HomeMy WebLinkAbout3551 1 StPermit #
Job Address:
Description of Workal
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Zoning:
Value of Work:
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AN Addition/Alteration Change of Service Tempofary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
F.
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: sidential Commercial` Industrial tal Square Footage:
P �pp,,�
Construction Typ rt/kof Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Address:
Mortgage Lender
Address: ---
Architect/Engineer: Phone:
Address: 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
issuance of a permit and that all work will be performed to meei' tandards of all laws regulating construction in this jurisdiction. I understand that a separate
permit must.be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc. "
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 YOLM PAYING
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.
NOTICE: In addition to the requirements of this permit, there maybe additional restrictions applicable to this prop at y,� nd in public records of
this county, and there may be additional permits required from other governmental entities such as water manage t dis c sta . ag . e , or federal ag "cies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of ri ie S
Signature of Owner/Agent Date at ctor/Agent Date
ROBERT G. DELLO Rte
PrintOwrier/Agents Name 4PrnintC ntrac r/Agent's N me ♦�
Signature of Notary -State of Florida Date Signa ure of Notary -State o Flon a ate