HomeMy WebLinkAbout309 Rochelle AveCITY OFS.ANFORD PERMIT APPLICATION
b Address..0.�P
-- p
ascription o(kVork 0.`(:OA1/._. !11Cp..��.CC ►Y1� j�- --- ............. Votal Square Footage----
istoric District: Loni i : Value of %Vork: S Z QdJ
- _..-----... -- --/ --- --------- --_ ..
:unlit Type: Building � Ulccirical is-techanical Plumbing Dire Sprinkler/Alarm Pool
ectrical New Service -- # vl AMPS tJjA Addittott/Altexation Change of Service I crnporary foie
echanical: Residential a/)4 Nokt-Residential Replacement Ncw (Duct Layout & Etter Cale Required)
umbing/ New CommereiaV 9 of Fixtures y 1A p of Water & Scwer Lincs ti of Gas Lutes
umbing/IVew Residential: N of \Vater Closets Plumbing Repair -- Residential or Commercial _-
ccupancy Type: Residential - Contrncrcial Industrial
ensfruction Typew,ppD --_ H orslories: -3 flof Dwelling Units: �� Flood Lone (FEA1a, term ucyaired )
'T-- --- 1-2-3 i --- Phnnc --- --
uttraetorName&Address .. ---I sfL-geC0.>lef4ruCTt0I1...._,d,-
_._.. State License Number C�.0�.�%
^Q r pp e �1j go --2-747C _ - _ ,
nne6Fac:�s/"f_�D$o-r�1:9 ��Js�nntactPersnrt _..a.•►_.Phone ZeZ7
riding Company: --- -- - --
(dress
u tgagr Lender.
dress:
chitcct/F,ngineer
dress:
('hone.
Fac.
plication is hereby made to obtain a lwnuit to do the work 111(1 installations as indicatul I ccrti(y Drat no work or insraflaUon Iran corumcnccd prior to the
ranee of a permit 111(1 drat all work wi l be per(onucd to mtxt standanls of all laws rcgutating arustnicAiun in this jurisdiction. I understand that a separatc
mit mom be secured for I-LECFRICAL WORK, PLUMDPNO SIGNS, WELL}. POO( S, 1=URNAC1 S, (BOILERS, I IVAI ERS, TANKS, and
( CONDURONEWS, ctc.
JNEICS AFFIDAVIT: I cculify that all o(tlte foregoing information is accurate and that all work will be done in compliance with all applicable laws rcgutating
rstruction and zoning. WARNING TO OWNER: YOUR FAILORE- TO RECORD A NOTUCE Of COMMENCEMENT MAY RESULT IN YOUR PAYING
TICE FOR IMPROVEME=NTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING. CONSULT 11rI1711 YOUR LENDER OR .AN
TORNEY BEFORE RECORDING YOUR NOTICE OF COMM NC6bf1iNT.
rIICE: In ad
: courtly, and
xptattce of
'ROVALS: ZONING:
tial Conditiotct
03/2(106
Personally Knowrr to
.-_---. --- UIIL,-
there may be additional resuictions applicable to this property that may he totuul in due public rCeords of
( for" other gvvcrruncutal entities such as water managetnait districts, -.rate agencies, or tedcral agencies
-
Uw property of tile rcqui rucnts n ,(Orilla (.icrr Law, GS 713.
14-7
pate e ^ Sirnalure of Coniraetor/Agc pate
ti :• #DD 418176
:s
4r, 0q••�'id eardedtt� CI
_ �//'9!- •'� �Wic •1k�'.: mac'
SIP
Print Co et r gent's Narne
Sign - - of terry -State ofFlorida---- ale ,Q�;•BSSlO • 's� /`�/
•�QJ mN•*=
> 'y• #DD 418176
( ,oma
Contractor/Au'll is •� c(sonally Known to Me or O
Produced Ip i 9 '.a %+dedtttt`s;
�����iAUBII • •STA�����`\
7
oa