HomeMy WebLinkAbout1116 S Magnolia Ave._ tI
0,3
CITY OF SANFORD PERMIT APPLICATION
Permit # : i� /
Date: y °o %
Job Address: (p S . M ,-Jo
I jA Aub, SnJi=u(ZD L 3Z7 -1 I
Description of Work: %,OOcE I j,J UfA :1 A,.,,p_
Historic District: Zoning:
Value of Work: $— n
Permit Type: Building Electrical
Mechanical _)�s_ 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 - -X— Commercial
Industrial Total Square Footage:
Construction Type: # of Stories: Z
# of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: 2` 19 3 D - 5-A& - 13 b3
- oW A (Attach Proof of Ownership & Legal Description)
Owners Name & Address: I/V i_
11) ( a S. M IG M D LIR 6 V C-
0 P t-
L. -120 1 1 Phone: ( (0 a-? ` S5
Contractor Name & Address: MID EtA A 11L
Con 0 11 t 14", 1 1 - q Z -
Phone & Fax:1. i`1n la L15 y
Bonding Company:
Address:
Mortgage Lender:
Address:
State LicAse Number: C A,('DS U �!( 2-1, p
Contact Person: kLE,) 1 Phone: ( -7,R 6)
Architect/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. 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: hi 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 su s water management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the req reme tsA F;oridi�e FAI
Signature of Owner/Agent
Print Owner/Agent's Name
Signature of Notary -State of Florida
Owner/Agent is Personally Known to Me or
_ Produced ID
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Special Conditions:
Date
Signature of
Print
n, _7"X">4 h A nr &2 l�
�0_7
Date Signatire of Notary-State)of Florid •y IWIrrcia Rodrigues
My Comm"ion D0327%9
a wP Expires June 09, 2008
Contractor/Agent is /— Personally Known to Me or
_ Producd ID
Zoning: Ol�/ tktolilities: FD:
(Initial & ate) (Initial & Date) (Initial & Date)
CITY OF SANFORD HISTORIC PRESERVATION BOARD
APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS
P.O. Box 1788, Sanford, FL 32772=1788
Phone: 407.302.5805 Fax: 407.330.5679
TO: THE HISTORIC PRESERVATION BOARD OF THE CITY OF SANFORD, FLORIDA
❑ Downtown Commercial Historic District ❑ Residential Historic District
❑ This application is filed in response to a notice from the Code Enforcement Department
ADDRESS OF PROPERTY: 1 I I lD / G o u /} /�J
Property Owner
Signature: Print Name: C6��
Mailing Address: i t S• /� ��� �1 ,Lf�}_ T 2, r-,-,
Phone: h o f to - S 5 7 Fax:
Applicant/Agent
Signature:
Print Name: <6yi lo 9GGtAA
Mailing Address: l it, 14%/,-4 l � Z '21
Phone: bRc,) (ol�� c715"z Fax: 03 Z_
I certify that all information contained 'n this application is true and accurate to the best of my knowledge.
Applicant/Owner: Date:
Please use the attached criteria checklist as a guide to completing the application. Incomplete applications cannot be
reviewed and will be returned to you for more information. You are encouraged to contact the preservation planner at
407-330-5672 to make sure your application is complete.
Description of Proposed Work/Application Category: (Check all that apply)
❑ Site Improvements/driveway/walkway ❑ Storage shed ❑ Moving structures
❑ Replacement. windows or doors ❑ Underskirting ❑ Awnings
❑ New construction/additions ❑ Signs ❑ Demolition
❑ Roofs/gutters/downspouts IKAC/Mechanical ❑ Fences/Gates/Pergolas
❑ Replacement siding/flooring/porch ❑ Paint ❑ Other
Completely describe the entire scope of work: all changes in material, color or location to the exterior of the building,
where on the property the work will occur and how the work will be accomplished. Fyr large projects, an itemized list is
recommended. Attach additional pages if necessary.
n�T
�`C(7LHCi7 119-5)1) - 9 0.-,) 75, nr L) S
Un] StL�.vn Fc dfl2 n t�l [
A Certificate of Appropriateness is valid for six months unless otherwise noted
OFFICIAL USE ONLY
Historic Preservation Board Meeting Date: Staff Review Date:
Application is Approved Approved with Conditions
Conditions:
Signed
Date:
Denied
***This Certificate must be prominently displayed on the building when work is in progress***
Requirements for Certificate of Appropriateness Application