HomeMy WebLinkAbout214 Towne Center Cir.rob Address: Z)q ) U C`
CITY OF SANFORD PERMIT APPLICATION
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Date:
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RECEIVED
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Description of Work: A 4A -i— 0? `oca+o Io.i/S U `H+ G(JeW __.II 'vtf"{ '
Historic District: _ Zoning: _ Value of Work. S 600
Permit "Type: Building _ Electrical Mechanical Plumbing lire Sprinkler/Alarm fool
Electrical New Service — # of AMPS _ _ Addition/Alteration Change of Service Temporary Pott,"
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Cale, Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines It of Gas Lines
Plumbing/New Residential: It of Water Closets Plumbing Repair — Residential or Commercial
Occupancy'Type: Residential Commercial e� Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: _ Flood 'Zone: (FEMA form required for other than X)
Parcel #: _ (Attach Proof of Ownership & Legal Description)
Owners Name & Address:
Phone:
Contractor Name & Address: >fMt��C� h�AVt2�/ `moi7C)� N 1�)1�vtiC;`eJYtel•YK��7 t/l(Gtir�d 1
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St License Number: C r 014
Phone & Fax: �/v �� 7. 3S 1162 �^2ji -llS� Contact Person: ( t%G[`] /' Jll G` Phone:
Bonding Company: —
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Phone:
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 meet standards of all laws regulating construction in this jurisdiction. I understand that a separate
hermit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, IIEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing infounation 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 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 may be additional restrictions applicable to this property that may be found in the public records of
this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of thu rcquiremcmts-ot Florida Liert.Laty, FS 713.
Signature of Owner/Agent Date Sit�aatme o Cf2ni1 to •tor/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
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APPLICATION APPROVED BY: Bldg:tC P Zoning:
(Initial k Date)
Special Conditions:
Signature of Notary�State of Flurida
Contractor/Agent is Personally Known ft¢MNA" Flo
Produced iD
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Utilities: FD:'y
(Initial & Date) (Initial & Date) (In n
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DRAWN BY.„
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fy CHECKED BY:
DATE:
69 MI 61IR 0,
2006
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TDRAWING "NAME:
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SCALE:
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PROJECT) No / PROMPTS No.
FILE LOCATION:
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