HomeMy WebLinkAbout241 Red Cleveland BlvdCITY OF SANFORD PERMIT APPLICATION
Application # : 0)' / a,51Submittal Date:
Job Address: d L ( G J ckye lard E31yd. Spy-) Value of Work: $ '900
Parcel ID:
Zoning:
Historic District:
Description of Work: IF- kc -l -vi L S ci`ur LceS -h-A --rC C S *IS Square Footage:
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Permit Type: Building ❑ Electrical Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service — # of AMPS i 506M PAddition/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
Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑
Plumbing Repair— Residential ❑ Commercial ❑
Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
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Property Owner: S C1 n TUr I?j 4A f por _kmoor i �.�r Contractor: S QrN � J A i , PP •i' t -v • kb rn�a
Address: Izoo Re.cl c c-yclQ(I& Nyel, Address: IZcxj {fid ckevcland Qkyd.
SCIAkra! �-�- - 3���3 �C.nZ-d E �L �a773
Phone:g61) E-mail: Phoney u State License Number:
Bonding Company: rj I /* Mortgage Lender: N f A -
Address:
Architect/Engineer:
Address:
Plan Review Contact Person:
Address:
Phone: Fax:
Phone:
Fax:
E-mail:
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: 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
this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
Acceptance of pe erification that I will notify the owner of the property of the requiremeentsonda Lien Law, FS 713.
S' a re of Owner gent Date S ature of Contractor/Agent Date
,2 o t
Print O /Agen ' Name Print tr tdr/A&,Name
Z IS d l /• /S(o 7
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date
PHYLLIS I. GIBSON
g�f
MY COMMISSION #DD477598
EXPIRES: OCT 02,2009Owner/Agent is Person lIP1�W&t%ugh 1st State Insurance
Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 02/2007
UTIL: FD:
PHYLLIS I. GIBSON
tiPaY ova
MY COMMISSION #D0477598
Contractor/Agent is _ /Person �A to
Ng6%PES: OCT 02, 2009
_ Produced ID ' M°`,` �° � Bonded through 1 st State Insurance
ENG: BLDG:__`