HomeMy WebLinkAbout2986 Magnolia AvePermit N./)&
Job Address:
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Date: -2! (, - 6
Zoning:
Permit Type: Building ElectricalMechanical Plum in Fire Sprinkler/Alarm Pool
Electrical: New Service – # of AMPS Addition/Alteration Change of Service TcmporaryPole
Mechanical: Residential Non -Residential —
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets _
Occupancy Type: Residential Commercial
Construction Type: # of Stories:
_ 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)
Contractor Name & Add r ;'�TZ A161A) lid NI�&2 4Y–CJ'!: 1--
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
State License
Contact Person: Phone:
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 M 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 of the requirements of Florida Lien Law, FS 713.
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida
Owner/Agent is
Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 03/2006
Personally Known to Me or
Date Signature of Notary -State of Florida Date
DEBBIE BLANTON
MY COMMISSION # DD 188461
EXPIRF-S: February 25, 2WT
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