HomeMy WebLinkAbout103 Stonehidge Ctr -
CITY OF SANFORD PERMIT APPLICATION
Permit #: v J J S Q Date:
Job Address: 1,03 to CI
Description of Work: —
Historic District: Zoning: Value of Work: $ 02 020 LP Co.
Permit Type: Building Electrical Mechanical Plumbing Y Fire Sprinkler/Alarm Pool
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 # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial RZLA,c)
Occupancy Type: Residential —4— Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Name & Address:
Contractor Name & Address:
Phone & Faz:o�j�I 7�3 �3��e�5� �l�a dU(o Contact Person:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
(Attach Proof of Ownership & Legal Description)
Phone:
License Number:
Phone:
Fax:
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
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
_ Produced ID
APPLICATION APPROVED BY: Bldg: Zoning:
(Initial & Date)
Special Conditions:
gn4rure or t ontracror/Agent ate i
t Contractor/Agent's e
Signature of Notary -State ofDate a�
Contractor/Agent is =Personally Known to Me or
_ Produced ID
(Initial & Date)
Utilities: FD:
(Initial & Date) (Initial & Date)
CONSTRUCTION
AFFILIATES
INC
November 3, 2004
City of Sanford
License Dept.
P.O. Box 1788
Sanford AL. 32772-1788
200 GOVERNMENT ST. • SUITE 101 • MOBILE, AL 36602
(251) 433-1328 - 1-800-291-3994 - FAX (251) 432-8046
I, Kevin Gillen give Danny Agar permission to pull a permit for 103 Stonehedge Court, Sanford,
Florida 32771.
Kevi M. illen
Florida. Certified License #CF -C058038
State of Alabama
County of Mobile
Sworn and Subscribed to me this
Notary Public
My Commission Expires: �Xa\off
day of \ o , 20 O k