HomeMy WebLinkAbout1616 E 7 St6 (, 12 D .6 f i 3 t' CITI' OF SANFORD PERMIT APPLICATION
Permit N : (' ' Date: 0 69
lob Address., I % t 6 ` T' J
Description of W 6,44-t, 1 4-7, 0Total Square Footage Historic
District: Zoning: Value of Work: S at, 0-n 0' Permit
Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Electrical:
New Service — # of AMPS Addition/Alteration Change of Scrvice Temporary Pole Mechanical:
Residential Non -Residential Replacement New (Duct Layout & Energy Ca1c. Required) Plumbing/
New Commercial: p of Fixtures P of Water & Sewer Lines of Gas fines Plumbing/
New Residential: 0 of Water Closets _ Plumbing Repair — Residential or Commercial Dccupancy
Type: Residential V"" Commercial Industrial Construction
Type: q'off Stories: # of Dwelling/Units: Flood "
Lone: (FEMA form required 3wners
Name & Address: l
f /--/- Phone. L-
ontractoLr Name & Address: re,, jZo S. Got. C et wr e G
CaV • Slatc License Number: F y o 3 O7,- hone & Fax:
u' 797-1 1yt7 fo7— 6 Contact Person: SAL' " JZ f C`y"s Phone: C'C77 7 % 7 _G 3onding Company: ddress:
Mortgage Lender:
ddress:
rchi(ect/
Engineer:
ddress: Phone. Fax:
pplication
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 ssaance of a
permit and dud all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate mrmit must be
secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and UR CONDITIONERS, etc.
WNER'S AFFIDAVIT:
1 certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating onstruction and zoning.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING WICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN TfORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT. 40TICE: In addition
to the requirements of this permit, there maybe additional restrictions applicable to this property that maybe found in the public records of his county, and
there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. cceplance of permit
is verification that I will notify the owner of the property of the requirements o 'lorida Lien Law, FS 713. r, Lv l
Lo G Signature of Owner/
Agent Date Signature of Contractor/Agent Date eve - Print Owner/
Agent'
s Name PrintRMtractor/Agcnt:5 Name Signature of Notary -
State of Florida Date Signature of Notary -St o Florida Date DEBBIE BLANTON MY
COMMISSION # DD
188491 EXPIRES: February 25,
2007 OwnedAgent is _ Personally
Known to Me or Contractor/Agent is i d%cwnAl(yrKnoVe assoe Co. Produced ID _ Produced
ID ePPROVALS: ZONING: UTIL:
FD: ENG: BLDG: pecial Conditions: ev
03/2006