HomeMy WebLinkAbout2429 S Bay AveCITY OF SANFORD PERMIT APPLICATION
TPermit N: O7 — 71
Job Address: /_ t
Description of Work:
Historic District: Zoning:
Date:
Total puare Footage
Value: of Work: S 1
Permit Type: Building Electrical Mechanical- Plumbing Fire Sprinkler/Alarm IIool
Electrical: New Service — N of AMPS Addition/Alteration Change of Service 'temporary Pole
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: N of Fixtures
Plumbing/New Residential: k of Water Closets
Dccupancy Type: Residential Commercial
Construction Type: N of Stories:
3wmers Name & Address:
3onding Company:
ddress:
Replacement New (Duct Layout & Enctgy Ca1c. Required)
H of Water & Scwer lines H of Gas Lines
Plumbing Repair — Residential or Commercial
Industrial
q of Dwelling Units: Flood Zone: (F'F.MA form required)
Phone:
f Gr elz- "7
Slate license Number: ei4 C O 57
Phone: Cf-07—
Mortgage Lender.
ddress:
rchilect/Engineer. Phone:
ddress: Fax:
1pplication 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
ssuanee 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
krmit must be segued 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 that 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.
40TICE: In addition to the requirements of" permit, there may be additional restrictions applicable to this property that may be found in the public records of
Iris county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies_
eceptance of permit is verification that I will notify the owner of the property of the requirements of Flom lien Law, FS 713.
Signature of Owner/Agent Date Signature of Contractor/Agent Date
LLr1Jrf' /C (U$!/S
Print Owner/Agent's Name Print Contract Agent's Name
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date
DEBBIE BL#
DD
TON
MY COMMISSION I N01
EXPIRES: Febru25, 2W7
Owner/Agent is _ Personally Known to Me or Com c( AhK—
Produced ID l7
d'PROVALS: ZONING: UTIL: FD: ENG: BLDG:
pecial Conditions:
cv 03/2006