HomeMy WebLinkAbout2901 Park AveCITY OF SANFORD PERMIT APPLICATION
Permit # : Q(P- 30¢S - - - + Dg": 91• I -O to
Job Address:
Description of Work: at WZ//IV i rL A 1C Y
Historic District: _/ Zoning: Value of Work: S
Permit Type: Building Electrical (Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS 6%7' Addition/Alteration &L Change of Service Temporary Pole
Mecbanical: 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 Total Square Footage:
Construction Type: _ # of Stories: —j— # of Dwelling Units: I Flood Zone: (FEMA form required for other than X)
Parcel #: Attach Proof of Ownership & Legal Description)
Owners Name & Address: Si9/r'1'
Phone:?
Contractor,Name & Address: t %4jyue IiYC tG./ 7/9if%/n/ 447/L/T ir //7 _isv
Phone sic Fax:
3onding Company:
Address:
vlortg2ge Lender:
kddress:
trcnitecvEnytneer•
ddress:
State License Number: 6C/_3A9 j2, ¢3
Contact Person: EiK%f Phone: 409 5Z Z.'/ Z .
crone:
opncation s i:e:eov made ro •rotata ,-,enni[ [o •:o cite wore: cno msailauors .: [noicatac. .:my tea[ co cmn; r.r ms[ailuron ,:a, .otpmencco ,-,nor :a tae
issuance of a aermn rid tnat :il orK .curl t e pe::ormed [o Weer standards of .:[I laws regtuaang construc:on in t is jurisdiction. , ;aaerstano tna[ a.eparte
permit must be secured lbr ELECTRICAL WORK. ?LUMB[NG, SIGNS, '.YELLS. POOLS - FURNACES. 301LERS. HEATERS. TANKS, anu
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 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, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requAme?a of Florida Lien 1A,4, FS
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
S&atur f Contractor/A
enti!
Date
V pa"AVT
Print C ctor n
Signature of Notary -State of Florida Date
ck4 (J.' I I :cA--
Owner/Agent is _ Personally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID _ Produced ID
APPLICATION APPROVED BY: Bldg:
Initial & Date)
Special Conditions:
Zoning:
Initial & Date)
Utilities:
Initial & Date)
FD:
Initial & Date)
ItrmitN: o(p 30YS
Jub Address:
CITY OF SANFORD PERI 11T APPLWATION
Date: i1 n—%]
o
r 3d / / •
Description of Work: Total Square Footage_ . R, S' SQ. FT•
Historic District: Ale Zoning: SR Value of Work: S ri SM o
Permit Types Building I:hxtrical _ Mechanical Nmbing _ Fire Sprinkler/Alarm —_ Puul —_
Electrical: New Service - N of AMPS Q.Tin — Addition/Alteration Lhange of Service Temporary I'olc _— __
Mechanical: Rcsidential V Non-Rcsi&-ntial ___ Replacement NcN _— (1) cOAAiiAt & Energy Gale. Re:quir till
Plumbing/ New Commercial: # of Fixtures _-_ N of Wata& Scwcr Lines--_— t ofGas Lines
Plembing/IVew Residential: I of Water Closets Plumbing Repair - Residential or Commercial
Occupancy Type: Residential _ Cumnrcrcial Industrial _
e jecio f
Construction Type: SoC [ N of Stories: _ ! of Dwelling Units: _1— Flood Zone- (FF:MA forty required
OwuersName & Addreu: —M&.MK_ .7 ILepiz i A. 1j1'1jL& — — VO"
L-WK A YF Contractor
Name di Address: Plane
di Fax: 1110"
ag Company: _ Address:
Mortgage
Leader. -- Address:
Arebilecf/
Eagiaeer: Contact
Person. State
License Number: Address:
Fag Application
a hereby nude to obtain a pane to do the work and installations as ireelrcated 1 emery thal no work or mstallatiun hat enerrreenced prim to the issuance
of a permit and dwt all wok will be performed to meet standards of all laws regulating construction in this jurisdiclian. 1 understand that a teporatc permit
must be soared fo ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOIS, FURNACES, BOILERS, HEATERS, TANKS, and AIR
CONDITIONERS, etc. OWNER'
S AFFIDAVIT: 1 certify that all of the foregoing information is accurate and that all work will be done in compliwkx with all applicable laws regulating canstruction
and moing. WARNING TOOWNER. YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN Y(R1R PAYING TWICE
FOR IMPROVEMENTS TO YOUR I'KOPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE:
In addition to the requouncros of din permit, there may be additional mstriclkms applicable to this property dial may be bhwrd in dec public roc wds of this
county, and there may be addiiiorol permits nquired Porn odher governmental enlities such as water management districts, state agencies, or federal agencies. Acceptance
of penal a verif ion that 1 will no tee owner of the premiy of the requirements of Fluids Lice Law, FS 713. Al -/
COE
9 -O o Signature
of Owaer/Agent Date Signature of Contractor/Age:nt Date E'
vl, Print
Owner/Agar's Name ro
Signature
of Notary -State of Florida e Aron _
MY
ISSON 11 6D 4197911 idoegr
j EXPIRES:Apil25,2009 y — —
F'"'^
hint
Cohtrao:torMgent's Name Signature
of Notary -State of Floida Date Contractor/
Agent is _ Personally Known to Me or Produced
ID APPROVALS:
ZONING: UTIL FD: ENG: Spacial
Conditions: Rev
OY1006 BL)
G:
F t rail N :
Job Address:
3DYS"
C T1 OF SANFORD PERMIT APPLN:ATION
Description of Work: _QbMrr1'AAiW&9Lj jd/eEA Total Square Footage_ • J S SOP • FT•
Historic District: JJA ?.owing: ' ! Value of Work: S csaa-vo
Permit Type Building I-3cciricsl _ Mechanical _1Clumbimg Fire Slhrinkla/Alarrm Puul
Electrical- New Service - / of AMPS _Addition/Altaaliorr (.lunge of Service Temporary Pole
Mechanical: Residential V Nun-Resitla:nlial Replacement New (p 04- A & Energy (:ak. RaluirWI
Plumbing/ New Commercial: 1 of Fixtwes —__ / of Water& Sewer I.incs._— M of Gas l.iries
Plumbing/New Residential: 0 of Water Closets Plumbing Repair - Residential or Cuinnsercial _—
Occupancy Type: Residential — Commwcial Industrial _
v k4 I
Construction Type: Stec C M of Stories: _ / of Dwelling Units: _L_ Flood ?.use (FT..MA farm regrird )
Owners Name & Address: - ft M&--X_ LEDIfM A. ArZk& —
o, LIAK R ve _ Pbowc. y off _ ? • _.. .
Contractor Name & Address: _
Pbwe & Fax:
tending Company:
Stair license Nomber:
Covet Person.---Plwne •- -•---.--•. _
Address:
Morotage lender.
Address: -- -
Addrem:
Phone.
FOR:
Application is bomby made to obtain a permit W do dw work and imsWlatimo as mdhcagcd 1 certify "no work or insaa own bas coaaamwd pner login
issuance of s permit and that all work will be*perknmed go nhest standards of all laws regulating canstraion in this jurisdiction. 1 undcutand that a scparatc
permit gust be secured for ElF.C1RICM. WORK. PLUMBING, SIGNS, WELLS. POOI S. FURNACES. BOILERS. HEATERS. TANKS, and
AIR CONDITIONERS. esle.
OWNER'S AFFIDAVIT: 1 artiry that all of ak foregoing information, is seewste and giver all work will be done in compliance with all applicable laws regulating
conanaaion and cooing. WARNING TOOWNER. YOUR FAILURE TO RECORD A NOTICE OF COMKIENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INW-ND -f0 OBTAIN FINAWING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMrWEMENT.
NOTICE: In addition Io the requrrarrains of this prnno, &me may be additional restrictions applicable to this properly divest may be fond in dhc puMa; mxwds of
this canny, and there may be additional permits required km odw Wvernmastal entities such as water rnmugc meni dkvias, stage agencies. Or fudval agencies.
Acceptance of pamht n vaef son that l will agar Ilse owner of the property of the requirements of loads Lim Law, FS 71).
SWUNut orOwaa/Agem Dane Signature OfCumracl r/Agem Date
yl:
Print Owner/Arm's Name
S*A me of Naary-State of Flo c
MY .
hlObrallrs isahlAstnnsRna /`
Cw--`ram
APPROVALS: ZONING.
Piing Cunmstar/Agcal's Name
Signawre of Notary -Stale of Florida Date
Coauactor/Again is — Personally Known to Mc a
Produced ID
UTIL• FD: ENG: BLUG:
Special Conditions:
Rev O3nM
ffV OF SANFORD PERI 11T APPLI ATION
C%
Fr-ralif N : 0CD "'cJ l _ Date:—J25 r
lob Address:
Description of Work• _&9=9- , _Total Square Footage_ . J S SQ. FT•
Hislork District: A 7,owing: _ SR Value of Work: f 4gSaA.00
Permit Type: Building I:kr:11' _ Mcchsnipl _jClumbing Fire Sprinkles/Alarm __ Paul _—
Electrical: New Service — N or AMPS _ Addition/Alteralior change of service Tenporary Pok __ __
Mechanical: Residential V Non-Resi&nlial —__ Replacement Neu (0174- AJAIA Energy (tale. Reyuir%wl Plambiag/
New Commercial: I of Fixtures _ I or Water a Sewer 1-ines-_— • of Gas I.ioes Mumbing/
New Residential: / of Waux Ckrsets Plumbing Repair — Residential or Cwm facial _—_— Occupancy
Type: Residential _ Cummacial lrmkkstrial vk
I Construction
Type: QtdC t N of Stories: _ / of Dwelling Units: _1—
Flood 7.owe (FF.MA form required 1 Owners
Name a Address: yf,MK- .T L FOAM A. [lir kE — 3Qo --
tMK AM- FPb~. y Contractor
Name di Address: Sate
license Number. Pbone
i Fax: _ Comet Person. —_—bane: , _ -.---•---• _ Bouding
Company: Addmu.
Morvew
Lcudw. Address:
ArebileeVEngincer: _
Address:
Phone.
Fax:
Application
is boAy aside lu obtain a prnne to do the work and w Wlal ns m mjwmed i cennfy tbat no work w it aMimmo bass comnem.od prior lu dw issuance
of s permit and drat all work will be performed to meet standards of all laws regulating cunsuuawn in this jurisdicim. I understand that a upraic permit
now be seared fw ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POCH S, FURNACES, BOILERS. HEATERS. TANKS, and AIR
CONDITIONERS, etc. OWNER'
S AFFIDAVIT: I aatify this all of 1be foregoing information is saturate and" all wurl• will be done in eonwhoux wish all applicable Was regulating construction
and zoning. WARNING TOOWNER. YOUR FAILURE TO RECORD A NOTICE OF C(HNMENCEMENT MAY RESULT IN Y(NIR PAYING TWICE
FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING. CONSULT WITH YOUR LENVER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE:
In addition to the requrattatts of Ibis pernut, these may be additiomal nalriaiuns sWicablc to Ibis pmpcny dw may be found in the puM c mxwds of dw
wary, and dwe array be addilional permits mquwed Gan oil= govaeme ud entities such as water mi naganar districts. slate agencies, or federal agem ors. Acceptance
of permits verir ion that 1 will not 7 owner of the peopaly or the requirements of Elands Lien Law, FS 713. SiPtisare
of Owner/Agar Idle Signature of Contractor/Agra Doc ED
l'i Print
Owner/Agar's Name Si
mmwc of Notry-Stise of Flond• e AIN
Tf . MW
N#W4197N E
2k 2a APPROVALS:
ZONING: Print
Coalwador/ cal's Name Signolae
of Notary-Stise of Florida Dole Conlranor/
Agar is _ Personally Known to Me or hodw
d ID UTIL•
FD: ENG: BLVG: Special
Conditions. Rt+
OMAN