HomeMy WebLinkAbout3350 Beardall Ave (3)CITY OF SANFORD PERMIT APPLICATION
Permit H :
Job Address: . -33 Description
of Work: WA-5 lei l/ A Historic
District: PILO Zoning: Dale:
Value
of Work: S 6 S!i A Permit
Type: Building Electrical V' Mechanical Plumbi Electrical:
New Service —11 of AMPS Addition/Alteration Mechanical:
Residential Non -Residential Replacement Ne Plumbing/
New Commercial: # of Fixtures H of Water & Sewer Lines Plumbing(
New Residential. q of Water Closets Dccupancy
Type: Residential Commercial Industrial Construction
Type: p of Stories: N of Dwelling Units: _ ng
fire Sprinkler/Alarm Pool Change
of Service Temporary Pole w (
Duct Layout & Energy Calc. Required) a
of Gas Lines Plumbing
Repair — Residential or Commercial Flood
Zone: (FEMA form required ) hoae &
Fax:'WJ 330ii940 % %NL i 7L Contact Person: Phone: 300ding Company:
kddress: Mortgage
Leader:
address: rchitect/
Eagineer:
I'teone: kddress:' Fax:
pplication is
hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no wort: or installation has commenced prior to the ssuance 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 iemtit must
be seared for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, BEATERS, TANKS, and UR CONDITIONERS,
etc. WNER'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 orstrucxion 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 TTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT. 40TICE: 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 his county,
and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. cceptance of
permit is verification that 1 will notify the owner of the property of the Signature of
Owner/Agent Date Print Owner/
Agent's Name Signature of
Notary -&ate of Florida Date OwnedAgent is _
Personally Known to Me or Produced ID
f[/ (s
Date Print
Contractor/
ARrl's Name Signature of
tida Date
BLANTONMYON
A
DD I OMI(z Ebruary25M, 2 0.0,7Contractor/ t@P4sTARRr rco. Produced 1
cPPROVALSY"ZONING:
UTIL: FD: ENG: BLDG. pecial Conditions:
e ev
03/
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