HomeMy WebLinkAbout1905 S Marshall AveCITI' OF SANFORD PERMIT APPLICATION
Permit # : 0-7— l s8 Date: /C // glc,(o RECEIVED
Job Address: /9O, 5. C-e.-&r aca PL ,39%77/ f)f T 9 n 20 0 uc
Description of Work: 01"16 a e CJLr 3 +C, \ 0 I P P VQ9 Square Footage
Historic District: "Zoning: Value of Work: $ (4. a% 3-0 C
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm 11001
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
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
Owners Name & Address: G n 1GC /n P e(mc n
9G ' Mr, fShn nUe Sc n>nrr/ Pl- 3a-;,-7iPhon/
ai
qr! 7 - 3e 3 -/
Contractor Name & Address: L_ram_ C_l mc,, f1 t, CCe 14-rt7( '7n1F6 K/l /rc G e-1 4(^ra Beading
Company: Address.
Mortgage
Lender: Address:
ArchitecUEngineer:
Address:
Phone:
Fax:
Application
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 issuance
of a permit 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. OWNER'
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 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. OTICE:
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 requiremen Flo Lien Law, FS 13, Signature
of Owner/Agent Date Signature of Contractor/Agent Uatc Ann
n wmnq Print
Owner/Agent's Name Print Contractor/Agent's Name Signature
of Notary -State of Florida Date Owner/
Agent is _ Personally Known to Me or Produced
ID APPROVALS:
ZONING: UTIL: FD: Special
Conditions: Rev
03/2006 AAr,
N REBECCA A. PERKINS 40'
MY COMMISSION # DD554219 Ort
p /EXPIRES: May21,2010 ENG.
BLDG: 5
3. 6v