HomeMy WebLinkAbout420 S Oak Ave (2)SAI
Permit # :
Job Address:
Description of Work:
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Historic District: —TLS Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date: O
Permit Type: Building Electrical
Electrical: New Service – # of AMPS
Mechanical: Residential Non -Residential _
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential Commercial
Construction Type: # of Stories:
Footage 3f o v w
Value of Work: 3 ?,0o 0
Mechanical Plumbing t✓ Fire Sprinkler/Alarm Pool
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Calc. Required)
# of Water & Sewer Lines # of Gas Lines
Plumbing Repair – Residential or ommercia a 'w� fly' ��
Industrial
# of Dwelling Units: Flood Zone: (FEMA form required)
Phone: Yo 7 — -7
Contractor Name &Address: `%& G r-pur ! LLL
State License Number:
Phone & Fax: Person: :__6 A ve– r_r64&71 Phone: 1qd 7–
047J/ CG/l
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Bonding Company: IV//r
Address: A
Mortgage Lender.
Address:
Architect/Engineer: �' Phone:
Address:
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, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: 1 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 o it is veri at 1 will notify the owner ofhe pr perty of the requireme t lorida Lien w, FS 13.
Si ure of Owner/Agent gate Sign u Contractor/Age t arc
Print Owner/Agent's Name Print Contractor/Agent's Name
.;ta Dt+ 046
Date Signature of No -State of Florida Date
ov Pc Notary uWic Slate of Florida
rP M I Reyes Cohn Dar Notary Public State of Florida
My Commission DD524 665 ;� M 1 Reyes-Colon
w a Expires 0 0 My Commission DD524765
rs _
ersonally bjwwn to Me or Contractor/Agent is _ Personally Known Expires 03102!2010
Produced ID _ Produced ID
APPROVALS: ZONING: UTIL: FD: ENG:
Special Conditions:
Rev 032006
TdS
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CITY OF SANFORD HISTORIC PRESERVATION BOARD
APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS
P.O. Box 1788, Sanford, FL 32772-1788
Phone: 407 330-5672 Fax: 407 330-5679
TO: THE HISTORIC PRESERVATION BOARD OF THE CITY OF SANFORD, FLORIDA
0 Downtown Commercial Historic District 0 Residential Historic District
0 This application is filed in response to a notice from the Code Enforcement Department
ADDRESS OF PROPERTY: L Ave,
Property Owner /
Signature: Print Name: K f 4e-,e-atG, G lya"
Mailing Address: yo? a S d2a 1& A-�
Phone: d(P'7— 41r'ar l7ys-* Fax:
Signature: _
Mailing Address:
Phone: R'( V 7 -41q9 — Ars / Fax:
Print Name: �Aly.-4 '4 , rV J- &-.n
I certify that all infoon conte' m this application is true and accurate to the best of my 1 wl dge.
Applicant/Owner: _ J J adal, 2 Date: [�
Please use the attached criteria checklist -as a guide to completing the application. Incomplete applications cannot be
reviewed and will be returned to you for more information. You are encouraged to contact the preservation planner at
407-330-5672 to make sure your application is complete.
Description of Proposed Work/Application Category: (Check all that apply)
o Site Improvements/driveway/walkway o Storage shed o Moving structures
O Replacement windows or doors O Underskirting 0 Awnings
o New construction/additions o Signs D Demolition
O Roofs/gutters/downspouts GPAC/Mechanical O Fences/Gates/Pergolas
o Replacement siding/flooring/porch 0 Paint o Other
Completely describe the entire scope of work: all changes in material, color or location to the exterior of the building,
where on the property the work will occur and how the work will be accomplished. For large projects, an itemized list is
recommended. 4ttqgh additionalages if necessary.
s A&IIa - ♦ -.-P W -tee -km
A Certificate of Appropriateness is valid for six months unless otherwise noted
Historic Preservation Board Meeting Date:
Application is Approved
Conditions:
OFFICIAL USE ONLY
Approved with Conditions
Staff Review Date:
Denied
***This Certificate must be prominently displayed on the building when work is in progress***
FASHA_EN"istoric Preservation Board\C of A Application.doc