HomeMy WebLinkAbout1460 Rhinehart Rdt
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b Address:
ascription of Work:
istoric District: Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date.
2-1 !;-/o G
CJVCI Total Square Footage
Value of Work: S 1 S'00
wasit Type. Building Cleclrical _— Mechanical : - Plumbing Fire Sprinkler/Alarm foul
ectrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary Pole _
1i eehanical: Residential Non-Residential-x Replacement New (Duct Layout & Energy Calc. Required)
umbing/ New Commercial: # of Fixtures # of Water & Sewer Lines
umbing/New Residential: # of Water Closets
zcupancy Type: Residential CommercialAt Industrial
instruction Type: # of Stories: # of Dwelling Units:
eaers Name & Address: I_ A'\1a VL pre" '
niractor Name & Address:
of Gas Lines
Plumbing Repair - Residential or Commercial
Flood Zone: (FEMA form required)
n G G MA,
l.ic nseANr er: C- rrL t:J`'F'/> 7 A V _
one & Fax: J fa l r 3 D Contact Person: A r 1G`- Phone: `TV - t% ' 6 ( /
ading Company:
dress:
rrtgage Under:
dress:
chitecVEngiaeer:
dress:
Phone
Fax:
plication 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
ranee of a permit and dim all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate
mit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
t CONDITIONERS, etc.
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NER'S AFFIDAVIT: I certify that all of the foregoing informalion is accurate and that all work will be done in compliance with all applicable laws regulating
t9ruction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
ICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
TORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
TICE: In addition to the requirements of this permit, there may be additional restrictions livable to this property that may be found in the public records of
county, and there may be additional permits required from other governmental entities s ch as water managane districts, state agencies, or federal agencies.
eptance of permit is verification that I will notify die owner of the property of the requi 7-tsent
e Law, FS 713
I
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Signature of Owner/Agent Date Signature of Contracto Agent
r
Date
Print Owner/Agent's Name Print Contractor/Agent's Name
z L 5 lob
Signature of Notary -State of Florida Date aturc of 15fbtaryMate 00DOW JOHNSON Date
MY COMMISSION II DD 265M
EXPIRES: March 23 2=
FOF Fl°aOp Bonded Thru Budget Notary Services
Owaa/Agent is _ Personally Known to Me or
Produced ID
ROVALS: ZONING: UTIL: FD:
vial Conditions:
03/2006
Contractor/Agent is _ Person ly Known to Me or
weed ID _ (
ENG: BLDG: