HomeMy WebLinkAbout1111 Retreat View CtCITY OF SANFORD PERMIT APPLICATION
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1'cnnit #: � �O I � � l � �-TDate:
Job Address: 1 lY 1 U,7 C'- . ---J—u �rl�i-f---_---
Description of Work: �� o;4,CAn S M--c}�� ���` �_
Historic District: Zoning:
Value of Work: S S 00
"e2'3
Permit Type: Building
Electrical
Mechanical Plumbing �>_C_ Firc Sprinkler/Alarm
Poo)
Electrical: New Service
— # of AMPS
Addition/Alteration Change of Service -1 emporary
Pole.
Mechanical: Residential Non -Residential
Plumbing/ New Commercial # of Fixtures
Plumbing/New Residential # of Water Closets
Occupancy Type: Residential Commercial
Construction Type: # of Stories:
Replacement New (Duct Layout & Energy Calc. Required)
# of Water & Sewer Lines # of Gas Lines
Industrial _
# of Dwelling Units
Plumbing Repair — Residential or Commercial
Total Square Footage:
Flood Zone: (FEMA form required for other Than X)
Parcel #: (Attach Proof of Ownership & Legal Description)
Owners Name & Address /Xs,L r`J7
Phone:
Contractor NanAaV0&4rTAQE PLUMBING, INC.
P.O. BOX 620027 -
State License Number:
Phone & Faz:4071 366-3994 Contact Person: rn/\' u
t_.� �i-ttMBtN6;-INC:---
Bonding Company:
Address: _ OVIEDO FIQRQA 32762_-0027
Mortgage Lender: (407) 366-399
Address:
Architect/Enginecr: 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 io thr,
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, HFATERS, 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 applicahlclaw;• r,.I : •;;
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN i I(!
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 grater management districts, state agencies, or federal agencies.
Acceptance of per tit i; v rific will notify the owner of the propert he requirements of Florida Lien Law, FS 713.
Signature of Owner/Age Date Signature of Contractor/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida
Owncr/Agent is _
Produced 11)
Personally Known to Me or
AI'I'LICA I ION APPROVED 13Y: IIIdg:
(Initial & Date)
Special Conditions:
Date
tom' sr,, +1,
Print. Contractor/Agent's Namc
j �L
I q II�-
Signature of Notary -State of I'londa hate
RTHY. HALL
C_�tttfroduc dtltl>s 'ci-tinnallyhtt��oia�Ol CAState of Florida
My comm. exp. Feb. 1, 2008
Pimm. No. DD 258139
%ovine: Utilities:
(Initial & Dnie) (Initial fi Datc) (Initial & Date)
It