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HomeMy WebLinkAbout312 Rochelle Ave (2)CITY OF SANFORD PERMIT APPLICATION 'ermit 9: 69 I i9 Date: lob Address: SU, R ocW&t t -L M.we 1501 L-Dk IJb # C1 )escription of Work: F� r SID A. RE. NOT, Total Square Footage 3istoric District: 0d Zoning: F-yus Sit fd' Value of Work- S 3 5� (ry O 4 0 'ermit Type: Building X Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool _ Klectrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole _ Wechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required) 'lumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines 'lumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial _ )ecupancy Type: Residential k Commercial Industrial -onstruction Type: WW # of Stories: 3 # of Dwelling Units:_ Flood Zone: _b (FERIA form required ) )woers Name & Address: -ontractor Name & Address: 11'1 GWn•,,, CltAV- 'hone & Fax: loading Company: [A -*Z' I I Phone: Wt•n` SPNnll, ` Z7,700. State License Number- C � (St ! - lJ Contact Person: } ► Im tWR5 1 Phone: +07' ?165.50r? Wdress: 4ortgage Lender. !" 1 tddress: Lrchitect/Engineer: Phone: Lddress: 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 >suancc 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 ermit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and dR CONDITIONERS, etc. )WNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all wort: will be done in compliance with all applicable laws regulating onstruction and zoning. WARNING TO OWNER YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING 'WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. IOTTCE: 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 tis county, and there may be additional permits required from other governmental entities suchmanagement districts, state agencies, or federal agencies. acceptance of permit' ver cation that T will notify the owner of the property of the requir encs o ori n Taw, FS 713- 107 Signature of Owner/Agent Date Signature of Contractor/Agent Date C.I-If�(, • 6AfZT)1- Print Owner/Agent's Name IF- Zs-.dIf Signature of Notary -State otfler+da_ Date T?X9 S " IRENE FUENTES P:;o� V --"P ^` testa Public, State of Texas Owner/Agen't is fO "�1rCommission Expires Produced ID '=�'+ +4e, btuaty l7, 2nin .PPROVALS: ZONING: UTIL: FD: pecial Conditions: ev 03/2006 PContractor/Agent's N 7 Signature of Notary -State of Florida CARMAN RiVERA N€ WY Public, Stat© of Florida Commis :,at;fD6 92 S X11 MY comm. cxp: s Contactor/Agent is _ Personally ' wr. o h; Produced TD % & -6o/10 ENG: BLDG: i