HomeMy WebLinkAbout201 West 1 StCITY OF SANFORD PERMIT APPLICATION
Permit #
Job Address: 0701t
Description of Work:
Historic District:
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Zoning:
Date: `?) ?L6 c
Neaf It AC ol Square Footage '
Value of Work: S tI tSw
Permit Type: Building Electrical Mcclianic4v 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 # of Gas Lines
Plumbing/New Residential: # of Water Clos Plumbing Repair — Residential or Commercial _
Dccupancy Type: Residential Commerci Industrial
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FENIA form required
wmers Name & Address: " L.5-r 7 7r alo p& A V e P O'l o .00 e3ra,2ZO
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Phone:
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contractor Name &Address rN t' Pea f ' " C kf , 6 0 (1n
State License Number: `d T.
hone & Fax: 7 G+7 a to tg 8 Contact Person: aV Phone•.' % /78a Ca'eB
3onding Company:
ddress:
4ortgage Lender:
ddress:
rchitecVEngincer:
ddress:
Phone:
Fax:
pplication 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
ssuance 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
wA mit trust be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, IIEATERS, TANKS, and
UR CONDITIONERS, etc.
WNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and Umat all work will be done in compliance with all applicable laws regulating
AmIruction 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
TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
fOTICE: 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
his county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
cceptance of perm' ' ve 'fncalion that I will otify the owner of the property of the requirements of Florida Lien Law, FS 713.
rgn alture•of O-were/
Aliwi
ate ture ofContractur/Agent Date
77 Print Owner/ c4dame Print Contractor/Agent's Name
IE TON
Signature of Not
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gn aryppMM[SSI Signature of Notary -State of Florida Date
EX01RES: February
FL
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Owner/Agent is _ Personally Known to Me or
Produced ID 1r,
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d'PROVALS: ZONING: D UTIL: FD:
pecial Conditions:
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Contractor/Agent is _ Personally Known to Me or.
Produced ID
ENG: BLDG:
CITY OF SANFORD HISTORIC PRESERVATION BOARD
APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS
P.O. Box 1788, Sanford, FL 32772-1788
Phone:407.302.5805 Fax:407.330.5679
TO: THE HISTORIC PRESERVATION BOARD OF THE CITY OF SANFORD, FLORIDA
o Downtown Commercial Historic District D Residential Historic District
o This application is filed in response to a notice from the Code Enforcement Department
ADDRESS OF PROPERTY:
Property Owner
Signature:
Mailing Address:
Print Name:
Phone: Fax:
Applicant/Agent
Signature: Print Name: Dv
iMailingAddress:
Phone: ! f% % Ba l0 8 . Fax: yd 7 e2% % Q Q 07.7-,
I certify that all informat' ned in ' application is true and accurate to the best of my 1now10 ge.
Applicant/Owner: Date: 8 Q
Please use the attached criteria ch st as a guide to completing the application. Incomplete applications cannot be
reviewed and will be returned to you for more information. You are encouraged to contact the preservation planner at
407-330-5672 to make sure your application is complete.
Description of Proposed Work/Application Category: (Check all that apply)
o Site Improvements/driveway/walkway o Storage shed o Moving structures
o Replacement windows or doors o Underskirting o Awnings
o New construction/additions o Signs o Demolition
o Roofs/gutters/downspouts mechanical o Fences/Gates/Pergolas
o Replacement siding/flooring/porch o Paint o Other
Completely describe the entire scope of work: all changes in material, color or location to the exterior of the building,
where on the property the work will occur and how the work will be accomplished. For large projects, an itemized list is
recommended. Attach additional pages if necessary.
A Certificate of Appropriateness is valid for six months unless otherwise noted
Historic Preservation Board Meetin ate:
Application is Approved
Conditions:
Signed
OFFICIAL USE ONLY
Approved with Conditions
Date:
Staff Review Date:
Denied
This Certificate must be prominently displayed on the building when work is in progress***
Requirements for Certificate of Appropriateness Application