HomeMy WebLinkAbout811 Rosecliff CirCITY OF SANFORD PERMIT APPLICATION
remit#: 5(0- ex 40 g
Cit
41
Datr. 4-1�-o G D J$6
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Description of Work: R C rQ0 0 ` Tomb Square
FlistoricDistrict: &/)r✓�rlFi4O1I Value ofWork S
permit Type: Building Electrical Mechanical Plumbing Fite Sp inldedAlarm Pool
Electrical: New Service - of of AMPS Additioa/Alo=fwn Change of Service Tompotary Polo
Medumical: RmdmuA ?loa'Residrt7ntiai Replacement New (Duct Layout & Energy Calc. Required)
Plttmbhtd New Comme rdal: # of roues k of Water & Sewer Lines 0 of Cas Lines
PlumbbidNew Ra ddeutiak d of Wales Cbsats IN—biog Repir- Residential or Cou m miol
Occupancy Type: Residential COTMOW681 Induce W
Construction Type # a[ SWw x of Dwelling Units: Flood Zone: (yKmA form required)
Owners Name & Address TOM K,*4/ �Ir C L. ) hf L.1,01
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wtraulor Nature ei Addrax TT --7 —y -E- y C1S 7 �1$ Sj
/63 -7 e, diAle S T sryc F' /f /SS Ca )L State License Nombw 6
p b Cootaet Parana: D �/� •✓ '4041C.0 �— J•door Y o-7 3 V l g 3
Yleone & Nus: Y 7 � � a 83
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Archifecf/NnIfeneer: Please:
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Appltaaion is Iveraby anadea obtain a pormit to do Ow wo& and iestalladoos as indica". I certify that ao work or iratallatioa bas comorwcod prior to the
issuance of a peamil and Thal all work will be performed to meet standards of all laws regulating construction in Osis jutisdiclion. 1 understand that a sepcuate
permit meal be secrued for ELECTRICAL WORK, PLUMING, SIGNS, WELLS. POOLS, FURNACES, BOILERS, BEATERS, TANKS. and
AIR CONDITIONERS, etc.
OWNER'S AFFIDA4TI: I neatly tho all oltbe foregoing honmaden is aaemare and am an workwill bedew in compliance wilt all applied& laws regulating
construction and zoning. WARNING TO OWNER;- YOUR CE OF
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOUR To
TO OBTAIN FINANCING GCONSSUULT WITH YOUR NT MAY LENDER OR AN
T IN YOUR PAYDVG
ATTORNEY BEFORE RECORDING YOUR N0710E OF COMMENCEMENT.
NOTICE In adcfition to the requucmrals of this permit, Ouse maybe additional sesbietims applicable b Ibis property that maybe round in the public records of
This county, and Were may be additional permits required fian over gumnurA dol eatilim such as water management dislsich, state agau:im, Or federal agencies.
Acceptance of permit is vaifwAim Wet 1 wig notify We owner of the property of the rogoocmmts oI ins Law. FS 713.
Eflorib 611 ��
nb -" � 6-/d- 06
D��,o7. Date
Sigo:dttre of OwaerlAgml /hal Signature of CoNracim/Agtad a
ICE I
Print / Cs Nam- C Print Coai>'cta/ cid'a NIT 1%1
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"- AIT. MYCOMMISSION+PDD52a132 / Q�ftY PETER �""'�••
rilofl>e EXPIRES: Mayg.2010 ANIELSIMON
OM =", watch NOWy Se vlcavom MY COMMISSION N DD524132
OwnrlAgcnt e _ pemunally Kaawn to W a CoofractorlAgent iAixo wn to M11PIRES: MaY 8.2010
Produced ID _Pmdo-ed1x3 rlda Notary tiwM-s.00m
APPROVALS: 7ANR:G:
Special Conditions:
Rev 03fM