HomeMy WebLinkAbout310 Rachelle Ave (4)CITY OF SANFORD PERMIT APPLICATION
mit # : 181 Date:
Address: 31C) (Zgyt tA,T_ ¢A/Z•r.JC eOlL N[& 7
cription of Work: I?WF 0VtVS Nyr4 OVA ML-cptJ ! ES Total Square Footage tonic
District: 1,40 Zoning: U(1511J& Value of Work: S 2 ! 3 0 mit Type:
Building_ Electrical ctrieal: New
Service - # of AMPS chanical: Residential
Non -Residential mbing/ New
Commercial: # of Fixtures mbing/New
Residential: # of Water Closets _ upancy Type:
Residential Y Commercial Mechanical Plumbing
Fire Sprinkler/Alarm Pool _ Addition/Alteration
Change of Service 'Temporary• Pole _ Replacement New (
Duct Layout & Energy Calc. Required) of Water &
Sewer Lines # of Gas Lines Industrial Plumbing
Repair -
Residential or Commercial tstruction Type:
Qtt.D N of Stories: # of Dwelling Units: Flood Zone: NID (FEMA form required ) sers Name &
Address: O tliez omimbn Re,-If!1 fP),!tf,_)1G 40 0
S az+ * k." of 2 3 9-19 Phone: TT )) 351.7 - tractor Name &
Address: _ AI _i h n G C 6644---t t 1 , I1 (-.I1e/
7H G'r+ GrL• titlfv 1.6-:t-t,wS fL, State License Number: ne & Fax:
40 /- 3G6 Cootaet Person: '1.K --motff"Y ding Company
tj /A 467. xr-) .
51 "A" Tess: gage
Lender:
01 P ress: t -
t}
omy,t _ sitecUEngineer: 'DE +'
tC tyQl y t`t`' Phone: 4o?. 37 t7 ress: 3
01t W • Nla-r aw O 50ITi 13L Fax: 40`7 . 37_1% c-,9 "I LrAYP Nl ,
rL 37-7 440 lication is
hereby made to obtain a permit to do the work and installations as indicated. 1 ocnify that no work or installation has commenced prior to the tncc of
a permit and that all work will be performed to moot standards of all laws regulating construction in this jurisdiction. 1 understand that a separate tit must
be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS. POOLS, FURNACES, BOILERS, HEATERS. TANKS, and CONDITIONERS, etc.
JER'S
AFFIDAVIT: I certify that all of the foregoing information is accurate and drat all work will be done in compliance with all applicable laws regulating truction and
awning 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. IF: In
addition to the requirements of this permit, there may be additional restrictions applicable is property that may be found in the public records of ounty, and
there may beadditionalpermits required from other governmental entities such as a aganer t districts, state agencies, or federal agencies. pranasof fi5wtion that
1
will notify Itre owner of the p{Operty of the requirem of Fl der Law, FS 713. ae Ser Owner
Datc Sign
IDate _ _ _ P. Print Owmer(
4
Name / M • •• MY MNNA
MARTINO !
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W& 10, 2010 Date n ThN &dDM
Nottty ServlCet Owner/Agent is _
Vel*`Persomally Known to Me or Produced ID tOVALS:
ZONING: UTIL:
FD: ial Conditions: 3/
2006 7
ractor/Agent
is
Perso 1 Me r Produced ! ENG: BLDG.