HomeMy WebLinkAbout324 San Lanta CirI Permit # : 07-92-7 CITY OF SANFORD PERMIT APPLICATION
Date:
Job Address: -324 SI.9N L19r/VTR Cr .SHIN/—ori✓
Description of Work: Bed Reww AWAw t&44
Historic District: Nn Zoning: Value of Work: S q�(
I Permit Type: Building Electrical Y 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 Commercial Industrial Total Square Footage:
Construction Type: BLOCK # of Stories: I # of Dwelling Units: Flood Zone: A&2_ (FEMA form required for other than X)
Parcel #:<",Nn ) j—A / (Attach Proof of Ownership & Legal Description)
Owners Name & Address: ,5,q/we
ed/ri/9 C&Vj$, , Div G�o�/.�i9N�✓.�/YG Phone: /'812iz-
Contractor Name & Address: Co Z Z,� �!%sj/� p/f b,
State License :Number: ����6/9 / T3
'hone -�c Fax:," 37,Z 5(o Z Contact Person: T ?hone:
3onding Company:
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iddress:
'Mortgage L; oder: _
Wdress:
.rc; cti :.. •:icer: —
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er Ue secured for ELECTRICAL VOR.K. 'LUPdBCNG. 'ZIGNS. 'vvLLS, POOL. i URNACES, 3017L3RS. fEA ERS. 7AiNKS.:md
AIR CONDITIONERS; ,=.
OWNER'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
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYW,
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. a
1
NOTICE: 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 9
this county, and there may be additional permits required from other governmental entities such as water managementdistricts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the reg;' of FloridaZien Law, FS 3.
Signature of Owner/Agent Date ture of Contractor/Agent Date
Print Owner/Agent's Name Print Co ctor/jens Name
Signature of Notary -State of Florida Date'Signature of Norary-State of Florida Date
Lori Willick
E 2 Commission #DD369931
Owner/Agent is _Personally Known to Me or Contractor/Agent is Personally Known to Nitl Dr *_
Produced ID
Produced ID
Plres: Sep 08, 2008
BondodThra
Bonding Co., 1w,
APPLICATION APPROVED BY: Bldg: Zoning: Utilities: FD: _
(Initial & Date) (Initial & Date) : (Initial & Date) (Initial & Date)
Special Conditions: