HomeMy WebLinkAbout1900 Washington AveDescription of Work: J� C t' V t G e� U n�ra�l
Historic District: Zoning: Value of Work:
Permit Type: Building Electrical )_ Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS
Addition/Alteration
Change of Service X Temporary Pole
Mechanical: Residential Non -Residential
Replacement
New (Duct Layout & Energy Calc. Required)
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# 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:
# of Dwelling Ur -its:
CITY OF SANFORD PERMIT APPLICATION'
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Permit #: T.
Date:
a 5 0 7
Job Address: I qQ� wd5htn5toh
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Description of Work: J� C t' V t G e� U n�ra�l
Historic District: Zoning: Value of Work:
Permit Type: Building Electrical )_ Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS
Addition/Alteration
Change of Service X 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:
# of Dwelling Ur -its:
Flood Zone: (FEMA form required for other than Y)
Parcel #: 11 (Attach Proof of Ownership & Legal Description)
Owners Name& Address:SVeiland -i3RC, 19up Wd$l,th440✓� Ayf- Sat-,fo-4 3a%7-7
``'' Phone: ,�tt�oo
Contractor Name& Address:_rr'IMe. FlecJrl"l Con��aG��r1q LLC 6j 14 ,�K�tina LQ,, -e- Odando
RIa Sbo State License Number: ER 0614.17 0 _
Phone & Fax: 407•aicl 654 F,4C8.678-ContactPerson: Pav,k J M218mtsvra Phone: 4o?.4(o6,V8B
Bonding Company: 140aKlt:b c rhV t 5 t hi e�/ ♦-._--
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Phone:
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: l 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 T,44000)y'.
ds ofthis county, and there may be additional permits required from other governmental entities such as water management districts,\S*056,0 �
Acceptance ofpermit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS.�"y
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110 J9
Signature of Owner/Agent Date Signature of Comr-aictor/Agent 1�4� • OVie _
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Print Owner/Agent's Name Print Contractor/Agent's Name i � . r, 51"i�`
Signature of Notary -State of Florida Date Sienature o Notary -State of Florida YNI'I I
Owner/Agent is -
Produced lD
Personally Known to Me or
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Special Conditions:
Contractor/Agent is,
Produced lD _
Zoning: Utilities:
(Initial & Date)
Personally Known to Me or
FD:
(Initial & Date) (Initial & Date)
11-25.00