HomeMy WebLinkAbout2644 S Sanford Ave (2)CITY OF SANFORD PERMIT APPLICATION
Permit li : / - 3 1 Date:
Job Address:/arvr-offh-
Description of Work:
Historic District: Zoning:
Total Square Footage
Value of Work: S Zg0,00 . of
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm, Pool _
Electrical: New Service — N of AMPS Addition/Alteration Change of Service Temporary Pole _
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: N of Fixtures a of Water & Sewer Lines 4 of Gas Lines
Plumbing/New Residential: q of Water Closets Plumbing Repair — Residential or Commercial _
Dccupancy Type: Residential Commercial Industrial
Construction Type: I q of Stories: N of Dwelling Units: Flood -Zone: FEMA form required )
waers Name & Address: N t W
I. y'o S M wov nty, f11 -,F-X- . 'l,.L r I It OJ f 15A, F-A .6 Phone: t.10 3 01 — v.
contractor Name & Address:
hone & Fax:
3euding Company:
ddress:
State License Number:
Contact Person. Phone:
Mortgage Leader: G•' 1i -" % l±r%%.-
ddress: C . .MAGwavu,A fft r,, h * Sk t+s.Torl+9
rchilect/Enginecr:
kddress:
Phone:
Fax:
kpplication 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
mrmit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOIS, FURNACES, BOILERS, HEATERS, TANKS, and
UR CONDITIONERS, etc.
WNER'S AFFIDAVIT: 1 certify that all of the foregoing information is accurate and dial 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 WIT11 YOUR LENDER OR AN
TTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
JOTICE: 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.
Acceptance of permit is verification I1WI it the owner of the property of the requirements of Florida Lien Law, FS 713.
Sign of gent Date Signature of Contractor/Agent Date
Print Owner/Agent's Name Print Contractor/Agent's Name
Si -Slate of Florida Date Signature of Notary -State of Florida Date
1
LANTONkDEBBIE
COMMISN # DD 1aWl
Hly. Contractor/Agent is — Personally Known to Me or
P u Produced ID
rPPROVALS: ZONING: UTIL: FD: ENG: BLDG:
pecial Conditions:
ev 03R006
d3
r
Company:
Owner:
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
name
address
phone
License M
Project Information
Permit #:
Subdivision:
Lot #:
I, i Hy S t•...t'rw- , affiant, hereby affirm that I am the duly licensed
contractor of record for the above referenced permit, that all the foregoing information is true
and accurate, and that the dry -in, flashings at the above referenced address or lot has been
installed in accordance with the applicable codes and standards.
Contractor:
si ure
mod.
printed name
STATE OF FLORIDA
COUNTY OF S Qv-• %,t-J•A.t
This instrument was acknowledged before me this day of N`'--, 20 41% by the
above referenced individual, 5Z .vv , who acknowledged that he/she is a
duly licensed contractor with , and who acknowledged that
he/she was authorized to execute this document. He/she is either personally known to me or
produced as valid identification.
WITNESS my hand and seal this
OEBBIE B ITON
MY C)ES SSION # DD 18134
EXPIRES: February 25. 7
1-000.3 A%y FLr Diet Wc.
day of , 20
Notary Public