HomeMy WebLinkAbout101 S French Ave (2)Permit # :_
Job Address: _ t�
Description of Work:
Historic District:
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CITY OF SANFORD PERMIT APPLICATION n
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Zoning: Value of Work: S
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Permit
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Permit Type: Building - 11/1 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 - ResidentialS Commercial
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Occupancy Type: Residential Commercial Industrial Total Square Footage: _
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form requtred fol= o h.er than X)
Parcel #: t //
Owners Name & Address: �h ('4 d T6 �Q
(Attach Proof of Ownership & Legal Description)
2 Z' 368'Lf Phone:
Contractor Name & Address: e- U✓S
Md r 1'5-11 e -t x-121 C S S, L 3'��fSVState License Number:
Phone & Fax: qo 7 - 33 0- 7a0 U Contact Person: -A n4t. Phone: 4_�O
Bonding Company:
Address:
Mortgage Lender: A A
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Address:
Architect/Engineer: d _ Allatcl, Phone
Address: _ A !I 4a marl G "!_OIsl 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 construction in this jurisdiction. I understand fhat a. aoparate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be done in compliance with all appliczblo. Jaws rn-gli'rair f_;
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER Of' AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTICE: 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 requirements lorida Lien Law, FS 713.
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Signature of Owner/Agent Date Signature of Contractor/Ager Date
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Print Owner/Agent's Name Print Contractor/Agent's Name
Signature of Notary -State of Florida Date Signature f Npte of C�ippi ""( +" fORRe
'? � ' o MY COPo,;..:S:ii;iN # DD540253
� EXF; > 3ia: Apr. 13, 2010
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Owner/Agent is _ Personally Known to Me or Con actor er�iisl Know d
Produced [D Produced ID M 3(DZ' 61,11 36
;4APPLICATION APPROVED BY: Bldg: Zoning: 7& -- Utilities: FD:
(InitiA & Date) (Initial & Date) I(Initial & Date
(Initial &Date)
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Special Conditions: most (-0 J ck- y Ilk YA 56,0" 0" b U Y G r 6LI'OJnrk
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i hereby name and appoint ,maud /--itmjrl
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for work to be perf6maed at a location described sr.
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OF EX?IkES: Apr. 13,2010
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,ommission DD592493
01' Ex-ires0612612009
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FIC
Structural plan review is limited noe No
general survey for code comp
review is implied nor was taken to
verify structural adequacy
FW,
PERMIT # 07 - �, 3qb
DATE; a
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/ Code violations found during inspection
(.0 are required to be corrected.
Plan/permit issuance does not grant
approval of a code violation. 2004
FBC109.1
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N
A —10)2E PH � 12
10
VV REG
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