HomeMy WebLinkAbout130 Belfiore CoveAv, be 76 w RECEIVED
CITY OF SANFORD PERMIT APPLICATION N O V 1 0 2006
Date:
Job Address: _ IL —or
Description of W k: {1 i
Historic District: _ ng: Value o
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool QwQ-t
Electrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair- Residential or Commercial _
O "e-z '•
13\ 6ZIJPO''-
Occupancy Type: Residential __ Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel C 0 : 20-3 I - J DU Q h Q— 00d D (Attach Proof of Ownership & Legal Description)
Owners Name & Address: 1!trEL- L- C 1 O 1 $t,,,r4 2-c,o L
3Z.7S1 Phone: y07- (I-isZ-9Z`t-._--. --- Contractor
Name & Address: d fP s'G t, State
License Number: - Phone &
Fax: Contact Person: e T' (T f ,4 eA Phone: _ .. ' F.63, f..
J
C Bonding
Company: _ / / — - Address:
Mortgage
Lender: J `•J // j Address:
Archi[
ecV inner //ir `Ir1i , (i/J//2' rJ u,N Jini'C .T 1L Phone: Address: _----- --
Fax:G Application
is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the issuance
of a pennit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. l understand that a separate permit
must be securer) for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIR
CONDITIONERS, etc. OWNER'
S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction
and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESI'I.T IN YOUR PAVING TWICE
FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE:
In addition to the requirements of this pennit, there may be additional restrictions applicable to this property that may be found in the public records of this
county, and there may be additional permits required from other governmental entities such as water manageme}r ldes%12ts, state agencies, or federal agencies. Acceptai •
per it is rificati t ill tify the owner of th pro ray of the requirements of ten Law, F Signature
of Owner/Agent ate Signature of Contra r/ a Date 4gnt
O`
mer/ gent's me P ' t ontractor/Agent's N meure.
ofNolary•Stwe of Florida I) ate Signs re of Notary -State of Florida Owner/
Agent is Pe Produced
ID APPLICATION
APPROVED BY: Bldg: Q'
Comew DD0415M Me
orExPiNS4 l2M 8&
X W Ihru (&W)4${= wwn
Zoninggk
Initial &
Date) r Sprcul
Conditions: is t'X o D e f' A- A 1S I,L Cont
Utilities:
Initial &
6atef IM/
vL EESSI( -'
AhTOMAUKU NotaryPurnlk
Nate of Florida n I.
11. ,,.5 Apr ?9, 2009 t°i4FP175
Assn. FD:
Initial &
Date) (
Initial & Date) U01