HomeMy WebLinkAbout206 McVay Dr (4)Al
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Permit # : 0(0-
Job
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Job Address: d(UI
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION nn tDate: Q10(p
SAA) F0 se 0 ,)Ct 3a �� ►
Zoning: Value of Work: S 46?3.4%
Permit Type: Building Electrical Mechanical 'ice Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential V/ Non -Residential Replacement leff 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 V-,*' Commercial Industrial Total Square Footage: 1100
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other then X)
Parcel #: V I — 2o " 31— 05 , a L oo " 0 a9 A (Attach Proof of
Owners Name & Address: A04 5 (X 4Q'An. V_LTG921� .06(a 4he
Phone:
& Address: --K 0 P I -A CC,
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
& Legal
7. s
e I If / S..'0J tate License Number: C (,- 0 J V y Z is
5 U - ontact Person: Roo F44c t rIt-wk Phone: V07-3-'12—
Phone:
07.,332
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. 1 understand that a separate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
3 -i -Y -Y 7
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 1 will notify the owner of the property
Signature of Owner/Agent
Date
Florida Lien Law, FS 713.
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Date
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Print Owner/Agent's Name APrior/Agent's NameZ„oolo
Signature of Notary -State of Florida Date State of Florida Date
Owner/Agent is _Personally known to Me orCon .....SE
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APPLICATION API'ROVFD BY: Bldg: "Zoning: Q s: FD:
(Initial & Date) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions: