HomeMy WebLinkAbout101 Garrison DrCITY Of SANFORD PERMIT APPLICATION /
!rmit # : () 1 — � 0 3 Date:
.b Address:
scription of Work: Y�� `TC Total Square Footage
istoric District: Zoning: _ Value of Work: S
:Emit Type: Building Electrical J(_ Mechanical Plumbing _ Fire Sprinkler/Alarm Pool
ectricaL New Service — # of AMPS 00A, Addition/Alteration Change of Service femporary Pole
echanicat Residential Non -Residential Replacement New (Duct Layout & Emergy Calc- Required)
umbing/ New Commercial: # of Fixtures _ # of Water & Sewer Lines # of Gas Lines
umbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial
, cupancy Type: Residential —)(— Commercial Industrial
instruction Type: # of Stories: # of Dwelling Units: _ Flood Zone: (FEMA form required)
rners Name & AddressPx -Cr
Phone: �/O'7 - C71-5
wtractor Name & Address:
one & Fax
riding Company:
dress:
)rtgage Lender:
dress
chitect/Engineer:
Contact Person:
State License Number:
Phone:
Phone:
dress: Fa x:
plication 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
lance 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
mit must be secured for ELECTRICAL WORK, PLUMBING. SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
2 CONDITIONERS, etc.
✓NER'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
istruction and zoning, WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
/ICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
'TICE: In addition to the requirements of this perttit, there may be additional restrictions applicable to this property that may be found in the public records of
; county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
xptance of permit is verilj that I will noti er of the property of the requirements of Florida Lien Law, FS 713.
(0-7
rgnature ofOwncc�/Agcnt Date Signature of Contractor/Agent
P Owner/Aggelf Name Print Contractor/Agent's Narne
ignature of Not -State of Florida Date Signature of Notary -State of Florida
-�i 0Et381E BLANT
t`!;.?,,i,liSSION # DD 188491
r ! E7;t'IFi .S: February 25, 2007
Date
Date
Owned en Personiyr[ao[gtrCo. Contractor/Agent is Personally Known to Me or
1-8 G ridE?FiTn +'
P .. ,_.., _..,r.., Produced ID
'ROVALS: ZONING: UTIL:
tial Conditions
FD: ENG: BLDG:
03/2005
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