HomeMy WebLinkAbout119 Larkwood Dr (4)NO — a37 CITU OF SANFORD PERMIT APPLICATION
Permit H : Date: 0 G • ou
Job Address: Q t^�%t%i w"Jo
Description of Work: A&4J%-r - METEA- C &?l Total Square Footage
Historic District: Zoning: Value of Work: S
Permit Type: Building Electrical `/ Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — N of AMPS
Mechanical. Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: k of Water Closets
Occupancy Type: Residential ✓ Commercial
Construction Type: # of Stories:
Addition/Alteration Change of Service Temporary Pole _
_ Replacement New (Duct Layout & Energy Calc. Required)
N of Water & Sewer Lines N of Gas Lines
Plumbing Repair - Residential or Commercial _
Industrial
# of Dwelling Units: Flood Zone: (FEMA form required)
Owners Name & Address: g0 nirlAIr I- /4'yL
Phone:
Contractor Name & Address: L/d-4 e: T/t✓G 1XIL
State License Number:
Phone & Fax: (y% _%?J 61PCo Contact Person: / ayAl/ t/a Phone: 407 32I6g64P
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer.
Address:
Phone:
Fax:
Application is berebymade 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 drat 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: 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 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.
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 water management districts, state agencies, or federal agencies.
Acceptance of permit is verification that l will notify the owner of the property of the requirements of FloridaLicn w FS-7fi .
Signature of Owner/Agent Date -.=sigmmie ofeorifractor/Agent Date
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 03/2006
FD:
&(AYM w�T�
Pri Gont actor/ ge is Name
(d. - T•
Signature of Notary -State of Florida —*—Date
Contractor/Age
_ Produced
DEBBIE BLANTON
MY COMMISSION # DD 1BMI
nt is _ P n Owrffipt W February 25, 2007
ID n'000_2: T lAscount nssoc. Co.
ENG: BLDG: