HomeMy WebLinkAbout311 Rosecliff Circo(a^a39a
CITY OF SANFORD PERMIT APPLICATION
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Demripdon of work: R Told SVM- Foabge %i�
Hristoric District: zonutg/)R✓►yfFR� jC Yabteorwork: S
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Permit T. Fire
Building Ekctacal Meobamcal Plumbing Fre SpRinkler/Alarm Pool
Electrical: New Service — 0 of AWS Addition(Altorauon Change of Service Temporary Flolo
. ecbanieal: Residential Noo-ReadeAdial Rcomcmont New (Duct Layout & GoergY Cala. Required)
Plttmbiogl New Ctmmaaal: of of Fixtures k of Water & Sewer Lincs f of Gas Lines
Pirmtbi WWvvr ROUWRGaL• d of Warta Closets Plttmbiag Repair— Residential a Commercial
occupancy Type: Residential Commardal Indushial
Cortdrmc im Type g or Stories: X arDwelbngtirdb: Flood Zone (FFJ4A fern mMuired )
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OrvnersName &Address o� Kf•t/ F Z-1,01Z-1,01/.S//Y�MCG
Contractor Name & Address:
/63 9 e, viNe s r
phone & Fax: L
Beading Company:
Address,
Mortgage Leader: .
Address:
Arehiteet/Mgineer:
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h �aS . � „� ca fL Y 7 YStite I.iaaae Nonber. G 6 � 0 S %
,3 d Ceatatl Person: `yhk' —Plane: y o% 3 V I g 3 0
phone:
Irak:
Address:
Appliati on is Iseceby madcto obLio a perrml to do tlw work and iaaWbdioss as irdicdod. I cer* mal no worker installation lose commenced prior to tho
issuance ora permit and that all work- will be perfarmed to meet aLmdards of all laws regulating cmahuclim in "jurisdiction- 1 understand oA a separate
permit mast be served for ELECTRICAL WORK, PLUMBING, SIGNS, WEILS. POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
with a0 lawn regulating
OW VER'S AFFIDAv I certify tlnl all of me fwegamli mfomratim b ant a and mat sR workwill be doaa io mspGaooe applicable
corohuetion and tuning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT W 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" permit, there may be additional nshic6cm applicable to this property that may be fowl m dm public records of
this county, and War may be additional permits reluirane
d loom oma goveaeobi —tai— such as water management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will unay me own" of the property of the requi emmts of Florida Lieu Law, FS 713.
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Signature of Ownm/Aged Dale Signa of Coutraclor(Agent Dalc
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Print OwncrlAgenra Name , e- Print Codraet-4 Age+trs'Name / r ,
'Ptv PETER DANIELSIMON ��r� PETERDANIELSIMON
'A + MY COMMISSION III DD524132 '% w MY COMMISSION * DD524132
7
OwnalAgan" ow lob&UPIRES: May8,2010 AgenPio&c tD to sui PIRES: Mayg.2010
153 Produced II) ° Notary Swvloaoom odds Noluy Servlce,com
APPROVALS:7ANQNG: UTUr FD:
Special Conditions:
Rev 0312006
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