HomeMy WebLinkAbout311 Rachelle Ave (3)CITY OF SANFORD PERMIT APPLICATION
mit # :
0 r71 DI W Date:
Address: 211 R*C R 4,',TL P(VWVC t} >V I L Dp pA, 8
cription of Work: RZF (VtV51 ot4 OF-S r3ALr-0N 1E•S Total Square Footage
toric District: 1,40 Zoning: r XI51146 Value of Work: S :)'Y, /G X•y a
mit Type: Building __X_ Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool _
ctrical: New Service — # of AMPS Addition/Alteration Change of Service 'temporary l'olc _
chanical: Residential Non -Residential Replacement New (Duce Layout &Energy Calc. Required)
mbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
mbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial _
upancy Type: Residential Y Commercial Industrial
instruction Type: UAI.AN N of Stories: # of Dwelling Units: Flood Zone: N& (FEMA form required)
rers Name & Address: 1/t-_4 4/r/)''t i mbyi Ree-I1ti Tpyti' tric
V% Z 3 Zl9 Phone:
tractor Name & Address:
It t vlt'=/T L-."tG -r"Ll = w"1v c.{r T 1. State Liccuse Number:
ae & Fax: 407' 366 . ti 1(ah 32705 contact Person: 1.Mr6otf
ding Compaoy: N%
ress:
tgage Leader: (J
ress:
467.%J1;.s1tob
mitect/Engine, DFA44y lam(, t--W4 • Phone: 407. 3Z4- rew.
IOlt 13L.VD SUIT* 13'L Fax: 407- -67A. c,-99`1 LAr
Mom; m i L 3Z7¢to lication
is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the unto
of a permit and that all work will be performed to meet standards of all laws regulating concoction 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. JER'
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 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 requirements of this permit, there may be additional restrictions applicable "is property that may be found in the public records of county,
and them may be additional permits required boar other governmental entities such as agcmcnt districts, state agencies, or federal agencies. ptarmce
of it' at 1 will ratify the owner of the properly of the requirem of F1 da L" Law, FS 713, fr //
6L tOTof?
Owner/Agent Date Signature ofCont for/Agent Date \\\\0%%1N1111111111/////, Print
Owner/A e;
A°
6` ANNA MARTINO Sigrnatureao '
EXPIRES.
October 10, 2010 Date
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Bo whru Budyq "Sr" Owncr/
Agent is _ Personally Known to Me or Produced
ID tOVALS:
ZONING: ial
Conditions: 3/
2006 UTIL:
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Agen,orOO-4 etrofNotary-Stateof •
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