HomeMy WebLinkAbout1701 13 StCITI' OF SANFORD PF.R&IIT APPLICATION
Permit k :
Job Address: /
Description of Work: l'r..r7 /.n X 0 1'olal Square Footage .S"G6 O
Historic District. Zoning: Value of Work: S
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm 11001
Electrical: New Service — N of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing! New Commercial: N of Fixtures 0 of Water & Sewer Lines It of Gas Lines
Plumbing/New Residential: p of Water Closets Plumbing Repair — Residential or Commercial
Dccupancy Type: Residential Commercial Industrial ,
Construction Type: N of Stories: # of Dwelling Units: Flood Zone: (FEMA form required
7waers Name & Address:
oalraclor Name & Address:
hone & Fax: _
3onding Company:
ddress:
Mortgage Lender.
ddress:
rchilect/Engineer.
ddress:
Phone: 007— 110.2—
Slate License Number:
Contact Person: K;;AZ QAMEC phone-.
1'bone:
Fax:
Lpplication 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
ssuanee of a permit and that all work will be performed to meet standards of all laws regulating concoction in this jurisdiction. 1 understand that a separate
Permit must be smmd for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, IlEATERS, TANKS, and
UR CONDITIONERS, etc.
r
WNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and Urat 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 W ITti YOUR LENDER OR AN
ITORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
40TICE: In addition to the requirements of this permit, Mere may be additional restrictions applicable to this property that may be 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.
acceptance of p lit is verificat^n that 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
Signature of 1pGiyof/Agent
Pri Owner/ Name
aturc of Notary_State of
Owner/Agent is Person
Produced ID --XL F
APPROVALS: ZONING:
pecial Conditions:
cv 03/2006
1
ice'
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D"1507298 No
UTIL: FD:
Signature of Contractor/Agent Date
Print Contractor/Agent's Name
Signature of Notary -Stale of Florida Date
Contractor/Agent is _ Personally Known to Me or
Produced ID
ENG: BLDG.
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CITY OF SANFORD FIRE DEPARTMENT
FEES FOR SERVICES
PHONE # 407-302-2516 - FAX # 407-302-2526
DATE: Q - k q --m
BUSINESS NAME / PROJECT:
ADDRESS: w k
PHONE NO.: `iy1' /2. 0 19 FAX NO.:
PERMIT #: (a_3 Z 3
CONST. INSP. [ ] C 10 INSP.:[ 1 REINSPECTION [ ] . PLANS REVIEW [ ]
F. A. [ ] F.S. [ ] HOOD [ J PAINT BOOTH [ ] BURN PERMIT
TENT PERMIT&]' OTHER [ ]
TOTAL FEES: S ; ` --
Comm
PER UNIT SEE BELOW)
9NO lz
v
Address / Bldg. # / Unit # Square Footage Fees per Bldg. / Unit
1.
2.
3.
4.
5.
6.
7.
8.
9.
10,
H.
12. _
13.
14.
15,
16.
17.
18.
19.
20.
Fees must be paid to Sanford Building Department, 300 N. Park Ave., Sanford, FI. 32771 Phone # -407-
330-5656. Proof of Payment must be made to Fire Prevention division before any further services can take
place. I certify that the above is true and correct and that I
will comply with all applicable codes and ordinances
of the City of Sanford. Florida.
rd Firerevention Division A a s Signatu