HomeMy WebLinkAbout314 Rochelle Ave (3)Permit 11 : y1 + ( �-- ) �0
CITA' OF SANFORD PERMIT APPLICATION
Date:
fob Address: 34 RbCAAC'L_F "p-144- SUILbi tJ& Ip
Description of Work: RcOF 1WtV-s 1 Dr1 OVIi-K r3AL1r,00 I E5 Total Square Footage
Historic District: NO Zoning: �XIS'tl*�G Value of Work: S
Permit Type: Building _)C_ Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical- New Service - # of AMPS Addition/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 Plumbing Repair - Residential or Commercial
Occupancy Type: Residential X Commercial Industrial
Construction Type: Lkkt_�)Z N of Stories: # of Dwelling Units: Flood Zone: 1146 (FEMA form required )
owners Name & Address: l/r ije4 Dm I Kibn Re-, f" , C:-YIC
40b !Wee+ Ch11 k:L►r+�+d %� 23 9-19 Phone: 020 35& - -31_
ontractor Name & Address:
It -1 Ck,:zrrC,oeA-_ Cor b W>7 t S I L State License Number: ,t7
'hone & Fax: 4 07' 'kfi • 1 Uh 32708 Contact Person: �� Phone: 4'rr'! • • 5f�6
3onding Company:
\ddress:
4ortgage Lender:
kddress:
krchitect/Engineer: 'Da`tLiri Gj6IN9 _qyj& I—VG•• Phone: BYO I, 3 �j�jdQ
I kddrem: 3�71 W • LA. R412_-� 0 W D 5111rf (3Z— Fax: 40-7- 329-. 15,15`iQj
(��►�� M�Li t f✓1. 327440
%pplication is hereby made to obtain a permit to do the work and installations as indicated. I certi(that no work- or installation has commenced prior to the
ssuance 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
rermit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
UR CONDITIONERS, etc.
)WNER'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
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
MORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
40TICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the vit. Nymwk
his county, and there maybe additional permits required from other governmental
entities suawanagement districts, state agenc`\�,G�\cceptance
I
I ien Law, FS 713.ty F/o
of eri tion that will notify the owner of the property of the
requireda 2/ •.
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t eo ed Date
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Signatur of Co tractor/Agent =Zpate
#DD 159717
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Q!/r�7 X99'0,
yp°nded 1hN \N ;� �Q
Print Owner/4 t am
ANNA MARTINO
Print Contractor/Agent' Nante � g � ••...•° OF i+°
rrA
III44��o�i
MY COMMISSION # DD 603692
Signature StaUSIFE SzWobel 1. ,:2010 Date
Signature of Notary -tate of FI ida Date
9�OFS-rle Bonded Du Budget Notary'Servvlt:'ds '
�//QD 0- �� o
Y
Owner/Agent is Personally Known to Me or
Contractor/Agent is _ Personally Known to Me or
Produced ID
Produced ID
LPPROVALS: ZONING: UTIL: FD:
ENG: BLDG:
pecial Conditions:
,cv 03/2006
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