HomeMy WebLinkAbout1001 E First St (3)CITY OF SANFORD PERMIT APPLICATION
Permit #
0277 - 712 1 Date:
-Job Address: 100 ( X's a A i S%, .S/4N A9 d Xf.. S L 7 7 1
Description of Work: /"AfwJt 6/6C,"htte Ayt WMIC ,�+rl Total Square Footage
Historic District:
Zoning:
Value of Work: $4/O0G *0 0
Permit Type: Building Electrical._zMechanical 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 Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial _
Occupancy Type: Residential Commercial Industrial
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
Owners Name & Address: W'C(4 TlaI�ftrd
Loco doAALL! sT SAa AciL, ec. Z2 -2-i1 Phone: y0'r] �3L3'3Y3o B><S`. 33d�
Contractor Name & Address:
01W%11900�
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
State License Number: C l.: i3oo 13 S0
Contact Person: 12a:6r wm! e)ilpo j Phone: 4/07.523"Nflb *r?:
Address:
Architeet/Engineer: Phone:
Address -- ----- _ 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. [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 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
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APPROVALS: ZONING:
Special Conditions:
Rev 03/2006
.;i ion that I will f4/ er of the property of the requirents of Florida Lien Law, FS 713.
i r Iz� I ole
Date Sig re of Contractor/Agent Date
c r Z,p�
r 's Name Print Con nt's ame
Iztos.66
I Date Sig e -of -Net -State of Florida Date
TIMOTHY W. MEISEL attar vtw KENNEM P. FR06T
MY COMMISSION 4 DD474305 MV COMMISSION 0 DD 432782
FXPI ovember 01.2009 t
EXPIRES: September 22, 2009
y /Fl. Notary Discount Assoc. Co. '% .a? Thru 8 et Notary Services
or Contractor/A�rm4s ersonai Known to Me or
_ Produced ID
UTIL: FD: ENG: BLDG:
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