HomeMy WebLinkAbout143 Scott Dr (4)Permit N:
,—Job Address:
No- a a `l
CITY OF SANFORD PERMIT APPLICATION
Date:
,description of Work: ATH'! 4- CIVA Ap #v- C,s ti f s ki to dv� ✓Notal Square Footage l/Q
Historic District: Zoning: Value of Work: S /_.Z r/4-5*�'
Permit Type: Building Electrical —L— Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets _
Occupancy Type: Residential Commercial
Construction Type: # of Stories:
Owners Name & Address:
_—�Contractor Flame & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
_ 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)
Phone:
State License Number: riG4740 /Segl
Contact Person: Phone:
Architect/Engineer: Phone:
Address: Fax:
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.
TI : 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 of Florida Lien Law, FSS 713.
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Signature of Owner/Agent Date Signature of Contr tor9c /Agent baw
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Print Owner/Agent's Name P, t Contr /A t' Name
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
_ Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 03/2006
UTIL:
FD:
Contractor/Agent is Personally Known to Me or
Produced ID � h i_ A 1-A 1 i r) � 0 �p
ENG:
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ABRAMS TOWN & COUNTRY
200 S. MYRTLE AVE, SUITE 204
SANFORD, FL 32772
JOSEPH ABRAMS, P.E. 407/947-8482
EC 0000148
City of Sanford:
PLEASE ACCEPT THIS LETTER AS AUTHORIZATION FOR Bruce Hicks OF
ABRAMS TOWN & COUNTRY TO PULL A PERMIT ON MY BEHALF FOR
ELECTRICAL WORK LOCATED AT: 143 SCOTT DRIVE SANFORD 32771
NATURE JOSEPH L. ABRAMS
TATX CERTIFICATION #EC00001 48
WORN AND SUBSCRIBED BEFORE ME THIS V'!�_D AY OF
U,C1Q MONTH (n YEAR IN
JOSEPH ABRAMS IS PERSONALLY KNOWN TO ME.
TURE/NOTARY
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