HomeMy WebLinkAbout1265 Upsala Rd (3)Job Address:
Description of Work:
Historic District:
Zoning:
CITY OFSANFORD PERMIT APPLICATION
Date: O %.5 0 6
s ,
Tq�a,l Square Footage A DLI
Value of Work: S .MP3 VC -7. 0'a
Permit Type: Building �*—, Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of fixtures
Plumbing/New Residential: # 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)
# of Water & Sewer Lines # of Gas Lines
Plumbing Repair - Residential or Commercial _
_ Industrial
# of Dwelling Units: Flood Zone: (FEMA form required
Owners Name & Address: ��-t2 rr.� n I6 /! olgae
Phone:
Contractor Name & Address: Y `2 r -Q- C_ esn S J [ W Ctr3 33 Inc -ITC)() 33 r Sir Stj Ax .[ A
0D
State license Number:
Phone & Fax: 40 !% - qq 6 -00-3 e!f�a 4f, Contact Person: � Phone: H 0 17 -4 6 6' D07 6
Bonding Company:
Address:
Mortgage Lender.
Address:
Archit"VEngineer.
Address:
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. 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: 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 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 governmental 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 requirements offlorida 1,irn 74% F 713.
Signature of Owner/Agent Date Signature of Contractor/Agent c
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
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APPROVALS: ZON /" iJTIL: FD:
Special Conditions:
Rev 03/2006
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Signature of Not a of Florida Date
KAREN H. NICE
MY oPWAISS ow # OD zraasas
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Contractor/Agcnt-is--Personally-Known to•Me or---
Produced ID
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Roposco
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F.F. CLU. 30.00
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08/07/06 13:46 FAX 407 290 9336 WORK SPACE PLUS ORLANDO Z005
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8' X 28' Double Office
2: Built in Desk Tops with Aluminum Siding
File Cabinets and Overhead Shelves Vinyl Tile Floor
Optional Plan Table Wood Grain Paneling
Optional Rest Room ;
Heat and Air
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800-330-6451
Orlando Branch Office 2895 Mercy Drive Orlando FL 3288 407-290-2323 407-290-9336 (fax)
Other Sizes and Models Available
Including our 20' and 40' Ground Storage Containers
8x28 Office / Storage Combo op
8x16 or 20 Single Office 1° :
12x44 Multi -Office
12x56 Multi -Office
3,5 and 7 Office Double Wides
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