HomeMy WebLinkAbout2714 Ridgewood Ave Bld 5.1
RECEIVED
t
JAN 2 4 2012 CITY OF SANFORD
B,Y: BUILDING ,& FIRE PREVENTION
PERMIT APPLICATION
Application No: Documented Construction Value: S (aZi •
P&
Job Address: 2.1 14 It: sLau2=2d I^#, W 5 Historic District: Yes ❑ No Q�
Parcel ID: 0 2.2 o —3C - 30o • t%l A[O — e& so Zoning:
Description of Work:
Plan Review Contact Person:
Phone:
Fax:
E-mail:
Property Owner Information
Title:
Name AW *: Tft_bio.V' Phone: gw— dol cf — &5,45S
Street: 06y Ys r �"K- Resident of property? : �&
City, State Zip:?i217
Contractor Information
Name t''h'«! GG E(eth&ygf SVGS Phone: ' — 3?%— 1-400 e
Street: ZIM h6dert 4we Fax:
City, State Zip: CH t4rwagD sr% 3Z frpq State License No.: FA 130 !Q 5 Rx
Name:
Street-.
City, St, Zip:
Bonding Company: _
Address:
Building Permit O
Square Footage:
Architect/Engineer Information
Phone:
Fax:
E-mail: _
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type: No. of Stories:
No. of Dwellin Units: Flood Zone:
Electrical
New Service — No. of AMPS:
Plumbing D
New Construction - No. of Fixtures:
Mechanical 0 (Duct layout required for new systems) Fire Sprinkler/Alarm O 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, beaters, tanks, and
air conditioners, etc:
OWNER'S,AFFIDAVIT: I certify that all of the foregoing information is accgrgte:and'tha'all work will
be done in compliance with all applicable laws regulating consfruction and zoning.
WARNING -TO OWNER; YOUR FAILURE TO RECORD A NOTWE O1F',CONi�1'IENCEMENT MAY
YIN
RESULT IN YOUR PAG TWICE FOR 1Nfi;ROVEMENTS TO YOUR 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 t) .requjreFtents of this permit, there may be additippal restrict ions 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°agertcies, br•federal agencjes.•'.
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 requires payment of a plan review fee."A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we"rdilerve,the-right to calculate the
plan review • fee ;basedpn past permit activity levels. Should calculated charges, exceed -the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released.
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Rev 11.08
UTILITIES:
FIRE:
ftffature of Contractor/Agent Date
V",14 wreF ;t -
Prin ntmctor/Agent's Nam
2y��2
Signature of Notary -State of Florida Date
Contractor/A�551
Perso;S� Known to Me or
Produced ID= 4r%. yve.f Il'ty