HomeMy WebLinkAbout2025 Summerlin Aven r
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CITY OF SANFORD PERMIT APPLICATION
Permit # : 0(0" a 7 Date:
Job Address: d0 a,' SW„r„,.-
Description of Work: i I (A rn loi., c Total Square Footage
Historic District: Zoning: Value of Work: S
Permit Type: Building Electrical Mechanical 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 Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial Industrial
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
iOwnersName & Address: f r 6 1 D
Phone:
Contractor Name & Address:
State License Number:
Phone & Fax: Contact Person: Phone:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer: Phone:
Address: 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. 1 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: I 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.
NOTICE: In addition to the requirements of this perm there may be additional restrictions applicable to this property that may be found in the public records of
this county, and there m e additional permi ui from other governmental entities such as water management districts, state agencies, or federal agencies.
AcceptancA-9fis
v ' ication th wil no fy caner or the property of the requirements of Florida Lien Law, FS 713.
Signature O er/Age t Date, Signature of Contractor/Agent Datc
PwnLOWner/Agent's Name Print Contractor/Agent's Name
Signature, of NoturyzState of Florida Date
OFBBIE BLANTON
MY CO!'ni:.iSSION # DD laW1
EXPIRES: r3bxuary 25, 2007
On /Agopbigou.av Pers9pWly W. W terw
APPROVALS: ZONING: UTIL: FD:
Special Conditions:
Rev 03/2006
Signature of Notary -State of Florida Date
Contractor/Agent is _ Personally Known to Me or
Produced ID
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DEBBIE BLANTON
MY COMMISSION # DD 1 OWI
EXPIRES: February 25, 2007
14004MTAFIY FL Notmy Discount Assoc. Co.
Steve Roscoe Plum6ing, Inc.
To Whom It May Concern:
Steve Koscoe Plumbing, Inc. would like to relinquish the permit
f454'for Katia Botello at 2025 Summerlin Ave Sanford, FL 32771. We
will no longer be doing work for this customer. The next plumbing company
chosen has my permission to continue the job.
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Steve Koscoe
President
407-797-1900
Fax: 407-302-6993
7 1 Itv: _,[- D