HomeMy WebLinkAbout701 W 24 St (2)CITY OF SANFORD PERMIT APPLICATION
Permit #: oy v 5
Job Address:
Description of Work:
Historic District: Zoning:
Date: / /Z7/zoo lG
Total Square Footage
Value of Work: S [(;w- 6y
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 Ncw (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer lines
Plumbing/New Residential: # of Water Closets
Dccupancy Type: Residential Commercial Industrial
Construction Type: I— # of Stories: # of Dwelling Units: _
H of Gas Lines
Plumbing Repair — Residential or Commercial
Flood Zone: (FEMA form required)
Jwatrs Name & Address: r f - /` • 6 t `" 7D 1 tk S-r.
Company:
ddress:
fortgage Leader:
ddress:
rchilect/Engineer:
ddress:
Contact Person: 51Krol- Phone:
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
ssuance of a permit and drat all work will be performed to meet standards of all laws regulating construction in this jurisdiction. I understand that a separate
xxmit 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 and that all work will be done in compliance with all applicable laws regulating
onstnu:tion 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.
MCE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that maybe 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.
acceptance of permit is verification (hat I will notify the owner of the property of the
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
LPPROVALS: ZONING: UTIL: FD:
pecial Conditions:
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fireIFSf F Lice Law, 713.
O/ / 17 af.
SigWatre opContractor/Agent
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Print Contractor/A ent' Nameg `,.
wry %/• .Cif
Signature of Notary -State of Florida= a • :y yCl5. o
Contractor/Agent is _ Personally Kno4d'
Produced ID I-1.. 12 9-P 3z(.OHM
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