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HomeMy WebLinkAbout2300 S Oak AveCITY OF SANFORD PERMIT APPLICATION Application 4: d / a a / Submittal Date: d .-Job Address: 2Zoo S • ()fkK • /NE Value of Work: $ �-- 1600 00 o Parcel ID: Zoning: Historic District: `Description of Work: AIEW �� �A�- �Z'KF_f'"(E-Wr Square Footage: _ ........................................................................................................................ Permit Type: Building )4 Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑ 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 Plumbing/New Residential: # of Water Closets Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑ Construction Type: # of Stories: # of Dwelling Units: _ # of Gas Lines Plumbing Repair — Residential ❑ Commercial ❑ Occupancy Use Group(s): Flood Zone: (FEMA form required) ...................................................................................................................... Property Owner: Contractor: Address: Address: it 5�5 j���4c K P t o0 2 t JE OQc-t, - 3Z $1� .40 367 s256 c c Phone: E-mail: Phone. % State Lic nse Number: t S t2 y�31 Bonding Company: Mortgage Lender: 1 A 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. 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 governmental entities such as water management districts tate agencies, or federal agencies. Acceptance of permit is verification that I will notify the owner of the property of the requiremen -da L" Law, FS 3. Signature of Owner/Agent Date Print Owner/Agent's Name Signature of Notary -State of Florida Date Owner/Agent is _ Produced ID APPROVALS: ZONING: Special Conditions: Rev 02/2007 Personally Known to Me or UTIL: FD: ©011. 1: i_i Name Date 4"j-Io9 Signature of Notary -State of Florida Date DEBBIE'�BLAN;TVN MY COMMISSION # DD629096 ,�F EXPIRES: February25, 2011 F1'de - Fl. Notary Discotmt Assoc. Co. 1$00 -3 -NOTARY Contractor/Agent ison y own to Me 4r _ Produced ID ENG: BLDG: $,V3