HomeMy WebLinkAbout2714 Ridgewood Ave Bld 4'_4 T AVED
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JAN 2 4 2012
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D ''..- FORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: Documented Construction Value: $ ( Zi • ts
Job Address: '� of tW fj ' -911EL4 Historic District: Yes ❑ No
Parcel ID: OL- ZD 3 30� - e�/yo "csao Zoning:
Description of Work: J.wslmli Ah- Discoomr- --s 444- uftev. /Z.cu,4&-Wvf
Plan Review Contact Person: Title:
Phone: Fax: E-mail:
rr Property Owner Information
Name Phone: t4oZ- za, d505
Street: b • AGS/ Yor-e Resident of property? : A&
City, State Zip: u- F%
" Contractor Information
Name t rwN�i� 1p _ 00, Fjp &( 6yeS Phone: ZI - 3 ?7— �L&%2r
Street: Zg17,. &jej& 4*40._
City, State Zip: Oro UAJ40�'/ 32 FJ v'z
Name:
Streei:' -� ►'
City, St, Zip:
Bonding Company:
Address:
Building Permit ❑
Square Footage:
Fax:
State License No.: • ra l301g3Y,f
Architect/Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type:
No. of Dwellin Units: Flood Zone:
Electrical
New Service - No. of AMPS:
Mechanical ❑ (Duct layout required for new systems)
No. of Stories:
Plumbing ❑
New Construction - No. of Fixtures:
Fire Sprinkler/Alarm ❑ No. of heads:
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 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 fo'regoiug informatop, iis acdfirate apd that all work will
be done in compliance with all applicable laws regulating construction and 'toping.
• . E i 4 . • • , • • . . .
WARINING.TO.OWNER: YOUR FAIL, URE TO REC,gRD k NOTICE OF�COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOiJR PROPERTY. A NOTICE
OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. 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 pernuts required
from other governmental entities such as water management districts, state agl6ncids; of federal agencies. =
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida
Lien Law, FS 713.
The City of Sanford reyuiies payment of a plan review fee. �A copy �of tf►e executed contract is in order
to calculate a plan review charge. If the executed contract is not submitted, we Feserve.the:right.to.calculate the
plan•;revievK fee,based, on past permit activity levels.. Should calculated, charges .exceed •the documented
construction value when the executed contract is submitted, credii will be applied to your permit fees when the
permit is released.
Signature of Owner/Agent Date giptfaiure of Contractor/Agent Date
1
4 M
Print Owner/Agent's Name ontiactor/Agent's Na
x2tt
Signature of Notary -State of Florida Date Signature of Notary•State of td* ..••••..
• N
Owner/Agent is Personally Known to Me or Contractor/Agent ism QwmlLy''[�own to Me or
Produced ID Type of ID Produced ID T hf ID ..
APPROVALS: ZONING: UTILITIES: WASTE WATER:
ENGINEERING: FIRE: BUILDING:
COMMENTS:
Rev 11.08