HomeMy WebLinkAbout1408 Sanford AvePermit H
CITY OFSANFORD PERMIT APPLICATION
Date: .7-7-0- 0(a
Job Address: V D fyr wx-
0
Description of Work: ��. '! t� G X00 ee WA
M%-Aaf tZQOifol7quare Footage—LVO
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Historic District: /7 U Coning: %C.� t OI C�TIO Value of Work: $
is• O 6
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm 11001
Electrical: New Service - H of AMPS Addition/Alteration Change of Service Temporary Pole _
Mechanical: Residential Non-Residcntial Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: q of fixtures 0 of Water & Sewer lines p of Gas lines
Plumbing/New Residential: tl of Water Closets Plumbing. Repair - Residential or Commercial _
Occupancy Type: Residential Commercial Industrial
Construction Type: N of Stories: q of Dwelling Units: Flood Zone: (FEMA form required )
Owners Name & Address: 1410
Contractor Name & Address:
Phone & Fax:
Boading Company:
Address:
Mortgage Lender. .
Address:
Architect/Engineer:
Address:
Phone:
State License Number:
Contact Person: Phone:
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, I IEATERS, 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 M 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.
NOTI E: 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 it is verification 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
Sig,
i of Owner/ g t Dat Signature of Contractor/Agent
Print Contractor/Agent's Name
Date
NbsillivomEAdalwy-State of Florida Date
/ YVONNE NOWtELL
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Owner/Agent is _ Perso 1 Known to aW", rYf 1CRtr/Agee
Produced ID a
APPROVALS: ZONING:
Special Conditions:
Rev 03/2006
UTIL: FD:
Personally Known to Me or
ENG: BLDG: