HomeMy WebLinkAbout519 E 1 StPermit # : 0(9—321-7
Job Address: 519 k 15.
Description of Work: Cih1 a.,
Historic District: Zoning:
CITY OF SANFORD PERMIT APPLICATION
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Date: 91 1l I Z00 (o
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Value of Work: $q 110 - —
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy 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 Commercial Industrial Total Square Footage:
Construction Type: T3L•oClC # of Stories: 11- # of Dwelling Units: Flood Zone: (FEMA form required for other tbao X)
Pared #: 30 -IS - 31, 51 S - I L4 00 . o o I 0
Owners Name & Address: s100 Y C/C H I I rN
Contractor Name & Address: ROD N A Ce rrt
4PoR0 , Pt 31-71/
Pbooe & Fax: 4407— ?l-lY15- IML
Boodiog Compaoy:
Address.
Mortgage Leader:
Address:
Architect/Engineer
Address:
Attach Proof of Ownership & Legal Description)
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Phone:
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State License Number: e,4 Co . 7 Z g
Contact Persoo: Ro 4 GA CIE 2W 1?? Phone: 5"007— 3Z1 2
Phone:
Fax:
Application 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
issuance of a permit and that all work will be performed to meet standards of all laws regulating constriction in this jurisdiction. I understand that a separate
perrrut must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAV fi: I certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
construction 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
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
N TI : 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
this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies
Acceptance of permit is verification that I will notify the owner of the property of the require; nt is f Florida Lien Law, FS 713.
il a Zoo CA Signature
of Owner/Agent Date Signature of ContractoAAgent Date Roo
FAee nAgwk Print
Owner/Agent's Name Signature
Notary Florida rRng"
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State of Date ign r State of Florida m''.
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COMMISSIONOwner/AgentisPersonallyKnowntoMeorCon - ISE]
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is EXPIRE&sliwaor Produced
ID ID BWAaTtru Notary P APPLICATION
APPROVED BY: Bldg: Initial &
Date) Special
Conditions: Zoning:
Initial &
Date) Utilities:
FD: initial &
Date) (initial & Date)