HomeMy WebLinkAbout2101 Airport BlvdPermit #: V(0
Job Address: P&
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Date. -a�0 - ;000/
Total Square Foobge j /LA
00
Zoning: Value of Work: S
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS ARD 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 Gras Lines
Plumbiug/New Residential: # of Water Closets Plumbing Repair - Residential or Commercial
Occupancy Type: Residential Commercial Industrial
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
Name & Address:
Contractor Name & Address: 5R 40WAIV/ � - CjZ W. JheYAV y //
)C?. -T,:771 P State License Number: f
Pbone & Fa:: 07-W -/%1 9107- 062 - 193 Contact Person: ��e--274770f Pboae:
Bonding company:
Address:
Mortgage Lender: Af
Address:
Arcblteet/Engineer: Phone:
Address: Fax:
39-73G 9
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 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 I property may be found in the public records of
this county, and there may be additional permits required from other goveromontal entities such as water anent d' .state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Sphlit Lien FS 713. , r- ,
Signature of Owner/Agent Date Si tune of tractor nt I Date
4
Print Owner/Agent's NamePrint nuactor/Agent' e
OA
j�g 6120
Signature of Notary -State of Florida Date Signature of Notary- o Florida
HEATHERKADKINS
w MY COMMISSION #DD5 W754
EXPIRES: May0.7o10
Owner/Agent is _ Personally Known to Me or Contractor/Agent is ersonaUy 390.0153 taorlda unary tlaMeuaoan
_ Produced ID _ Produced ID
APPROVALS: ZONING: UTIL: FD: ENG: BLDG:
Special Conditions:
Rev 03/2006
POWER OF ATTORNEY
Date: j 0
I, So hn Cdvyyi , do herby authorize eri,5-hn to
pull the El eC rl G'a' permit for Q I D/ A I r j)oY f (3) vGI . �Ci�l F- , 3a -7-73
Type of pemut
job address
IC
EATMMKADKINS
YCOMMISSIONiDDM""*
EXPIRES: MayIL2MO
FWft Noway 3w*w M
Personally known to me or 'vers license # ,
State o _ on a, County of on o2G_ day of
%UALf , 20 f k.