HomeMy WebLinkAbout111 Lakeside Cir (2)RECEIVED
CIT\' OF SANFORD PERMIT APPLICATION
Permit #a 32_/ 1' ,2_ Date: 1,711 b1 CTO O C T 2 0 Z006
Job Address: 1) I LG k el IC1 P C hrC( 2 SC, n'%t: l - P 9 3al7 3
Description of Work: ChGrS e oc,+ 3 4cn PIg CCnI/Pn$ P Total Square Footage
Historic District: Zoning: Value of Work: S y
1
l.P ?q'0G
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — q of AMPS Addition/Alteration Change of Service . Temporary Pole _
Mechanical: Residential boNon-Residential Replacement New (Duct Layout &Energy Calc. Required) Plumbing/
New Commercial: N of Fixtures M of Water & Sewer Lines # of Gas Lines Plumbing/
New Residential: # of Water Closets Plumbing Repair — Residential or Commercial _ Occupancy
Type: Residential Commercial Industrial Construction
Type. # of Stories: q of Dwelling Units: Flood Zone: (FEMA form required Owners
Name & Address: 0_5(7 d2C n- cn d _) qr e4- I
I A A Ps Cl e e l Contract
Name & Address: 9SG
roc cl Phone &
Fax:lfn-Cp(4LI-, Bonding
Company: Address:
Mortgage
Lender: Address:
Z
71_ 3a7 rnS
C 11 c,4- 1 U-
Ifn +P 0 rG y'1. 3a-64 fV
I-(Lo' P- Contact Person: Phone:
7 ) 7 ' SG IF `/C13.7 License
Number: C17 CCL/'?&&'ri Z
I C ret r\C'Lc-- I / Phone: Archilecl/
Eagineer: Phone. Address:
Fax: Application
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 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 permit
must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIR
CONDITIONERS, etc. OWNER'
S AFFIDAVIT: 1 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 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 1 will notify the owner of the property of the requirements of nda Icn Law, FS 7 3. Signature
ofOwner/Agent Date Sig ure of Con r or/ t Date 1
C1 r W rCYY1 Print
Owner/Agent's Name Popt Contractor/Agent's Name Signature
of Notary -State of Florida Date Owner/
Agent is Produced
ID Personally
Known to Me or APPROVALS:
ZONING: UTIL: Special
Conditions: Rev
03/2006 FD:
o
MYCUMMISSiONNDD3S1219 om,
EXPIRES: Msy21.2010 407)
39"153 Florida Norery Senke.cam Contractor/
Agent is _ Personally Known to Produced
ID ENG:
or
BLDG: