HomeMy WebLinkAbout480 W Airport Blvd (3)b Lrjo�t 2
Permit N :
Job Address:
Description of Work:
CITY OF SANFORD PERMIT APPLICATION
Historic District: 1 -AC) Zoning:
'Total Stare Footage
Value of Work: $
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS
Mechanical: Residential Non -Residential _
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets _
Occupancy Type: Residential Commercial
Addition/AIteration Change of Service Temporary Pole _
_ Replacement New (Duct Layout & Energy Calc. Required)
# of Water & Sewer Lines # of Gas Lines
Plumbing Repair — Residential or Commercial _
Industrial
Construction Type: N of Stories: 9 of
S Dwelling Units: Flood Zone: (FEMA form required)
ANOwners Name &Address: lJ—G 5)?DA U 1m , LaF)n AoCz)
0.' `� ..2�:0lPhone
Contractor Name & Address: 'c1�id.a 7�� 1 r� IMI -
S !, I 76 State License Number: enc
Phone & Fax: "t c � �� (Contact Person: ►'1 l JZt ul)6er Phone: t6 2 'S/6"J25G
Gooding Company:
Address:
Mortgage Lender n
Address:
Architect/Engineer: N.& Phone:
Address:
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: ! 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.
N TICE: 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 "it i� � that 1 notify of �operty of the requirements of rida Lien Law, FS 713.
�� O.L CR 1
Signature of Owner/Agent 'Date Signature of Contractor/Agen Date
Daniel B. Ffench Q_sd �
Print O er/Agent's%Nam Print ntracto gc C Name
?a, . ,ter' �r/e� 0i az-n.
Signature of Notary -State
APPROVALS: ZONING:
Special Conditions:
Rev 03/2006
EUDA A. MNO
MY COMMISSION EXPIRES
Jung 22. 2006
UTIL: FD:
tulI"" r • ••••••••••••� Date
! A 'aii�'Fncrc
Camntll 000/49077
ExW. • 7/7019009 i
Inru (80003242ti4:
a". Inc S
acMrlA tw9.JK:..snon°� "We or
Produced ID �16t14cv1 610
ENG:
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