HomeMy WebLinkAbout316 Rochelle Ave (2)CITY OF SANFORD PERMIT APPLICATION
mit 9: 09— /A0 Date:
Address: '1((, R0(,E1V-lig, VV.,iVT (3UI LDI ?4. 0
cription of Work: 1X1" r-YtV'S 1yt4 OVF-K i3AI_cotJ 1 e5 Total Square Footage
toric District: P40 Zoning: t✓XlS�t Jv Value of Work: S
mit Type: Building __,X_ Electrical Mechanical Plumbing Fire Sprinkler/Alarm __ Pool
-trical. New Service - # of AMPS Addition/Alteration Change of Service Temporary Pole _
-hanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
mbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
mbing/New Residential: # of Water Closets Plumbing Repair - Residential or Commercial _
upancy Type: Residential X Commercial industrial
istruction Type: �_ # of Stories: # of Dwelling Units: Flood Zone: �b (FERIA form rtquired )
iers Name & Address: LWieci Jyl`I 11i10Yj {SPG
4nCb E S�ee�- iZic l�a+.n�
tractor Name & Address:
11,1�r L'41ctril G,"eek Gvc l.> �tit61� '
ne & Fax: `'t' c, /' 3(fit • � 162 32?y0 C
ding Company: t"LA
A A 23219 Phone:35e-
r-
j rL _ State License Number:
Person: -h•�A
ress: ff
(gage Lender:
rens:
titecUEngineer: � � 6l`/ �' � IJG- i � -- Phone : �{r07 � % 2,c��
rens: 3 "7 it-kNz--e 13 t -y iz S U t Tfi 13 "L Fax: 4b-7 ' c -9q
�e� Mari; t ru 3274(,
ication is hereby made to obtain a permit to do the work and installations as indicated, t certify that no work or installation has commenced prior to the
nce 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
A must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
CONDITIONERS, etc.
JER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that aH work will be done in compliance with all applicable laws regulating
truction and zoning WARNING TO OWNER YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
CE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT-
. ICE:
OMMENCEMENT.
'ICE: 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
;ounty, and dxxe may be additional permits required from other governmental entities such as er management districts, state agencies, or federal agencies.
ptance of "fication that I will notify the owner of the property of the requ- ments Flori ien taw, FS 713.
-(y /�� L! � `111111411011/
gnature o gent Date Signature of ontractor/Agent Date,\\e`` �� A Rl/,/��'s
Print is Nan�NA �nNO
* * MY COMMISSION # DD 603692
'If—prQ. Arfnhw 4A r1n4n I 1 /9
Sign 1 oP -one uoti�j� taryServices Date
SOF Fl
6)4�a
A/P/Agent is ✓ Personally Known to Me or
roduced ID Z��
tOVALS: ZONING: UTIL: FD:
ial Conditions:
`oPe.MwSSIO/Vg..9y
o�Ja`y 2lo
l ?�A9•• '
®.O*r
#DD 159717 Q;
� �'.yOia Bonded lbN c�m�: pQ�
/41//0I1i1111' \\V"
//(-9
V-WZ4/0
Cont or/Agent is Personally �wn to Me or
Produced ID / e7j�
ENG:
BLDG:
)3/2006 ,
X12