HomeMy WebLinkAbout1403 Mara CtV
CITY OF SANFORD PERMIT APPLICATION
Permit N: 0 Date:
Ab Address: _ 717aca e�
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Description of Work: S i i� Total Square Footage _
Historic District: Zoning: a1�' 1 ofd $ C-,2 _73S.
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool _
Electrical: New Service - # of AMPS 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 Lincs
Plumbing/New Residential: # of Water Closets Plumbing Repair - Residential or Commercial _
Occupancy Type: Residential Commercial Industrial
Construction Type: N of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
Bonding uompaoy:
Address:
Mortgage Leader:
Address:
Architect/Eagineer.
Address:
Phone:
Fax:
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. 1 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: 1 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 ater management districts, stat agencies, or federal agencies.
Acceptance of permit is verification that 1 will notify the owner of the property of the requireme Florida Lie w, FS 7
Signature of Owner/Agent Date atur of- o ractor/Agent bate
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
_ Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 038006
UTIL: FD:
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Signatur of State UE0' BLANTON Da
MY COMMISSION # DD 188491
EXPIRES: February 25, 2007
1400.3 -NOTARY FL Notary DlecWd A1130C. CO.
Contractor gen is _"�crsona'�I'y own to a or
Produced ID
ENG:
BLDG01t h
L
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AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: NYR ,c� GYJ �(, License #:
/4--K C -Z)
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1 Project Information
Owner: / Permit M
name
/` 03 /?&,r, dl
address
phone
Subdivision:
Lot M
r
affiant hereby affirm that I am the duly licensed
> Y Y
contractor of record for the above referenced permit, that all the foregoing information is true
and accurate, and that the dry -in, flashings at the above referenced address or lot has been
installed in accordant with the applicable codes and standards.
Contractor:
signal
printed name
STATE OF FL
O
COUNTY OF
This instrument was acknowledged before me this day of , 206,(, -,-by the
above referenced individual, , who acknoxWedged that he/she is a
duly licensed contractor with , and who acknowledged that
he/she was authorized to execute this document. He/she is either personally known to me or
produced
WITNESS my hand and seal this
as valid identification.
day of , 20
olary Public
DEBBIE BLANTON
M . CoMM13SION O 0D X88481
EXPIRES: February 25 20o7
7ARY FL
nlaery qac A•eoc. Co.