HomeMy WebLinkAbout305 S Palmatto AveCITY OF SANFORD PERMIT APPLICATION /
Permit # : V (os Date:
Job Address:
Description of Work: ,i1/fiA/..-4 o•L/y'`!' L/N-X- "trTotal Square Footage r,90Historic
District: Zoning: Value of Work: S 3000 Permit
Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Electrical:
New Service — # of AMPS Addition/Alteration Change of Scrvice 'TemporaryPole _ Mechanical: Residential
Non-Residential/AdiReplacement 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 Construction Type: 13JKCH of
Stories: # of Dwelling Units: _ Flood Zone: (FEMA form required) Owners Name & Address: 6,.
95 S Phone: Contractor Name & Address: _
01-
11- /t lew, 0420y S, Dr9C Ave
Awze e /—r,77%/ State License Number: CA(t 00/d 5:?— '/ Phone & Fax: f' W _
Q z Contact Person: de Phone: Yo7-y Y;ZZj Bonding Company: Address: Mortgage
Leader. Address:
Architect/
Eugineer: Address:
Phone:
Fax: Application
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 issuance 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 permit must be secured
for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and 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 1 will notify the owner of the property of the requirements o ida Lien w, 713, vG Signature of Owner/
Agent
Date 'Signature of Contractor/Agent Date Print Owner/Agent's
Name Signature of Notary -State
of Florida Date Owncr/Agent is _ Personally
Known to Me or Produced ID APPROVALS: ZONING:
UTIL: Special
Conditions: Rev 03/
2006 3AA0
0,r,,4os
Print
QmVactor/AgenCs Name
Signature QDDEBBIE BLANTON MY
COMMISSION #
DD ISM1
EXPIRES: February 25, 2007
ItA3o, C/sonalk K{ ,
pdR,%& co. FD: ENG: BLDG.