HomeMy WebLinkAbout480 W Airport Blvd10
Permit N: FJ (O
Job Address:/ �� Q. i e2C
Description of Work: V"7�i�i'�1t' iJlf
Historic District: 1c— Zoning:
CITY OF SANFORD PERMIT APPLICATION
Total Square Footage C,
$_!3 � 10*
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition /Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement 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 Commercial Industrial
Construction Type: UN of Stories:\, # of Dwelling Units: (� Flood Zone: (FEMA Form
form required )
Owners Name /& Address: �I\ �^ Cb ^J -Pkn(( �G U?RR V ) 1 (k Ktiy FAL,
I � omdc c VD � e_ 0 _ _ Phone::
Name & Address:
State License Number:
Phone & Fax: �2 — Contact Person:
Bonding Company:
Address:
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. 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: 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 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 i verification that 1 w' otify the own of the rty of the requirementsof Flo 'da Lien law, FS 713. 1�
oc .dl01121cA
Signature of Owner/Agent ate Signature of Contractor/Agent Date
Daniel B. French`�C�
Print er/Agent's N President PrinyCpntracto g ntName
— 60�� 6171,00 o�
Signet' o t -S ate
of to gnauYpAfAAt a;tate r�4f Florida Date�.. *r ...... sISA D WITTSTRUCK
aj ►, ,� EUDA R. CERNO d,:. comms OD0449077
Y COMMISSION EXPIRES +:ExFlrrs 7/10/2oos
'.+ .• •,; : June 22, 2006 t Bonded thru o00 72-4250:
Owne Contra��o��rrtisaRyA6W.M%toMeor
Produced ID _Produced ...................""'e
APPROVALS: ZONING: UTIL: FD: ENG: BLDG:
Special Conditions:
Rev 03/2006