HomeMy WebLinkAbout1613 Terrace DrCITY OF SANFORD PERMIT APPLICATION
01- A IDate:D 7
Application #:
/ _� Submittal S�
Job Address: Y D l3 e "I'ler'P Or Value of Work: $ �D
Parcel ID:
Description of Work:
Zoning:
Historic District:
Square Footage:
.....................................:.......................................................................................
Permit Type: Building P Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign
13
Electrical: New Service — # of AMPS Addition/AIteration ❑ 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.
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑
# of Gas Lines
Plumbing Repair—Residential ❑ Commercial ❑
Occupancy Use Group(s):
Construction Type:
# of Stories: # of Dwelling Units:
Flood Zone:
(FEIYIA form required )
............................/...................... .............................. ...,......
s!" Contractor:
...............................
Property Owner:
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Address:
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Phone: ' a
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E-mail:
Bonding Company:
Address:
Architect/Engineer:
Address:
Plan Review Contact Person:
Mortgage Lender:
Address:
Phone:
Fax:
Phone: Fax:
E-mail:
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 that a separate
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 applicable laws regulating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING; CONSULT WITH YOUR LENDER OR 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 govemmcntal entities such as water ma cnt districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the require t, of F 1 Law, FS 713. 5��e/q
Signature of Owner/Agent
Print Owner/Agent's Name
Date
Signature ofNotary-Stale of Florida Dale
Owncr/Agent is _
Produced ID
APPROVALS: ZONING:
Special Conditions:
P, mnnm
Personally Known to Me or
UTIL:
FD:
ofNotary-Slate of Florida Dale
"N'�'DMIES 1
MY COMMISSION # DD629096
EXPIRES: February 25, i0l t
F' Ft. Notary Discount Assoc Ca -
1$001 NOTARY..
Contractor/A r
Produced ID
ENG:
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