HomeMy WebLinkAbout1301 E Airport Blvd (4)CITY OF SANFORD PERMIT APPLICATION
Permit # : 0 n g, S -s41-G . Ye I•/K I t Date:
Job Address: 130 £ u 5 j r&'t Q IQof'T ,6 C tJ-1
Description of Work: hwr u-A g U+fr ir-do t tAL Total Square Footage '—CN 61—• TA GR-
Historic District: Zoning: Value of Work: S
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/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 Z # of Gas Litres
Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial Industrial
T A A it-f Tit iv\ ro,
Construction Type: # of Sto es: # o Dwelling Units: Flood Zone: (FEMA form required)
Owners Name & Address: Lt' n ^ ti r
Phone:
Contractor
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State License Number: C F C- 111 ? foS3?
Phone & Fa:: — 2-) 3 —S2 ( -'Si 3Coatae rsoo: Ptrone: y0 r1 — 9 yY—Z 7/ %
Bonding Company: / T j±:R 12 e PC- t- C QS_P
Address:
Mortgage Lender.
Address:
Arcbiteet/Ea;ioePhone: Address: /
iM tP 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 permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. 1 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 foregoing infomuation 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 RESULT 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. NCITICE:
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 management districts, state agencies, or federal agencies. Acceptance
of permit is verification that I will notify the owner of the property of the requi enu of Florida Lien Law, FS 713. Signature
of Owner/Agent Date Signature of Contractor/Argent Date Du
f\-% e. P, . Print
Owner/Agent's Name Print Contractor/Agent's Name Signature
of Notary -State of Florida Date ignature of No State of Florkle Date Owner/
Agem is _ Personally Known to Me or Contractor/Agent is = Personally Known to Me or ProducedIDProducedIDAPPROVALS:
ZONING: UTIL: FD: ENG: BLDG: Special
Conditions: t
Rev
03/2006 NOTARY
MIC-STATE QF FLORIDA 1.
Hemdon Commission #
DD431558 may'
F.rpires: MAY 22, 2009 Bonded
Thru Atlantic Bonding Co., Inc.