HomeMy WebLinkAbout306 Rachelle Ave (3)CITY OFSANFORD PERMfI' APPLICATION
mit N : 01 = & 7 I Date:
Address: 30(,-, l2AGNCUA' 4-
cription of Work: R, E; P:Vt151 Dr4 OVA r3AIL<--oN t Ir5 Total Square Footage
uric District: NO Zoning. Xls l JG Value of Work: S %Z4 . 1 (a :!>• t)r)
mit Type: Building __,X_ Eleclrica) Mechanical Plumbing Fire Sprinkler/Alarm Pool _
ctricai: New Service - N of AMPS Addition/Alteration Change of Service Temporary• Pole _
chanical: Residential Non -Residential Replacement Nev (Duct Layout & Energy Calc. Required)
mbiag/ New Commercial: A of Fixtures 0 of Water & Sewer Lines q of Gas Lines
mbing/New Residential: N of Water Closets Plumbing Repair - Residential or Commercial
upancy Type: Residential Y Commercial Industrial
nstruction Type: k N of Stories: # of Dwelling Units: Flood Zone: NID (FEMA form required)
rers Name & Address: LJ k"-4 Dm i n 1bn At?i- I t LJ. nC
40d :5k e+ IZk,l run c1 A 23 2tPhone: zl 3Sn - 3 _ tractor
Name & Address: n "6— C"...
k 61frI _ .n+1fV M.j fL ,,%StateLii ce aseNumber: at &
Fax: 407` • ei 16a 327Contact Person{t-M : t ""0•'r-1 Phone: 467• ?ac; • 5f t-6 ding Company:
N fiA ress: Igage
Leader:
ti P ress: ritecUEngineer.
DF-
i 'I E J6luS" ll G 3 24- ?.dp ress: 301
W • Wye t3wD 501ri 13L Fax: 40. 32,9-. ia5 L Yfc
N(SZ; m rL. 37,7¢le lication 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 utce of
a permit and drat all work will be performed to meet standards of all laws regulating construction in this jurisdiction. 1 understand that a separate tit must
be scatted for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and CONDITIONERS, etc.
JER'S
AFFIDAVIT: 1 certify drat all of the foregoing information is accurate and dint all work will be done in compliance with all applicable laws regulating truction and
zoning. WARNING TO OWNER YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING CE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING. CONSULT WITH YOUR LENDER OR AN ORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT. ICE: In
addition to the roquirernents of this permit, there may be additional restrictions applicable to this property that may be found in the public records of xmunty and
Ihae may be additional permits required from other governmental entities such as watyrfi ni agauart districts, state agencies, or federal agencies. ptance of
permit twtioa that 1 will notify the owner of the property of the of Owner/
Agent Dale Print Ownw/
AgenTs Name Si Date
byBtrYlots Owner/
Agent
is Personally Klrnown to Me or Produced ID
tOVALS: ZONING:
UTIL: FD. ial Conditions:
iircmen3prof Flra
Lin Law, FS 713. `11111111p///7
GPPMEN
A.
q i Signature of
Con tor/Ageni e ; p MISStONF 'Q9'' x-y
z, J N
1 Contractor/
Agent's e _ .'a159717 Signature
of
Notary -St a of Florid A •.OQ Cont Produced
IID
d6orftent is
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