HomeMy WebLinkAbout200 S Myrtle Ave (4)t.
CITY OF SANFORD PERMIT APPLICATION
RECEIVED
Date:.
-b Address:_S ���:rt i� c1�e FEB 0 6 2007
--scription of %York: 5 G xY1 (jr1 YY\�t,-k;-� 1e bu'. Q's Jet k Total Square Footage
istoric District:# � (n Zoning _ Value of Work: S `� b
— lam_—
:unlit Type: Building Electrical
ectrical: New Service - ft of AMPS
echanical: Residential Non -Residential
umbing/ New Commercial It of fixtures _C
umbing/New Residential: # of Water Closets _
-cupancy Type: Residential Commercial
instruction Type: It of Stories:
Mechanical Plumbing Fire Sprinkler/Alarin Pool
Addition/Alteration Change of Service ___ Temporary Pole
_ Replacement New _ (Duct Layout & Energy Calc. Required)
ft of Water & Sewer Lines to of Gas Lines
Plumbing Repair - Residential or Commercial
Industrial
k of Dwelling Units: _ Flood Zone: __ (FEMA form required )
vuers Name &Address:, tt ]Uy a\sl ` c [nt1t7cN,� n1_n \!�S ''7V\g1r1 M, 4CDc c, �u,
_ Phone:
,mtractor Name & Address:
one & Fax:
i
dnding Company
Idress:
utgagc Lcuder
dress:
chitect/Engineer.
dress:
State License Number: __ , i _ _ �•
Contact Person:' _ Phone:
Phone
Fax
plication is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the
mace 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, POOI S, FURNACES, BOILERS, HEATERS, TANKS, and
{ t CONDITIONERS, etc.
j ✓NER'S AFF(DAV(T: I certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
I 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
i TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT_
i
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
;ired Dorn other governmental entities such as water management districts, state agencies, or federal agencies
county, and there may be additional permits requ.
eptance of pwrtnit is verification that 1 will notify (he owner of [he property of the requirements of Florida Lien Law, FS y l 3.
0.2 a(, ' V1
igtat+rue o Owner/ nt Date Signature of Contractor/Agent
P wn Agent's a e Print Contractor/Agent's Naine
S aturc of Notary -State of Florida Date Signature of Notary -State of Florida .
MY COMMISSION # DD629096
EXPIRES: February 25, 2011
Date
Date
Owner/Agent is rb.T o Discount Assoc. Contractor/Agent is _ Personally Known to Me or
Produced (D Produced ID
?ROVALS: ZONING: G K -L `' 1 LffIL.: FD:
tial Conditions:
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