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Home My WebLink About105 E 1 StCITY OFSANFORD PERMIT APPLICATION !rmit 9: o-7- �� 6 Date: -! -b Address: � 1 Si �} QUA eseription of Work: ,C1S*F1S W1ESS SES S t^ks tr\ r��n Total Square Footage_ istoric District: Zoning: Value of Work: S �Uw �- :rmitType: Building Electrical Mechanical Plumbing Sprinkler/Alarm Pool ectrical: New Service - # of AMPS Addition./Alteration Change of Service _ Temporary Pole echanical: Residential - Non -Residential Replacement New (Duct Layout & Energy Calc. Required) umbing/ New Commercial: # of Fixtures 14 # of Water & Sewer Lines 7l of Lias Lines umbing/New Residential: ## of Water Closets Plumbing Repair - Residential or Commercial xupancy Type: Residential Commercial [ndustrial Instruction Type: # of Stories: # of Dwelling Units: Flood Zone. (FEMA form required ) vuers Name & Address:(�Tt7tJU _ —17 Phoue. o'z �Q3_ a3.� ,ntractor Name & Addresses` LFgr� S te" `A n r' State license Number: _ LFC elm one & Fac. Contact Person: Phone. (4V Gyp �1Uy>� riding Company: fdress: )rtgagc fender: ,dress: chitect/Engineer: Phone. _ dress: Fax 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 t CONDITIONERS, etc. JNER'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. \\\\x\11111/�� 1TICE: In addition to the requirements of this perant, there may be additional restrictions applica �tis�t(pp' © ,f ay be found in the public records of county, and there may be additional permits required from other governmental entities such � Ivvuufa tort (C�f. state agencies, or federal agencies. �c.}� PtRF i :eptance of permit is verification that 1 will notify the owner of the property ofthe require rti r1�a� Signature ofOwtter/Agent Date Sig rc Ef Contt4r e . O Date rA w It Print Owner/Agent's Name Print C, efW N �� llql -7 Signature of Notary -State of Florida Date ignature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID 'ROVALS: ZONING: cial Conditions o3noos UTIL: FD: Contractor/crit is Personally Known to Me or Produced — - ENG BLDG: