HomeMy WebLinkAbout123 Hays DrICITY OF SANFORD PERMIT APPLICATION
Permit # : 10-1—coo Date: l 1216
fob Address: 191 3aava T)r snnford
Description of Work: instil 6' wood fence along property 111MI Square Footage
f{istoric District: Zoning: Value of Work: s350. 00
Permit Type: Building Electrical
Electrical: New Service - # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets _
Mechanical Plumbing Fire Sprinkler/Alarm Pool
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Calc" Required)
# of Water & Sewer Lines # of Gas Lines
Plumbing Repair – Residential or Commercial
Dccupancy Type: Residential X— Commercial Industrial
Construction Type: i # of Stories i # of Dwelling Units: _ 0_ Flood Zone: (FENIA form required)
Jwners Name & Address: __J Wpnd t-11 Agee
—40'5 N Cottntry Club RD. Lake Marv, Fl, 32746 Phone: 407 323-1663
::outractorName&Address: _) WPndpll Agee 123 Hays Dr. Sanford _
State License Number:
'hone&Fax: 407 323-1663 Contact Person: same Phone: same
3onding Company: NA
kddress:
Aortgage Lender:
\ddress:
\rchitect(Eugmeer: NA Phone: _
\ddress: Fax.
kpplication is hereby made to obtain a permit to do the work and installations as indicated. 1 certify 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
+crmit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
UR CONDITIONERS, etc.
)WNEWS 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 M YOUR PAYING
'WICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
\TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
40TICE: to addition to the requir is permit, there may be additional restrictions applicable to this property that may be found in the public records of
his county, and there may be ttional permits r uired from other governmental entities such as water m ets, state agencies, or federal agencies.
lcceptance of it is veri cats a that I will oti the wner of the p petty of the requir ents F rida Lien Law, FS
Sign ure Date e o in c r/ Date
J. [ e gee
P nt er/Agent's Namri t Con actor/Agent's N%� to�
tgnature of Notary -State of Florida Da Signature of Notary -State of Florida ate
Barbara Fodder N" Bwbma Fodder
rniasion DD257253 My Commission DD2572s3
Owner/Agent is X— Personally Known to Me orN E .res �� � C�pp-actor/Agent is X Personally Known to Me or a poor 30 2407
_ Produced ID a• Produced ID
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d'PROVALS: ZON[N�il % / L FD: ENG: BLDG: Z) M4.01W
pecial Conditions:
.ev 03/2006
W4-AI,91,111. 41
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