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HomeMy WebLinkAbout208 Palm Pl (2)Permit # : Job Address: CITA' OF SANFORD PERMIT APPLICATION G �.J _` r Date: ZC ✓ Iy t b Description of Work: Q OC Total Square Footage seji• 't"1'r 00 Historic District. Zoning: Value of Work: S 0 b . Permit Type: Building Electrical Mechanical Plumbing 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 Repair – Residential or Commercial Occupancy Type: Residential Commercial Industrial Construction Type: _-4— # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required ) 017 Owners Name & Address: UL Contractor Name & 760 Gee Phone & Fax: Bonding Company: Address: Mortgage Lender. Address: Archilect/F.agineer: Address: Phone: Z9� Stale License Person: 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, 1-1EATERS, 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 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 require nts of or' ren Law, FS 713. Signature of Owner/Agent Date Signature f Co actor/A ent Date Print Owner/Agent's Name Pri tractor/A s Name Signature of Notary -State of Florida Date Signature o ate of r1orida Date Xr%;tt; IEON Owner/Agent is _ Personally Known to Me or Contr*-1:VQP My r Produced ID F�Co. APPROVALS: ZONING: UTIL: FD: ENG: BLDG: Special Conditions: Rev 03/2006 jqo .-.A AFFIDAVIT REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS Company: /Mev., K ©>/' a �o�S &trhow License #: Owner: O. Ae_CLJt"'t name 4209 P�yy\ �tice address q36� phone Project Information Permit #: Subdivision: Lot #: CCC /3a los / I, Aa". -14 , affiant, hereby affirm that I am the duly licensed contractor of record for the above referenced permit, that all the foregoing information is true and accurate, and that the dry -in, flashings at the above referenced address or lot has been installed in accordance with the applicable codes and standards. Contractor0'�Oolffl'4�� : Cf/t� sigf��V _ Vi printed name STATE OF FLORIDA COUNTY OF This instrument was acknowledged b fore me this /9-114 day of v , 20Q(, by the above referenced individual, /4ce!r14-e-I , who acknowledged that he/she is a duly licensed contractor with ar , and who acknowledged that he/she was tho ' d to exe ute this document. He/she is either personally known to me or produced 1- �'1" % �as valid identification. WITNESS my hand and seal this day of 20 MY�MMBIEB�T ,r�ar�P�A�••�,�+� SON F� � Z007 4ft. �.