HomeMy WebLinkAbout800 W Fulton Strmit N: lJ
b Address: CFA
ascription of Work: _
isteric District:
rmit Type: Building
Zoning:
CITN' OFSANFORD PERMIT APPLICATION
Total Square Footage_; 0
Value of Work: S oCn 3 a"
Electrical Mechanical Plumbing Fire Sprinkler/Alarm fool
ectrical: New Service - N of AMPS Addition/Alteration Change of Service Temporay Pole _
echanical: Rcsidential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
umbing/ New Commercial: N of Fixtures N of Water & Sewer Lines N of Gas Lines
umbing/New Residential: N of Water Closets Plumbing Repair - Residential or Commercial
cupancy Type: Residential Commercial Industrial
nstruclion Type: —
77/—=
N of Stories: N of Dwelling Units: Flood Zone: (FEMA form required)
veers Name & Address: C SQ, 6"m t '¢ / O ' — fG/ 'len }/
Phone. /
otractor Name & Address: J t! 4C rt 6 _
7
State license Number-t t 77e —
one & Fas: D7/ Contact Person: Zr/-/— Phone: 10/ /27--..T 7ea
riding Company:
Idress:
rrtgage Lender:
dress:
chilect/Engincer. &44 Phone.
dress: Fax:
plication 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 Ure
lance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. 1 understand that a separate
mit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOIS, FURNACES, BOILERS, BEATERS, TANKS, and
CONDITIONERS, ctc.
NER'S AFFIDAVIT: I certify Ural all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
tslruction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
r!C" FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING. CONSULT WITH YOUR LENDER OR AN
64 EY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
TICE: 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
county, and Utae may be additional permits required tom other governmental entities such as water management districts, state agencies, or federal agencies.
xptance of permit is verification Thal I will notify the owner of the property of the requirements of F nda Lien w, S 713.
i
Signature ofOwnu/Agent Date Signature of ntraclur/Agent Date
Print Owner/Agent's Name Pri Contra clo /Agen Nnc
Signature of Notary -State of Florida Date Signature o otary- e o ort a bare
DEBBIE BLANTONzMYCOMMISSION # DD I SM1
EXPIRES: February 25, 2007
t.e0oa-NornaY FL Notwy Discount Assoc. Co.
Owner/Agent is _Personally Known to Mc or Contractor/ r5oaally.F:rrowrH
Produced ID Produced ID
ROVALS: ZONING: UTIL: FD: ENG: BLDG:
cial Conditions:
03n006
0`