HomeMy WebLinkAbout2714 Ridgewood Ave Bld 9+ W C Jr
JAN 2 4 2012
1-
CIT-Y=OF=SAN ORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No:
POP
Documented_ Value: S iG 2J.
Job Address: ZZ �4. 1ZiAWoar�_
eConstruction
gi�[ Historic District: Yes ❑ No
Parcel ID: 07.-2.0 ^30 -300—04.&IP - 0000 Zoning:
Description of Work: X-y46'r%
4I 4/y 045coneck 444&(- aet'%¢- ®R-& Krm
Plan Review Contact Person:
Title:
Phone:
Fax: E-mail:
Property Owner Information
,L�Qn
'KD�lX�
Name �'
Phone: Yw_ &9 D5 aS
/-M
Street: 261
Resident of
property?
City, State Zip:
Contractor Information
_ r -
Name J44AWA rU4 OA&_ la'1lift fml Sof 4�S Phone: 32J - S22— L4 04:0% -
Street: 744T%Z A&Ie✓t,
4%r- Fax:
City, State Zip: Qr- 4W&gg:&
Z? lk'yq State License No.: E2
Architect/Engineer Information
Name:
Phone:
Street:
• . �� . ; Fax:
City, St, Zip:
•' E-mail:
Bonding Company:
Mortgage Lender:
Address:
Address:
PERMIT INFORMATION
Building Permit O
Square Footage:
Construction Type: No. of Stories:
No. of Dwelling Units:
Flood Zone:
Electrical
Plumbing O
New Service — No. of AMPS:
New Construction - No. of Fixtures:
Mechanical 13 (Duct layout required
for new systems) Fire Sprinkler/Alarm 0 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,,•foiregoing.information;is accurate and:thd all work will
be done in compliance with all applicable laws regulating construction and zoning. .
WARNING TO OWNER: YOUR. FAILURE TO RECOfMIA NOTICE Og. CQMI,VIENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE
OF COMMENCEMENT MUST BE R&ORDED 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 tjie 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 agenci•e$ or••fed`eral agencies`. •••
Acceptance of permit is verification that I will notify the owner of tlie•property of the requirements of Florida
Lien Law, FS 713.
The City of Sanford requires paymerit of a plan review fee. A copy of the executed contract is required IT order
to calculate a plan review charge. If the executed contract is not submided,'-we reserve-thd fght.to.ealeulate the
plan review'fee based -on 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:
1w., //�, 3r I-!;q'1Z.
' nature of Contractor/Agent Date
&&A yd 11F1±!!1 ?�
Priv mractor/Agent'sNa e
zr/a
Signature of Notary -State of Florida Date
`tom: §�\S 16,0�9
Contractor/Agent 019� nail
Produced ID �. � q ,IDB
WA -9 EI
BUILDING:
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