HomeMy WebLinkAbout402 S Holly Ave (2)CITY OF SANFOR7 PERMIT APPLICATION
Permit H :
S v)
hate: 0&
Job Address: 0 S_-1- 01y Aw- Description
of Work: . 6M0 S FZ Total Square Footage Historic
District: Zoning: Value of Work: S 1000 Permit
Type: Building Electrical Electrical:
New Service - H of AMPS Vechanical:
Residential Non -Residential Plumbing/
New Commercial: H of fixtures _ Mechanical
Plumbing Fire Sprinkler/Alarm Pool _ Addition/
Alteration Change of Service Temporary Pole _ Replacement
New (Duct Layout & Energy Cale. Required) H
of Water & Sewer Linesk of Gas Lines Plumbing/New
Residential: H of Water Closets Plumbing Repair - Residential or Commercial Occupancy Type:
Residential 1 Commercial Industrial Construction Type:
Rom_ H of Stories: 4— H of Dwelling Units: _ Flood -Lone: (FENIA form required) Jwners Name &
Address: 1 -no npVG Y\ qy Phone. contractor
Name &
Address: ` $NhA t t'1 0n 124,CyC (1'19 ->o To)c 5LO Nl.' R 32" 11 I' ,/ /
Statc License
Number: r, / u ,
hone & Fax:
qy7 - qp 7 7k[ 7j7 d'a fpp&J Contact Person: ..S Cie lCi f Phone: 7 7 7;,z %7Uo 3omding Compauy:
ddress: Mortgage
Lender:
ddress: krchitecVEngineer:
ddress:
Phone.
Fax:
pplication
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 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 tomtit must
be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, 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 onstruction and
zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING WICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN TTORNEY BEFORE
RECORDING YOUR NOTICE OF COMMENCEMENT. NOTICE: 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 its equired from other govemmental entities such as water managcmern districts, state agencies, or federal agencies. acceptance of
permit is v t' 1 notify the owner Jo7i property of the requirements of Florida Lien Law, FS 713. L Signature /
Agent
I Date Signature of Contractor/Agent Date Print Owner/
Agent's Name 9gn;Sypature
of Notary -State o Iorida Date t"°I•,
JO ANN M. MOMN MY COMMISSION
0 DD 29M EXPIRES: March
23, 2008 r R&*
d Thro • rCp agBIIdQEt $ilYlgt Owrrer``gent
is Perso ly wn to Me or roducedlD' (. C-
y3Z• IlS '13 4VgrD d?PROVALS:
ZONING: pecial Conditions:
ev 03/
2006 UTIL: FD:
Print Contractor/
Agent's Name Signature of
Notary -State of Florida Date Contractor/Agent
is _ Personally Known to Me or Produced ID
ENG: BLDG:
GSJ as
BP006UO2 CITY ' SANFORD 11/17/06
Edit ivarrative 16:44:54
Application number, type . . .
Property address . . . . . . .
Type information, press Enter.
07 00000350 DEMOLITION - SINGLE FAMILY
402 HOLLY
DEMO sign off:
P&Z: LR 11.06.06
Uti : SB 11.17.06
Police: LT DEL RUsso 11.06.06
PW: BI 11.08.08
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