HomeMy WebLinkAbout480 W Airport Blvd (2)Permit #
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CITY OF SANFORD PER, APPLICATION,
Job Address:
Description a
Historic District: n,(.)
Value of Work: S. �-(DrIJ •"'--
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: \ N of Stories: �y �#-o�f Dwelling Units: Flood Zone: (FEMA form required)
Owners Name & Address: C1c ��
G / "" ' ` ^ , ULC, \R \IRP kfCb C)126-71
JGG 1 Phoue:
Contractor Name & Address:
Phone & Fax:,
Bonding Company:
Address:
Mortgage Lender:
Address:
Architeet/Engineer:
Address:
v_ f%(n \State License Number. �,li I
Contact Person: h1`VjQ_h kr'" Phone:
Phone:
Fax:
Application is hereby made to obtain a permit to do the work and installations as indicated. I 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 is erification that 1 will n=theo the pr pe of the requirements of FI a Lien Law, FS 713.
G 0.(, r �- 12.�1AQ
Signature of Owner/Agent Dae Signature of Contractor/Agent Date
Daniel B. French Qt Q Sti1��.
Print
Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 03/2006
it's N e resiaeni Prin n_tract g Name
...........i Date
LISA D WITTSTRUCK
ti EUDA R. CERNO Comma DOW49077
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MVOMMISSION EXPIRES a4 at�- ExFin s 711012009
'� June 22,2W6 � = Bonded thru (900)472-4254:
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