HomeMy WebLinkAbout758 W 25 StCITY OF SANFORD PEItMF ArrULWHU14
permit#: .J, 2 -j -z -z //--. Date: 4�F C7 fF'^
Job Address: W 9's, -rn —
Description of Work: $ e rb,;c 'c fi�l' C 0 81 �Y g ' . Total Square Footage
Historic District_ Zoning Value of Work: S !200c. air
Permit Type: Building ElectricalL Mechan cal Plumbing Fue SpnmkkdAlatm Pool
Electrical: New Service —# of AMPS % OC AdditionfAlttration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct layout & Energy Calc. Required)
Plumbing/ New Commercial: # of FLMM # of Water & Sewer Lines # of Gas Lines
Plumbing/New, Residential: # of Water Closets Plumbing Repair—Residential or Commercial
Occupancy Type: Residential Commeread X_— Industrial
Construction Type: # of Stories: # of Dwelling Unita Flood Zone:(FEMA form required)
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Owoers Name &
Contractor Name& Address:
State I,i eNumber- _J'�c 1 go o 3,0
Phone & Faz yG 7 — a �1 � �g 7 Z Contact Person i -i CA �G 10 ti 1 1 7 Phone: yG 1— 2
Bonding Company: ,T�1-
Address:
Address:
Ambitet &ngineer. Phonic
Address:
Fins:
Application is hereby made to obtain a permit to do the wont and installations as indicated i certify that no work or installation has eonunenced prior to the
issuance ora permit and that all work will be performed to mteet standees of all laws tegulaft—a construction in lbis jurisdiction. I understand that a separate
permit must be seemed for ELECTRICAL WORK, PLUMBING SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFLDAVff: I certify that an of the foregoing information is neonate 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 DdPROVEMENIS TO YOUR PROPERTY. IF YOU MEND TO OBTAIN FMANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMETTf.
NOTICE: In addition to the n gtrirmuci is of this permit, there may be aMtiorwl 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 colons such as water roanaeerao�4disbicts, state agencies, or federal agencies.
Acceptance of permit is verification that I will no* the owcer of the property
Signature of Owner/Agent Deft
Print OwnedAgent s Name
Signature of Notary -Stats of Florida Date
Owner/Agent is_ Personally Known to Me or
Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev MAW
UTIL FD:
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of Contracud'jgent L Date
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i Agem's'►r�-.J'�dCil �9.�Y, �- ZI -v(�
' 40911illy-StalAAfA_r WWOHNSON Date
MY COMMISSION t DD 285622
# EXPIRES: March 23.2008
�r-0,�j4 Th u 8uduet NoUry Services
CoalmctodAgent is Pe som illy Known to Me or
_PtoducedlD
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