HomeMy WebLinkAbout312 Rochelle AveCl'UV OF SANFORD 1'ERMt'1' At'1'L(CATION
-to Address: _..._ ..I. Z__�' _b�_ .►.ep__�iC�/ Ili_. ..n_,�'as ..- �'L .3_.. 77L---_-----_--._.___.......--------.—...-.–.--
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istotic District: ............ Zoning" ---- --- -- Value of Work: $__:
rniil. -1 ype: Building Glcclrical Mechanical Plumbing _- Fire, Sprinkicr/Alarm foul
.- --- -._........- --- -
ectrical: Nets' Servii;e --ft oC AMPS _ N1 �'f:Addiuort/AI(cranon Change of Service hemporary foie _
echanical: Residential t
jjj4ls!.i-Rc,idcotil Replacement Ncw (Duct Layout & 1.7.110gy Calc. Rc(Iuircd)
umbing/ New Commercial) Af of 1-imuics �4 of Water & Sctver Lincs H of -Gas bines
umtaing/New Residential: It of %Va(cr Closes N A - fit uint ing Repair - Rcsi(Ic(Ito al or Commercial -- - -
xupancy Type: Residential r C(Inuncrcial Industrial
Instruction Typev�ppp - - H u$Storics: 3u - N of Dwelling Units' �� Vlood Lone (1:EN1A G)rm required )
t
veers Name& AddrU-A-
ess . e (' _l_Q/t_Itra f Tr J♦-�.VtS�
._yo__
,atraclor Nance &Address:
State license Nuntitcr —
nne & Fa
C � _'D.�d- .l.Tl9 . 4 SD z�Z;�('.7'antacl l'crsou.._.a.,ll ._ C./I-���T ...__....Phone *I- y-�•'.V 7
nding Company: -----...._
Idress:
rrtgagc Lcnd<c
Arent:
chitcct/F;nginccr
(Ir'ess.
Phoric.
Fax:
plication is hereby made to obtain a pcnuit to do the work and installations as indicated I certify that no work or installation has conuncaccd prior to the
cane of a permit and Urat all work will be perforated to mixt standards of all laws regulating coasouct ion in this junsdiclion. f undctsland that a separate
mit must be secured for IA.I C.rRICAE. WORK, PLUMBING. SIGNS, WELLS. POOLS. FURNACI S, BOILERS. Ill::AI-ERS. I'ANKS, and
t CONDf1TONERS, eta..
JNUCS AFFIDAVIT: I ceatify 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 FAILORE TO RF -CORD A N0110Q Of COMMGNCEMGNI' MAY Rf;;SULT IN YOUR PAt'(N(;
1ICE FOR (MPROVEMl:KfS TO YOUR PROPERLY IF YOU INTEND TO OFTI-AIN FfNANCING. CONSULT' W fE f( YOUR LENDER OR AN
TORNFY BEFORE RECORDING YOUR NOTICC OF COMME NCV,&fl:NI'.
rfIC6 In addit* tae roquireme It: ofutis pe mit, there may be additional resbictions applicable to this property iliac may he found in dic public reco(ds of
county, and ( e m y be a�A�tiWal pemul�wired from other povcrnmcnta) entities Such as water ruanagemGtt districts, %talc agencies, or federal agcacic.s.
xptarace of mit is a rcza t r t o(ify the owner o the property of the rcqui mcnts n 9urida Licn Law, FS 711.
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Sign a At n( p:uc Sirnaturc of (.nnu:�clodAgc — -Dale
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Print O / cn s Nam
1111 fit
Si of cry State of Ilorida ` , �N • tsOy�i
Owncr/Agent is Personally Known (o #DD 418176 ; a
Produced ID i 9�•.ay�rdedt� ' •' ��
'ROVALS: ZONING: _-.---_._ UHL:
cial Comitiotts:
03/x106
Print C nt r or gent's NameRY��S,--------------�
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Signatuce o N cry -Stale of Florida D' tcs13o
rOi
1
,o9c�
2 % #DD 418176 ; o
O j�
Contractor/Agent is (usona(!y Known to Me or �j 9` •,EYP �. \
Produced ID /�/��AUBi •••• Qrt�\\\
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1110 II11NON
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