HomeMy WebLinkAbout215 S Maple AveCITY OF SANFORD PERMIT APPLICATION
Permit # : 1— 1 :4 Date: I — 036
Job Address:
Description of Work: _K blJ
O
Total Square Footage
Historic District: ,(i Zoning: PA&TIACYalue of Work: $ fQG
Permit Type: Building Electrical
Electrical: New Service — # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets _
Dccupancy Type: Residential Commercial
Construction Type: # of Stories:
Mechanical Plumbing Fire Sprinkler/Alarnt . Pool
Addition/Alteration Change of Service ` Temporary Pole
Replacement New (Duct Layout & Energy Calc. Required)
of Water & Sewer Lines # of Gas Lines
Plumbing Repair Residential or Commercial
Industrial
of Dwelling Units: Flood -Lone: (FEMA form required
3woers Name & Address: S[D ,r(Z 11 . /\ C rr! Ate e r C.t'h9VlY' — 3 Z%? 1
Phone:
Zentraclor NaAdd4,4: TK-t 7t + vC 141'I 7/
76 910(M. l c State license Number: CCC dol ?i hone &
Fax: 30ading
Company. ddress:
Person:
4ortgage
Leader: ddress:
rchilect/
F.ngineer: Phone: ddress:
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 ssuance
of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. f understand that a separate remit
must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and UR
CONDITIONERS, etc. WNER'
S AFFIDAVIT: I certify that all of the foregoing information is accurate and t at 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 TTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. IOTICE:
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. cceptarnce
o it is v 'fiwt 1 ill rtoti a owner of the property oCthe rcquir of FI Lic Law, FS 713. D
o ls%r, Io i
eofOwner/Agent D Signaturcof o ractor/Agent Print
Owner/Agent's Name Print Contractor/Ageent's N he Is
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Signature
of Notary -State of Florida Date Signature of Notary -State of Florida D ,ie w • _ A.
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v, ,n„a p Owner/
Agent is _ Personally Known to Me or Produced
ID Contractor/
Agent is Personally Kn =w Produced
W V 111
PROVALS:
TONING: UTIL: FD: ENG: BLDG: pecial
Conditions: cv
03/2006 r. , $
143.0a