HomeMy WebLinkAbout2416 S Palmetto Ave (3)Permit # : 0 03
CITY OF SANFORD PERMIT APPLICATION
Date: (a'0 0 (D
Job Address: a 5• i;—-Me7TO A/,)FOQr)
Description of Work: t J1( d.'^ SC 1h4 aJ / / aNV ,&A,1
1.1.
Historic District: Zoning: Value of Work: $ qw,
y
Permit Type: Building Electrical Mechanical V". Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
y
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures of Water & Sewer Lines # of Gras Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair— Residential or Commercial
Occupancy Type: Residential V Commercial Industrial Total Square Footage: 016at
Construction Type: # of Stories: of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: " 5 l"Poo` a (
Attach Proof of Ownersbip & Legal D r' tioo)
C 7OenNoe & Address: mot. w % tJ A a; a y/ef S. vye9 `r ' a 7 7 Pbooe: Q — 5 % 4(7iZ Coo
ctor Name&-Address:J !-
A
e e C jf . S Yh S ZA 4FOR013 7 r MateLicense Number: 9'e.4,ftcl.). Pbooe & Fax:
nV Bonding Company:
Address: Mortgage
Leader:
Address: Arcbitect/
Eneacer:
Address: 2 •%
f(!
3 Z S^Cootact Person: Pbooe: Fax:
Application
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 issuance of
a pemtit 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: t 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. NOTIC)i:
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, of federal agencies. Acceptance of
permit is verification that 1 will notify the owner of the property of the requir is Florid ien Law, FS 7l Q1t4 /O, Signature of
Owner/Agent Date Print Owner/
Agent's Name Signature of
Notary -State of Florida Date Owner/Agent
is _ Personally Known to Me or Produced ID
APPLICATION APPROVED
BY: Bldg: Initial & Date)
Special Conditions:
Date f{
e
e n4 Attent's
Name MY COMMISSION #
DD 164329 a•. ' = EXPIRES:
January 24, 2007 naidrd Ift
Ndary Pikk Undamufts ga M" "-- L Me or Produced ID
Zoning: Utilities:
FD: initial & Date) (
Initial & Date) (Initial & Date) 53.od