HomeMy WebLinkAbout500 Art Ln (5)CITY OF SANFORD PERMIT APPLICATION
3Date-
Job
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Permit #': •'�• Date:
Job Address:
'44- Lbyw-
Description of Work:�. •&J'� Total Square Footage
r
Historic District: Zoning: Value of Work: S l GO
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:
Mechanical Plumbing Fire Sprinkler/Alarm Pool _
_ Addition/Alteration Change of Service Temporary Pole _
Replacement New (Duct Layout & Energy Calc. Required)
# of Water dt Sewer Lines # of Gas Lines
Plumbing Repair — Residential or Commercial _
Industrial
# of Dwelling Units: Flood Zone: (FEMA form required )
Address:
MortgageLender: A
Address:
Architect/En ueeeer: /h �'7 Phone;qFr-j C�
Address: I - 1 m 0. O`- I a 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 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 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 resTag,'
pperty that may be found in the public records of
this county, and may be ditional permits required from other governmentalment
districts, state agencies, or federal agencies.
Acceptance ca on that I will notify the owner of the property of tLien
Law, FS 713.
Si wner/Agent Date
ctor/Agamt Date
QX)6
al -0
PrivOwner/Agent's Na
t ntractor/AgenMtfmW100(p
Signature of otary-State of F orida Da
Signature o Notary -State of Florida HEATHS afOHNSTON
HEATHER JOHNSTON
Notary Public, State of Florida
Notary Public, State of Florida
My comm.. exp. Dec. 19, 2007
Ower/Agent is Perao.ally KrmoMA comm. exp. Dec. 19, 2007
'�L`ifl9i. No.
Cn tor/Ag is Personally KnCwnitmo MiorDD274373
DD274373
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_Produced ID
duped ID
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APPROVALS: ZONING: Ca lt►' La o�
Special Conditions:
Rev 03/2006
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