HomeMy WebLinkAbout209 Porchester DrF'
CITY OF`SANFORD PERMIT APPLICATION
14
Application.# : 1 � �
Submittal Date:
of
mb-Addr6Us:J`l1`"I r
Value of Work: $
'
y� (
Parcel ID. sl'- ��� �1 1 ^ "oo `� DC Zoning:
Historic District:
Description of Work: I /J tai i2'K/ a 1 L-4 ill `t��
�e,Fla ootage:
•......
• • • • • • . • • • • • •
•❑
• • •Fire
•❑
•Permit •Electrical •❑ • •
.•
Type:.Building ❑ • Mechanical P tfrnN
g AV/ Sprinkler/Alarm ❑• Pool Sign
Electrical: New Service - # of AMPS Addition/Alteration
❑ Change of Service ❑ TemporaryPole ❑
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 -Residential ❑ Commercial ❑
Occupancy Type: Residential L7 Commercial ❑ Industrial ❑
Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units:
Flood Zone: (FEMA form required)
................. ............. .. .................................
.... ....................
UC
- -Property 0wrer:
/�cC
Contractor: -r
Address: t9oqrch a -
Address: '
M
_ ...E=mall: _
CQij� State License Number:
Phone: �_
Phone:--
Bonding Company:
Mortgage Lender:
Address:
Address:
Architect/Engineer:
Address:
Plan Review Contact Person:
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. 1understand 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. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION 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 governmental entities such as water management districts, state agencies, or federal agencies -
Acceptance of permit is verification that 1 will notify the owner the pro e } of the requirements �F( rida Lien Law; 13.
Signature of Owner/Agent Date re of Contract gent Date
Print Owner/Agent's Name Pr.in Contractor/Agent's Na e
Signature of Notary -State of Florida Date Sri a ure of Notary -State of Fl ` da Date
°qP"Y p"e< JO ANN K JOHNSON
hAY COMMON # 00 285622
` * EXPIRES: March 23, 2008
or c e�OP Bonded Thru Budget Notary Services
Owner/Agent is _ Personally Known to Me or Contractor/Agent is r" Personally Known to Me or
_ Produced ID _ Produced ID ^� M
APPROVALS: ZONING: UTIL: FD: ENG: BLDG:
Special Conditions:
Rev 07.07 /
SEP -13-2007 13:29 SANTORO STATE FARM 4073215476
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120 UG
PROPANE
TANK
TANK IS A MIN. 10 FEET FROM
HOUSE AND PROPERTY LINE, NOT
IN AN EASEMENT, AND 20 FT FROM
SPA HEATER
20FT 1/2" 01
POLYETHELENE PIPE
TER DR.
32771
D'. U OPANE, INC
5 RD
D& FL 32713
(386)668-0111
LICENSE #04172
REG
SPA HEATER
400,000 BTU
400,000 BTU SPA HEATER
120 UG PROPANE TANK
DELIVERY PRESSURE- 11 INCHES
10# GOES TO 11"
3/4 Hard pipe
2 foot
TANK IS A MIN. 10 FEET FROM
HOUSE AND PROPERTY LINE, NOT
IN AN EASEMENT, AND 35 FT FROM
SPA HEATER
35FT 1/2"
POLYETHELENEE
� o
DON GAGNON
209 PORCHESTER DR.
SANFORD, FL 32771
DISCOUNT PROPANE, INC
546 S. SHELL RD
DEBARY, FL 32713
(386) 668-0111
LICENSE #04172
�•s
120 UG
PROPANE
TANK
3 0,
REG
SPA HEATER
400,000 BTU
400,000 BTU SPA HEATER
120 UG PROPANE TANK
DELIVERY PRESSURE- 11 INCHES
10# GOES TO 11"
3/4 Hard pipe
2 foot
S,EP 13-2007 13:29 SANTORO STATE FARM 4073216476 P.01/01
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