HomeMy WebLinkAbout124 Krider Rd (2)Permit #: (')(z
Job Address: _ 1f
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Date:
Footage
Permit Type: Building Electrical Mechanical Plumbing f/ 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 Lines
Plumbing/New Residential: # of Water Closets Plumbing Repa' — Residenti r Commercial _
Occupancy Type: Residential ' Commercial Industrial
Construction Type: # of Stories.
'Owners Name & Address:
Cou#rwWr Name & Add►
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender.
Address:
Architect/Eagineer:
Address: Fa::
# of Dwelling Units: Flood Zone: (FEMA form required) "
72
Phone: f42= GiDtE�
—State I.Am�use Number:
Contact Person: Phone: y// - y
Phone:
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 Ihat 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 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 govemmental entities such as water management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the retiffllorida ien wFS713.
Signature ofOwner/Agem Date f Co tractor/Agent
Pruett Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
APPROVALS: ZONING: UTIL:
Special Conditions:
Rev 03/2006
Name
DEBBIE BLANTON
MV COMMISSION m# DO I owl
EXPIRES: February 25, 2oo7
ISN0Tcr.:PersonWIyTav&u;ft4jw*. Co.
FD:. ENG: BLDG: