HomeMy WebLinkAbout209 W 1 StPermit#:���� 1
Job Address: 1209
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
51
s
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Date: 71;-, �
Zoning: Value of Work: $ DD
Permit Type: Building Electrical )� Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service – # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential Commercial
Addition/Alteration Change of Service Temporary Pole
– Replacement New (Duct Layout & Energy Calc. Required)
# of Water & Sewer Lines # of Gas Lines
Plumbing Repair – Residential or Commercial
Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: (Attach Proof of Ownership & Legal Description)
Owners Name & Address: C'� rTYI �—
Phone:
Contractor Name & A
ddress- &)4-e4llC A CO2— G
Z�S ��• LY/u'Y fCIC (Q6 19r– 3 Z7�f JL State License Number: G lZ Z
Phone& Fax: y0%— 7-1' Contact Person: &I0 --t,2. Phone: yb %-3ZI"24Yy
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer: Phone:
Address: Fax:
Application 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
issuance of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. 1 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: 1 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 governmental entities such as water management districts, state agencies, or federal agencies.
Acceptance of permit is verification that 1 will notify the owner of the property of the requir e iso lorida en La , FS 7 _ 7
Signature of Owner/Agent Date re o Contractor/Agent to
0itilyl-nl lq-y�s
Print Owner/Agent's Name Print Contractor/Agent's Na
zy�v -7
Signature of Notary -State of Florida Date Signature of Notal&ate of Florida Oate
NOTARY PUBLIC -STATE OF FLORIDA
/ """�•• Marie A. Zettlemoyer
Owner/Agent is Personally Known to Me or Contractor/Agent is v Personally Knbw SF?missian #DD6791�5
Produced 1D Produced ID
xPtres: JULY 15, 2011
�:.r , rl'L1�NT1C BUNDiNG CO., INC.
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Special Conditions:
Zoning:
(initial & Date)
Utilities:
FD:
(Initial & Date) (Initial & Date)
$30,60
CITY OF SANFORD HISTORIC PRESERVATION BOARD
APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS
P.O. Box 1788, Sanford, FL 32772-1788
Phone: 407.302.5805 Fax: 407.330.5679
TO: THE.HISTORIC PRESERVATION BOARD OF THE CITY OF SANFORD, FLORIDA
❑ Downtown Commercial Historic District ❑ Residential Historic District
❑ This application is filed in response to a notice from the Code Enforcement Department
ADDRESS OF PROPERTY:
Property Owner
Signature: Print Name:
Mailing Address:
Phone: ,109 403 8458 Fax:
Applicant/Ag e19,
Signature: Print Name:
Mailing Address: ZZG e-,
Phone: 40 32 Fax: 40 2 -326 0034
I certify that all information contained in this'application is true and accurate to the best of my knowledge.
Applicant/Owner: &,,,� � LJAJ4Vi-Y d�1„C Date: Z�/—y7
Please use the attached criteria checklist as a guide to completing the application. Incomplete applications cannot be
reviewed and will be returned to you for more information. You are encouraged to contact the preservation planner at
407-330-5672 to make sure your application is'complete.
Description of Proposed Work/Application Category: ,(Check all that apply)
❑ Site Improvements/driveway/walkway ❑ Storage shed ❑ Moving structures
❑ Replacement windows or doors co Underskirting ' ❑ Awnings
❑ New construction/additions 11 Signs ❑ Demolition
El Roofs/gutters/downspouts ❑ AC/Mechanical ❑ Fences/Gates/Pergolas
❑ Replacement siding/flooring/porch ❑ Paint t I Other '
Completely describe the entire scope of work: all changes in material, color or location to the exterior of the building,
where on the property the work will occur and how the work will be accomplished. For large projects, an itemized list is
recommended. Attach additional pages if necessary.
A Certificate of Appropriateness is valid for six months unless otherwise noted
OFFICIAL'USE ONLY
Historic Preservation Board Meeting Date Staff Review Date:
Application is Approved Approved with Conditions Denied
Conditions:
Date:
***This Certificate must be prominently displayed on the building when work is in progress***
Requirements for Certificate of Appropriateness Application