HomeMy WebLinkAbout211-234 Rosecliff Ciro(,P- d39 /
CITY OF SANFORD PERMIT APPLICATION
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Description of Work: R of o i TotPOOH\ 6 T
Westoric District: Zoraot/H✓''Tf`/ W) rYalaeof Work:
Permit Type: Building Electrical Mechanical Plumbing Fire Sp inklerlAlwm Pool
Electrical: New Service — 0 of AMPS AdditionfAltoation Clamp of Service Temporary No
Medunieal: Residential NorrResdatttial Rgoaccmnt Now (Duct Layout & Coup Cala Required)
Plttmbinef New Commera&k' d of Fixtures 4 of Water & Sower Lioes ii of Gas Lincs
Plumbing/New Rrsiden6aL 0 of Water Closets Plumbing Repair— Rasidenfial or Commercial
Occupancy Type: Residential Commercial industrial
Construction Type # of Sloria4: X of Dwelling Volta. Flood Tone: (Fh MA form rarovd )
OwnersNasw&Addreo o/a1KL F C i—I hf Z-1-0
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Controdor Name&Address
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Phone & Fax: L
I Bonding Company:
Address,
Mortgage Leader:
Address:
ArebdectXnginew:
Address:
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F %( �S f i n. ^s cc -AZ- YStite l.ireose Number C h ef 0 S 79� 9
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Pbose:
Ness:
Applialion's 6weby ...a_ to obtain s permit to do the work and iastaUations as andiestad.
I=%*" no worker iro4llstioa bas commna"d pries to the
issuance ora permit and that all wad will be performed towed standards of all laws regulating construction in Wa juradiclioa. 1 nndastaad flat a sepurac
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS. and
AIR CONDITIONERS, dc.
OWNER'S AFFIDAVIT: I certify dud aU of the foregoing mfomufim isado and dal aU west wO bedoae imompiiaocs withal applicable laws regulating
construction and zoning. WARNING TO OWNER YOUR FAILURE TO RECORD A NORCE OF CONWEN(EMENf 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 COMIMENCEMENT.
NOTICE: In addition to the requiremewls of" Permit, due may be additional resbiclims applicpMe b Win property tat may be fowl m the public records of
Win manly, and alae may be additional permits r quired Lem other gav ro meatal entities such as wale management districts, state agcxis, or federal agencies.
Acceptance of permit is vaifiealioo that 1 will notify de owner of We property of the rego6emmts of Florida Lim Law, FS 713.
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Signature of OwnedAgenl Date Sigaatwe of Codraclor/Aged Ualc
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Print nalngent G.��L,1�o6 -- -
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PETERDANIELSIMON
MY COMMISSION* DD524132
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EXPI§,� May 8,2010
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ID
PETER DANIELSIMON
MY COMMISSION I DD524132
pro EXPIRES: May8,2010
16llltttilmwn-itdaebtery Sadoacom
APPROVAIS:7ANII:G: VITL "M' WG: BLDG:
Special Conditions:
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