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HomeMy WebLinkAbout308 Rochelle Ave (2)CITY OF SANFORD PERMIT APPLICATION mit # : O l — 6 7, Date: ' L. I 1 o c Address: '08 C< 4* t.L, knt-Mf 130L O 1 N(o 5 criptioa of Work: RCO WV510t4 OVA I3A,4G0tJ 1 F-5 Total Square Footage toric District: NO Zoning. Value of Work. S 24 1 (n g _ o c) mit Type: Building __X_ Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool _ ctrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary Pole _ chanieal: Residential Non -Residential Replacement New (Duct Layout & Energy Ca1c. Required) mbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gass Lines mbing/ New Residential: 0 of Water Closets Plumbing Repair - Residential or Commercial _ upancy Type: Residential _Y Commercial Industrial rstructiou Type: k l`iD N of Stories: # of Dwelling Units: Flood Zone: N& (FEMA form required) aers Name & Address: Uht-_d ©bwtlnlbn RP. -l;-,l tPL;5t:_TNG qVO > Yccl Kk,Mmwx al VA Z 3_9-1Phone. tractor Name & Address: i.M GG (.G+fi LL(i lkl c lterr ."+C GrL _ (.h'1 h j EL Slate license Number: ne & Fax: 407, 3(A • 162, 32708 Coataet Person: il•M r--'( ding Company: N A ress: Igagc Leader. ti P ress: iiiect/ Engiaeer. EkA- '1 6iys Qli G t ' Phoac: Aeo 37k cif» ress: 30 ' t W • LAWS 13wo slur$ 13L Fax: 40- 329-. G`ieil LP.r. c Mom; t t Lu 3Z74'lo 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 ahce 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 tit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS. POOLS, FURNACES, BOILERS, HEATERS, TANKS, and CONDITIONERS, etc. NER'S AFFIDAVIT: I certify go all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating trutxion and tubing. 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 requirements of this permit, There may be additional restrictions applica4lep this property that may be found in the public records of muray, and there may be additional permits required from other governmental entities such wat anagcmcnt districts, state agencies, or federal agencies. ptance of will notify the owner of the properly of the reyui 74* ien Law, FS 713. gn of Owner/Agau Date Slrnaitke of ntrwtor/Agent Dat 11111111111q// SSA c>[ 3 %7MGlili X % `.PQ`4N A Print Owner/ A s ame Punt Contractor/Aeent's Name S L.: _ ail Si p Sta1eAfVjftN0 Date My COMMISSION # DD 6W2 EXPIRES: October 10, 2010 OvmhafAgent is Z ly Known to Me or Produced ID IOVALS: ZONING: UTIL: FD. ial Conditions: 3/2006 Cont or/ Agent is Produced ID ENG: BLf) G.