HomeMy WebLinkAbout104 Sugar Maple CtCITY OF SANFORD PERMIT APPLICATION
Applicationit GJ�— l 6 �z Submittal Date: 03l 21 t0_7
Job Address: ®�F Su Cr Ir`� hil C -C✓ L7 Value of Work: $ -5-,-72-0
Parcel ID: Zoning: Historic District:
Description of Work:Ci,C e- 1:�_L Square Footage: 02
........................................................................................................................
Permit Type: Building Ed* Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service - # of AMPS Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
Mechanical: Residential ❑ Non -Residential 13 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 ❑ Commercial ❑
Occupancy Type: Residential 1!3�' Commercial ❑ Industrial ❑ Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
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Property Owner: j1 01-ty AI- ✓' r) Contractor: J4 Li A&u 7 44 4 --
Address: lbs Suis-- w+"c4LP 5 L7• Address: 34Zi CO&Vt_- c4 G% 00---01-40 Pc 3243%
s4w«Q Ec- 12-1-13
Phone: C+ai 310 cl rSG E-mail: Phone: Cto7 �S_7 2 State License Number:
Bonding Company:
Address:
Architect/Engineer:
Address:
Plan Review Contact Person:
Mortgage Lender:
Address:
Phone:
Fax:
Phone: Fax:
E-mail:
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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. I 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 othergovemmental entities such as water management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida w, FS 713.
C_ c., v& t¢MW $ 3-26.-0 -67
Signature of Owner/Agent Date Si6w6re o ontractor/Agent Date
J'otfN ) tv`c b q-tg" ,Q�lL7Ltj l 32G-0
Print Owner,Agent's Name / Print Contractor/Agent's Name —
Signature tCNc
'A
Owner .
ProducedI
APPROVALS: ZONING:
Special Conditions:
Rev 02/2007
KAREN BARRETO PUCA
MY COMMISSION #DD 429693
EXPIRES MAY 14, 2009
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UTIL
FD:
KAREN BARRETO PUCA
MY COMMISSION #DD 429693
Oz
EXPIRES MAY 14, 2009
?„g; ; � ` Bonded Thru olaq kuf�Gs Iladet+vtite
Contractor/Agent is
Produced ID _
ENG:
Date
Known to Me or
BLDG: