HomeMy WebLinkAbout480 W Airport Blvd (8)CITY OF SANFORD PERMIT APPLICATION
Permit # : bCD Z O( Date:
Job Address: okof lvcj
Description of Work: otal Square Footage
Historic District: (�i!� Zoning: Value of Work: S 9mc�l
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 bines
Plumbing/New Residential: # of Water Closets Plumbing Repair —.Residential or Commercial
Occupancy Type: Residential Commercial Industrial
Construction Type: ^ 1 `# or Stories: #. of Dwelling
/ Units: /FFlood rZon�e:-yam (FEMA form required)
Owners Name & Address: PAS �Ai �. I LI --1-.,, � Ry I I �WV /U C.f V'Y1K:�
Phone:
Contractor Name & Address: i inc,
t'1 �A 5occ-2 ( % State License Number: CCC `_76q'1
L,
Phone & F.&'C c7� — Contact Person: Al C,I )` R—[mac Phone:
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. 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: I 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 verification that I will notify the owne of the ppe y of the requirements of F ida Lien Law, FS 713. (r�^ �++��
w �C. 2 (.`p
Signature of Owner/Agent a tgnature of Contractor/Agent Date
Daniel B. t=rench c\, t^_ _ t C) .. cr, i 0.
PripfOwner/AgentX14ma rreslaenI Print tractor/Agent'Name
G G (.42-A(.2Signature of Notary -State of Elo.ide Date Signature of Notary- tate of Florida Date
LISA D WIITSTRUCK
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EUDA R. CERNO .,*� -4 t:w"m>, 0t s9on
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V EXPIRES;p N EWr, a 7/104009
+; 10ru Goo mown to M r Contractor/a�A t+te or
APPROVALS: ZONING: UTIL:
Special Conditions:
Rev 03/2006
FD:
ENG:
BLDG: