HomeMy WebLinkAbout914 Willow RdCITY OF SANFORD PERAifT APPLICATION
rmit # : V I-
b Address: q 1 L
ascription of Work: I I S e A N / w i KC Total Square Footage
istoric District: "Zoning: Value of Work: S 3 soo -
wmil Type: Building Electrical Mechartical Plumbing Fire Sprinkler/Alarm fool
ectrical: New Service - # of AMPS Addition/Alteralion Change of Service Temporary Pole
Vechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Requi(ed)
umbing/ New Commercial: # of Fixtures # of Water & Sc%vcr Lines # of Gas Lines
umbing/New Residential: # of Water Closets Z Plumbing Repair - Rcsidential or Commercial
cupancy Type: Residential Commercial Industrial
instruction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
voers Name & Address:
alraclor Name & Address:
u (2 I
one & Fax:
riding Company:
dress:
trigage Lender:
dress:
chitecl/Engineer:
dress:
Contact Person:
Phone.
Slate License Number:
Phone.
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 the
ancc 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 separale
mit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
t CONDITIONERS, ac.
NER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and dial all work will be done in compliance with all applicable laws regulating
tstruction and inning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
ICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
TORNEY 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 there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies.
plane of permit tsycrifiwNion that 1 will notify I e owner of the property of the
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Signature of Owner/Age Date
2-zo-ou
Print Owncr/Ap-ent's4anic
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
ROVALS: ZONING:
cial Conditions:
03/2006
UTIL: FD: jircjpcnls
of F orid ien Signature
of Con lode k -
I Print
Contractor/Agent's Law,
FS 713, i
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et w° 6'` Signalum
of Notary•Slale Contractor/
Agent is _ Produced
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