HomeMy WebLinkAbout114 Lake Ada Cir' / CITY OF SANFORD PERMIT APPLICATION /
Permit # :_ f?Y -3 00 Date: e - % &t
Job Address: /14 L./4 KV h 6 4 GL dZ S N F,- 3 2'733
Description of Work: I
Historic District:
Zoning:
Value of Work:
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
Replacement New (Duct Layout & Energy Calc. Required)
# of Water & Sewer Lines # of Gas Lines
Occupancy Type: Residential Commercial `' Industrial
Plumbing Repair — Residential or Commercial
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: / it! S C t a y
I 14 L -416r .QrAA Gree 5.4.n1FZ-� _ Phone. 407 - 46/ --SW b
"ntractor Name & Address: tiFill-
c�S-
Phone & Fax: S L 2 j r �7(
Bonding Company: _ F aX
Address: y� ,
Mortgage Lender: S1V1
Address:
State
�License
nNumber: �i <O C 0
Person: � -8 r icI . 1` /stpZ Phone:
Architect/Engineer: Phone:
Address:
Fax:
v.> k✓
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 pnor 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 VOEDR, 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, at maybe found in the public records of
this county, and there may be additional permits required from other governmental entities such as water mariagemer� it tricts, state agencies, or fede;al agencies.
Acceptanceof nit is verification that I will notify the owner of the property of the
Signature of Owner/Agent Date
r/Lr21s
Pi {nt Owner/Agent's Name
�/V
to o Fbrida Date
DEBBIE BLAN
MY COMP.y,i3S1UN # DD 188491
T. is EXP�ReES : February 25, 2007
P�t9@t @Tt4�Y F� goaJV,Lr °1Yw-M6Q)r
P t Contractor/Agent's Natpe _ I
Si azure of N da- �„ L�
DEBBIE BLANTON
MY COPelMiSSION # DD 188491
Contactor/A_ tis' ecsol�yECCiiof312fNRtI! d$, 2007
' ` _ ProdUCed I 1X00-3 N01'A'Y =L ;J 47ry Disro,- AsgoC. CO.
APPLICATION APPROVED BY: Bid : ,� 11)Zbning: Utilities: rtv
(I 'tial & Da aaTT" JJJ (Initial & Date)
Special Conditions:
(Initial & Date)
FD:
(Initial & Date)
7 CrrYOFSANFORDP:•:s'MI; .`..'.'13CATION
- Permit
Date: 9'J/ Z, -74o-!t
Job Address: 114 1-,,4K9- A 6 ,4 [,L z _
:02✓� 3 2 '733
Description of Work:
Historic District: Zoning. Value w `"'
;: 4 b D
Permit Type: Building Elxhical Mecl>anical Plumb::,,
_ fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration __ _
; of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement Ne%
(Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Line. _
_ .:, of Gas Lines
Plumbing/New Residential: # of Water Closets —1—
in, Repair— Residential or Commercial
Occupancy Type: Residential Commercial ` Industrial
_
are Footage:
Construction Type: # of Stories: # of Dwelling Units:
v— , :d Zone: (FEMA form required for other than X)
Parcel #:
-oof of Ownership & Legal Description)
Owners Name & Address:
Name & Address: yXLDw
j
Lb
Phone & Fax: , S 2 667
kootact Person: _
Bonding Company FN X
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
_401 - 6 -3? b
Z S . 1 Y�1 y � ��✓
�.� Phone:
_ Phone:
Fax:
Application is hereby made to obtain a permit to do the work and installations as indicated. r th 1 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 regul _tion in this jurisdiction. I understand that a separate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOL :S, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that oc done in compliance with all applicable taws regulating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A N )MM ENCEMENT MAY RESULT IN VOUit. PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OB1,%1 . • .. ;G, 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 restriction
this county, and there may be additional permits required from other governmental entities ,
Acceptance of nit is verification that [will notify the owner oft'
f the property of the renu
S/tJgn/azure of 0wner/Agent Date
tt's Name f.
k/uyto o arida Date
DEBBIE BLANTON
COMMISSi0N # DD 188491
EXPpES: February 25,2007
,�n�
APPLICATION APPROVED BY: Bid : ening: _
(I tial & Da (Initial .`. D
Special Conditions:
dt is, propertythalmay he found in the public records of
mar ageme istricts, state agencies, or fede agencies.
rda'Lie�-
S.
ont actor/AE nt aur
/. g.nt's Natpe - —r
-
DEBBIE BLANTON
MY CO<dNiSSION # DD 188491
;ti is _ ersotl�j)Pl�io�fi 2&ML. 2007
-0CU-3-r3-rlOiP, -,'I =L rd,anry
Co
s: FD:
(Initial & Date) (Initial & Date)