HomeMy WebLinkAbout1115-1119 W 8 Str� (�p —I (Y CITY OF S,ANFORD PERMIT APPLICATION
:rmit H: V� ` \ Date: 1 ��
b Address: r \\z)
-seription of Work: \�� 4es�f ���^�� �_ S�S��^— Total Square Footage_
istoric District: "Zoning: Value of Work: S
Trait Type: Building Electrical Mechanical Plumbing —" Fire Sprinkler/Alarm Pool
eetricaL New Service —1( of AMPS Addition/Alteration Change of Service _ _ fempora" Pole
eehanical: Residential Non -Residential Replacement New (Duct Layout & Energry Calc_ Required)
umbing/ New Commercial: it of fixtures H of Water & Sewer LinesN of Gas Lines
umbing[New Residential: tt of Water Closets Plumbing Repair — Residential or Commercial
mupancy Type: Residential ✓ Commercial Industrial
instruction Type: # oof^Stories: \ ` \1! of Dwelling Units: \_\Flood Zone: (FEMA form required)
ruers Name & Address:
Phone. _� \, --- --
-ntractor Name & Address: ��n �� �J"��`^S V4(-
State License Number:
one & Fax
nding Company:
(dress:
rrtgage Lender:
:dress:
chitect/Eagimeer:
dress:
Contact Person:
Phone:
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 [tic
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
Z 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 permit, 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 man4gbTent districts, state agencies, or federal agencies.
xptance of permit is verification that 1 will notify the owner of the property of the
713.
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Signature ofOwner/Agent Date Signature of Contractor ent Date
Print Owner/Agent's Name Print o /A arae
Signature of Notary -State of Florida Date Signature of Not a lorid
a mv c0AiMl9Ssra ON
t EXPIRES: Febr a# DD 188481
"'�*rvOTAHY rY25, 20o7
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Owner/Agent is _ Personally Known to Me or Contractor/Agent is Personally nototr. Co,
Produced ID Produced ID
'ROVALS: ZONING:
tial Conditions:
03/2005
UTIL: FD:
ENG:
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