HomeMy WebLinkAbout125 Mayfair Cir (2)CITY OF SANFORD PERMIT APPLICATION
Date: 07
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-b Address: i',1S�l V �a i V" G i 1r'c
.scriptionofWork: .uSTA1(� Cc NJTfAL ell ( Uiv( Total Square Footage
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istoric District: Zoning Value of Work: S �1j5C)
:rmit Type: Building Electrical _ Mechanicals Plumbing Fire Sprinkler/Alarm Pool
ectricaL New Service - # of AMPS Addition/Atteration Change of Service ____ Temporary Pole
echanical: Residential`- Non -Residential Replacement.. Newi/(Duct Layout & Energy Calc. Required)
umbing/ New Commercial: # of Fixtures # of Water & Sewer Lines b of Gas Lines
umbingfNew Residential: # of Water Closets Plumbing Repair - Residential or Commercial _
ccupancy Type: Residential I. Commercial industrial
)nstruction Type: # of Stories: # of Dwelling Units: Flood Zone_ _ (FEMA form required)
vuers Name & Address: A A) G- e L .BOG
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mtractor Name & Address: ;fi M [ l7 l t G% /i le
State License Number CA Ly q % 4___ j
one & Fax: Cnntaet PefsOn:./L i 1� �� Phone: U% - 3,1t c / 7 5
riding Company:
Idress:
rrtgage Lender: — —
dress
chitect/F:ngineer
dress:
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 the
rance 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, POO", FURNACES, BOILERS, "EATERS, TANKS, and
t 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 Olt AN
TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT-
NICE: to 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 management districts, state agencies, or federal agencies.
;eptance of permit is verification that 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713-
�11e/1 2 -,;Z -0.7
Signature of Owner/Agent Date -f, of Contractor/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID - - --
'ROVALS: ZONING: UTIL: FD-
cial Conditions
0312006
� Mss fir wh,�t?i�e-
Print Contractor/Agent's Narne
Sin ulo
re of t Stat f Date
t ,ear?rY J�RNNR NSON
MY COMMISSION # DD 285622
* EXPIRES: March 23, 2008
Rondetl Thru Budget i10M Service
Contractor/Agent is Personally Known to Me or
Produced ID Z5
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