HomeMy WebLinkAbout2150 Marquette AveCITY OF SANFORD PERMIT APPLICATION
Application H: / Submittal Date:�t ��1
Job Address: � �� _ Value of Work: S&560 , 00
Parcel ID: Zoning: Historic
•Description of Wo............ ( C / v�l✓����:�\_�� _tl �:� : Square .Footage:
................... �
Permit Type: Building A. Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service -11 of ANA'S _ — Addition/Alteration ❑ Change of Service ❑ 'I emporary Pole ❑
Mcchanical: Residential ❑ Non -Residential ❑ Replacctnent ❑ Ne%v ❑ (Duct L.tIyout & Diti-gy Calc. Rcquircd)
Plumbing/ New Commercial: H of Fixtures ._ N of Water & Sewer Lines_ 11 o1'Gas Lincs
Plumhing/New Residential: 11 of Water Closets —,_� Plumbing Itepuir - Itesidenlial ❑ Commercial ❑
OceupancyType: Residential ❑ Commercial ❑ Industrial ❑ Occupancy Use Group(s):
Construction Type: _ # of Stories: k of Dwelling Units: Flood Zone: ___ (H-,Nbforst required )
Property Owner\�tiiJ� }__ •~ �• • • • • • • •Contractor•_ _ Q��`� •SZC�,�����TC�iG `� =
Address: �� `.�-� Address:
Phone: _-- E-mail:
Liontling Company: —^—
Address:�—
Architect/Engineer:
Address:
I'larn Iteview Contact Person:
Ph r e. State L[lt ISe unr ere --
Mortgage Lender:
Address: _ _ _
Phone:
Fax:
Phone: hax: E-mail:
Application is hereby made to obtain a permit to clu the work and iuslatlations as inclicatecl. I certify that no work or installation hax commenced prior to the
issuance of a permit and that all work will be performed to steel slandinds of all laws regulating construction in this}uriscliction. I understand that a separate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, FICATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIllAVIT: 1 certify that all of the foregoing information is accurate amd 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 CONINIENC1 MENf MAY KE:SULT IN YOUR PAYING TWICE FOR
IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST LIE RECORDED AND POSTED ON TILE JOB SITE BEFORE THE
FIRSTINSPECTION. IF YOU INTENDTO QB,rA1N FINANCING, CONSUL: I' WITH YOUR LENDER OR AN ATTORNEY BEFORE. RECORDING YOUR
NOTICE OF CONIMENCENIENT.
NOTICE: ht addition to the requirements ofthis permit, there may be additional resUictions 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 nntnagemcnt districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property. n' )ie requir nls r Ida Lien L,aw, F5 713.
Signature of Owner/Agent — --- - pate signatilre ool,co Uac r/Accnl J Date
Print OwnedAgent's Name ,—_--~ Pnnt C'ontrtclodAgent's Nance
Signature of Notary -State of Florida llalc Signature Ul T tart' -State of Flond a„a,asenLgaa„r
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yVm=I
Mlm
Owner/Agent is Personally Known to Me or Contractor/Agent is I'ersona�y'�°ti�ititl Zd 114R�9f
Produced ID Produced ID _
APPROVALS:
BLDG:--.—
SpecialConditions;
Rev 07.07 %P.w�Oa/ F67Ge '" /�/°`i� CO INo..f�i5 lear �ws�. secwtef%
1� 4 1,00
SET IRON &
CAP (#33/1382)
40"
'
FND IRON &
6
CAP (#3144)
40N 0.25E
F--0.79