License Number:
?hone & Fax: i10� G S, 14 11 cllio
Contact Person:
%D Q� Yee 3/�t A" 4 r Z
b
Phone: t-) O1L �% Ii 0 t' /�
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3ooding Company.
kddress:
Mortgage Leader.
Wdress:
\rchilect/Engineer: Phone:
\ddress: -- --- ----- -- - - -- - Fax:
\pplication 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
ssuatrcc of s permit and diet all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate
Permit mast be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS. TANKS, and
UR CONDITIONERS, etc.
)WNER'S AFFIDAVIT: 1 certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
.onstruction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT M YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING. CONSULT WITH YOUR LENDER OR AN
\TTORNEY 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
his country, and there may be additional permits required from other govcmmental entities such as water management districts, state agencies, or federal agencies.
Wceptance of permit is verification that 1 will notify the owner of the property of the requirements of Florida Lien Law FS 713.
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Signature of Owner/Agent Date Pgnature of Contractur/Agent Date
f -U- q/ L
Print Owner/Agent's Name Print Contractor/Agent's N
Signature of Notary -State of Florida Date *.u,-eo Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
dPPROVALS: ZONING: UTIL.
pecial Conditions:
:cv 03/2006
FD:
Contractor/Agent is Pcrsonall KUP" to Me or. (b 1 S 3Z S
'duced ID
ENG:
BLDG:
a '0 - Z' 00ST--
Permit N: (,
Job Address: . 1.01,0
Description of Work: –
Historic District:
CITI' OF SANFORD PERMIT APPLICATION �(
Date: V II
c L_ l
_It 1&*, 5 M 1 V C..G VN G1" fyn* Total Square Footage
Zoning: Value of Work: S 4-/7 ot0 CD
Permit Type: Building Electrical Mechanical /\ Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service – N of AMPS
Addition/Alteration
Change of Service Temporary Pole _
Mechanical: Residential Non -Residential
Replacement I!,_
New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: N of Fixtures
P of Water & Sewer Eines
q of Gas Lines
Plumbing/New Residential: k of Water Closets
Plumbing Repair – Residential or Commercial _
occupancy Type: Residential Commercial
Industrial
Construction Type: I N of Stories: —I— q of Dwelling Units:
Flood Zone: (FEMi A form required )
owners Name & Address:
I onding Company:
%ddress:
Mortgage fender.
\ddress:
\rchitect/Eagincer: Phone:
ILddress: Fax:
\pplication is hereby made to obtain a permit to do the work and installations as indicated. I certify that no wort: or installation has commenced prior to the
ssuance of a permit and drat all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate
wrmit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS; POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
UR CONDITIONERS, etc.
26rZ
)WNER'S AFFIDAVIT: 1 certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
:onstruction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
. WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
\TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
40TICE: 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
his county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
Weeptance of permit is verification that 1 will notify the owner of the property of the regtrtfenSett f F ida Lien Law FS 713. /rp"f
x P 406
Signature of Owner/Agent Date Signature of Contractor/Agent Date
Print Owner/Agau's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
LPPROVALS: ZONING: UTIL: FD:
pecial Conditions:
:cv 03/2006
Print C tr or/ ent' Natoe
Signature of Notary -State of Florida Date
DEBBIE BLANTON
MY COMMISSION # DD 188491
EXPIRES: February 25,
Contractor/L
ra to or
Produ
ENG: BLDG:
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