HomeMy WebLinkAbout2665 Magnolia AvePermit N : V c' d cd
Job Address. z (
Description of Work:
Historic District:
Zoning:
Permit Type: Building Electrical
Electrical: New Service - N of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: N of Fixtures
CITY OF SANFORD PERMIT APPLICATION
L- ,
Date: W 1 �2- - b
d Total Square Footage
Value of Work: S \ 2;lS'fl
Mechanical Plumbing ----.1 Fire Sprinkler/Alarm Pool
_ Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Calc. Required)
N of Water & Sewer Lines N of Gas Lines
Plumbing/New Residential:Water Closets �_ Plumbing Repair - Residential or Commercial
Occupancy Type: Residential V Commercial Industrial
Construction Type: N of Stories: N of Dwelling Units:_ Flood Zone: (FEMA form required)
Owners Name & Address:�v�1 �- EST
_ Phone:
Contractor Name & Address: E� LtJW1g�►y G `S22 y �_Si 1Fi►b M� A Iia
`4' State License Number: C F C- 10,Q -11 V'S7
Phone&Fax: ��^"tbg^�5by� Contact Person:�1°lNrm Phone: y0�^b�'��1111,11
Bonding Company:
Address:
Mortgage Lender.
Address:
Architect/Enginecr:
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. 1 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.
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 re4lnu=iIems of Florida Lien Law, FS 713.
t-0-&-Ot►o
Signature of Owner/Agent Date Signature of Contractor/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida
Owner/Agent is _ Personally Known to Me or
_ Produced ID
APPROVALS: ZONING: UTIL:
Special Conditions:
Rev 03/2006
Prjnt,Contractor/Agent's Name
Date Signatu o -State- of FloriDa
DEBBIgaB A TON
MY COMMISSION # DD IeWl
EXPIRES: February 25, 2007
1400.3-WTARY FL Notary DWcoW Acsoe. Co.
Contractattg'K>>0— t'� 0 r of
_ Produced ID
ENG: Bl
a%-4