HomeMy WebLinkAbout414 B S Palmetta AveArch itect/Engin eer:
CITY OF SANFORD PERMIT APPLICATION
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Application #: l 1 Submittal Date:
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414- C ) 5 AGMef-1A rod Work:
Job Address:
Value of $
- Parcel ID:
Zoning: Historic District:
Description of Work: �*lieeyp O"o%
T2O0 Aiwa Square Footage: �QQ
..............................................................................................................1.........
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Permit Type: Building ❑ Electrical W"' Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm O Pool ❑ Sign ❑
Electrical: New Service - # of AMPS
Addition/Alteration ❑ Change of Service Mr'- Temporary Pole ❑
Mechanical: Residential ❑ Non -Residential O
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 Er"" Commercial ❑
Industrial ❑ Occupancy Use Group(s):
Construction Type: W ocrd # of Stories: Z.
........................................................................................................................
# of Dwelling Units: _� Flood Zone: (FEMA form required)
Property Owner: lQ/d CBSAjt_5Ay
Contractor: 5AVQK&1 64&7✓!f CO XAC
' Address: 4-14- l0i4L~i70;4- i4 V&
Address: 2522 _3*,4X r /f -dr
,S/�iJFo%✓ ISG 3 Z99
,SsLrr� f 3Z�� L
Phone: "91DZ&E-mail:
Phone: gZZ,I5&ZStateLicense Number: 5C1301914!
Bonding Company: _.; ....
Mortgage Lender:
Address: _ _
Address -
ddress:
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, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713^
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Signature of Owner/Agent Date ' rature of Contractor/Agent
Print Owner/Agent's Name Print,Corpl, ractor/Agent's
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID
APPROVALS: ZONING: UTIL: FD:
Special Conditions:
Rev 02/2007
t:Z-67
Date
Date
b P -r
BLDG:
or
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: 414 S AZNe71i Ave
Property Owner /
Signature: Print Name: )!gc `j Ce5,41 ,se
Mailing Address: 4-f4 S fit% It�tG_A PC
Phone: q to - Z& 7-- Fax:
Applicant/Agent
Signature: Print Name: i, rcT�1O 1 �'1 SD w
Mailing Addre
61 6Z
Phone: ZZ—2 Fax: - 3:30)9v/-
I
'30I%G/I certify that all inform ' contained ' this applic tion is true and accurate to the best of my knowledge.
Applicant/Owner: Date: 2 • D
Please use the a cri ria cheo4 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 ❑ Underskirting ❑ Awnings
❑ New construction/additions ❑ Signs ❑ Demolition
❑ Roofs/gutters/downspouts ❑ AC/Mechanical ❑ Fen ces/Gates/PergoI as
o Replacement siding/flooring/porch ❑ Paint enther
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.
666CZY117,07 L Serv
A Certificate of Appropriateness is valid for six months unless otherwise noted
OFFICIAL USE ONLY
Historic Preservation Board Meetin Staff Review Date:
Application is Approved Approved with Conditions Denied �,:
Conditions:
'This Certificate must be prominently displayed on the building when work is in progress—
Requirements for Certificate of Appropriateness Application