HomeMy WebLinkAbout150 Bob Thomas Cir (2)CITY OF SANFORD PERMIT APPLICATION
Permit # : IQ '� 2� I Date: I rJ J
Job Address: /SD 30 B n4 n Mq s Cr tz
Description of Work: .SZ r'W f,g V ?Cy aA n C' Total Square Footage
Historic District:
Zoning:
Value of Work: S
Permit Type: Building Electrical ✓ Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS C 0800 Addition/Alteration Change of Service _sem Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Due( Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential. # of Water Closets Plumbing Repair - Residential or Commercial
Occupancy Type: Residential ✓ Commercial Industrial
Construction Type: �I # of Stories: / # of Dwelling Units: Flood Zone: (FEMA form required )
Owners Name & Address: V C- z SJ MARZF_94 / S,KI 3O 6 1 k over A S
nn .. Phone:
Contractor Name & Address: % Csti2i - lie..o C 9,mproe i df,) 4 N 0 C� Z h S %� y G Ole L t L 32,5101
Stale License Number: C AZ Dy 0 73 fq
Phone & Fax: j�D% - `1 �,j - 6 6 J. g Contact Pcrson: ;:--4 alL Phone: 7> 461, 3
Bonding Company:
Address:
Mortgage Leader: .
Address:
Architect/Eagineer:
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 COMMENCEMENTMAY 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 o of rida Licn 713.
Signature of Owner/Agent Date Signaturentractor/Agent Date
Print Owner/Agent's Name Print Contractor/Agent's Name
Y't1. • 1 Zoo
Signature of Notary -Slate of Florida Date azure of Nolmy-Stale of Flor Date
J0 AN M. JOHNSON
MY COMMISSION 4 DD 285622
` * EXPIRES: March 23, 2006
�,9JE�fIF' Bonded Thru odgel Notary Semen
Owner/Agent is _Personally Known to Me or Cont ctor/Agent hPersonal Known to Mc or l' /-
Produced ID �roduced TD • �4• TSV ' 2� •0
APPROVALS: ZONING:
Special Conditions:
Rev 03/2006
UTIL: FD:
ENG:
BLDG: IAA . - S