HomeMy WebLinkAbout1008 French AvePermit # : ( I
,lob Address:
Description of Work: IIIC,UY\ �g I W
Historic District: Zoning:
RECEIVED
CITY OF SANFORD PERMIT APPLICNFION
Date: 'll JAN 112007
3a-) -) %\, 0
a ll Q.,L, A_
Value of Work:
Perntit'fype: Building / Electrical i/ Mechanical _—_ Plutitbing_.__ Fire Sprinkicr/Alarm _ fool _
Electrical: New Service - # of ANIPS
Mechanical- Residential Non -Residential
Plumbing/ New Commercial: It of Fixtures
Plumbing/Neto Residential: # of Water Closets _
Occupancy Type: Residential Commercial
Addition/Alteration Change of'Service Temporary Pole
Replacement New ___,__. (Duct Layout & Energy Cale. Required)
It of Water & Sewer Lines # of Gas Lincs
Plumbing Repair - Residential or Commercial
Industrial 'total Square Foulage: -)_L
Construction Type: # of Stories: It of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel It. 95 C) -!U. s 1 �CG1 ^ Qo DD (Attach Proof of Ownership & Legal Description)
Owners Name & Address: IQ Al C''k-, S �
Phone.
Contractor Name& Address:( uV11V_ [1 ICL!` )� 1 cel . L Cif 1 1 leLe^Y,[�_, 1 C -4A t�lLe
`Kt _ State License Number: C'E J IlQolnoltv
ll'Phone & Fax: Contact Person: 11 �
_ �U1 • t I Ip�d ,1�c ��
Bonding Company:
Address
Mortgage Lender: .
Address--
Architect/Engineer:
ddress:Architect/Engineer
Address: ✓S 1 D
Fax: L l�) l . ���1 h . _ 4c)i (�
Application is hereby made to obtain a,pernit to do the work and installations as indicated. I certify that nu work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet standards ()fall laws iceulating consttuctiuu in this jurisdiction. I understand that it sepmatc
permit i n st be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, IIEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: I ccitify that all Of the foregoing iuforutalion is accurate and that all work will be done in compliance with all applicable laws regulating
comsouction and -coning. WARNING TO OWNER: YOUR FAILURE: TO RECORD A NOTICE OF COMMLNCLMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTENDT 0 OBTAIN FINANCING, CONSULT' WffH YOU LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF CONINIENCEMENT.
NOTICE: In addition to the requirements of this pennit, there may be additional restrictions applicable to flus pruperty that may be found in the public records of
this county, and there may be additional peewits required from other governmental cutities such as water management districts, state agencies, or federal agencies—
Acceptance of permit is verification ti tat I will notify t owner of the properly of the requirements of Flo ida Licn aw, FS 713.
Srgnahue o rowncdAgent Dale Slgnature of Coutrtctor Agent Dale
k1LV) , (-C\> Q . e r-tm �� .Ina c � . __
Print Owner/Agent's Name P -Ah I Contractor/Agent's Nacre
Si�AN\
e of rich ate Signature ol•Nutary-State of lila Late
ty Nichole J Gracey
r'u, Nichole J Gracey
My Commission D0330205 � p,ty Commission DD330205
,, y, P
Owner/Agent isersunadly Known to Me tRr wdl Expires June 17 2006 / Contractor/Agent is V Personally Known to Ivt� (� r Expires June 17 2006
Produced IU 1'ruduced ID
APPLICATION APPROVED BY: Bldg:"' (Zoning: Utilities: FL:
(Initial (initial & Oate)� (Initial & Date) (Initial & Late)
Special Conditions: _
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