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HomeMy WebLinkAbout4405 St Jones Park WaySO - — Permit # Cffl' OF SANFORD PERMIT APPLICATION Dale: a 410,57 OeL-e- P*,/G V-1 ZfobAddress: 72 Description of Work: ,4 ROAAdV i 4C16S Total Squar Footage Historic District: Zoning: Value of Work: S i 7 s Permit Type: Building -Iectri Mechanical Plumbing Fire Sprinkler/Alarm Pool Electrical: New Service - # of AMPS Addition/Alteration Change of Service femporary P e Mechanical: Residential Non -Residential Replacement New (Duct Layout & L-•nergy Calc. Required) Plumbing/ New Commercial: # of Fixtures of Water & Sewer Lines # of Gas lines Plumbing/New Residential: # of Water Closets Plumbing Repair - Residential or Commercial occupancy Type: Residential mmerci Industrial Construction Type: # of Stories. of Dwelling Units: Flood Zone: (FEMA form required) 3woers Name & Address: Phone: 47 ootraclor Name.& Address: y S G / C JGQS.q 7- 6 6 116Z4 -C& ; ??_- 2 ^_ `State License Number: 5 i OU 2_0 Z z y tent & Fa:: 40)- . kd -h Told Contact Person: ___ 1f / L.s i A Phone: 4o/ - esa ! 3onding Company: 4 ddrtss: Nortgagt Lender: ddress: rchilect/ Eagincer: ddrtss: Phone: Fax: pplication 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 ssuanee 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 w4mit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and UR CONDITIONERS, etc. WNER' S AFFIDAVIT: 1 certify that all of the foregoing information is accurate artd that all work will be done in compliance with all applicable laws regulating instruction 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 permits required from other governmental entities such as water management districts, state agencies, or federal agencies. eceptance of permit is verification that I will notify the owner of the property of the requirements of Florida nl3. Signature of Owner/Agent Datc Signature of Contract cat Date Print Owner/Agent's Name Signature of Notary -State of Florida Date Owner/ Agent is _ Produced ID LPPROVALS: ZONING: pecial Conditions: ev 03/2006 Personally Known to Me or UTIL: FD: b Signature of Nota>-r i f Florida iv Vie Contractor/ Agent is c gaily ovC b loL -f t 8 _ ProducedID7- lllll l lll1 ENG: BLDG: 30. oa