HomeMy WebLinkAbout1301 E Airport Blvd (3)104Nbe,, awn h0,>^-e,5
RECEIVED
50 10'" ' - JV CITY OF SANFORD PERMIT APPLICATION
Permit # : ±_ 1 1 CLU Date: _
Job Address: _ t ft;>,t Description of W k: V t1
Historic District: 'ng: Value o
NOV 1 U 2006
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinlder/Alarm Pool _
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 _
Occupancy Type: Residential Commercial Industrial Total Square Footage:
fi
O Wa.tk -
laa I,1Dtd r
Construction Type: _ # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel q: _ 2 "' 3 I - 3 DU ( _ C1 d (Attach Proof of Ownership & Legal Description)
Owners Name & Address: DtrE: Wk*sT- I. L- C I O I So.siT+ t-L 2-oo
J 2 327S1 Phone: '/A/7- (',tsZ-42`1_L"._... ---
Contractor Name & Address: a lP .?6 Ly-EL,FU /
01
State License Number: _
Phune & Fax: Vic, 9 (- ?yC r ZS 1(7 Contact Person: _ iL' Y i 2 , Phone: . E % " J J2
Bonding Company: _\fir
7 _
Address.
Mortgage Lender:
Address:
ArchltecUd t %2C4_ Phone: Eft-2-/97Address. -- Fax:
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 pennit 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.
W NF.R'S AFFIDAVIT: l 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't.T 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 managemer AksU its, state agencies, or federal agencies
Acceptam per it is rificati t ill tify the owner of th pro try of the requirements of ten La F:::-
Signature of Owner/Agent ate Signature of Contra r/ a Date
ra - 11110. Sam 0 CL s
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n,notsSontractor/
Agent'
s N meCASign re
ofNotary-State ofFlo Signridaef Notary-ateFlorida JESSI( "01TOMAURO
KRISTEN RODRICK
ti;.'.i;., aisle of Florida l/ COrnffW
DD041100 a?o "": NotaryPUUIn. Owner/Agent
is Persona Me orExp pNtil pp Contract : c o t'to Apr 75 2009
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ION APPROVED BY: Bldg: Zonin Utilities: FD: Initial Da(
c) (Initial & 6atef (Initial & Date) (Initial & Date) 1 _/iG/
vL Special Conditions
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