HomeMy WebLinkAbout114 Winding Ridge Dr (3)CITY OF SANFORD PERMIT APPLICATION
Permit # : (D4- Z�O-el, Date:
Job Address: ) � �k LJ t a d \ V\ Cl `4L"r \0 .
Description of Work: "4W 66&C%Ll C!¢L Oto%L&JS /,-I _JU h 42eOHA,
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 Replacement New 2!�_ (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
Occupancy Type: Residential • 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:
(Attach Proof of Ownership & Legal Description)
L✓//) C" 1,M g /e/ (71aS �/� 5 il-I f -U K [' Phone: - ---------
Contractor Name & Address: tC -L"7k/c //./C
State License Number.
Phone & Fax:Contact Person: Phone: 2�_.
Bonding Company: �-�L Y o�Q�lc q +1�
Addrpcs
Mortgage Lender:
A dd reqs
Architect/Engineer:
Address
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 lite 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 ' Florid ien w, FS 713.
Signature of Owner/Agent Date Signature of Contractor/ nt Date
Print Owner/Agent's Name Print Contractor/Ag ne is Name
,.lel ,1, ,l' , - ADO.
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Special Conditions:
WXCEai31E BLANTON
A11' C�pw p,/,!SSION # DD IBU91
Con qt@O E"' tP S61ft Il (932SNgpMe r
$�Y—f u;cJ D'
"Zoning: Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date)
;�� V
CITY OF SANFORD PERMIT APPLICATION
Permit # : 04 - Date:
Job Address: tJ t % d N vs a \?-k. - 1D o
Description of Work: ; 4w ��ECi`i2 / C f¢L O (A h i2 eo nA ,
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 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
Occupancy Type: Residential 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:
(Attach Proof of Ownership & Legal Description)
or LV/I 6161,,g de -las 4— 5 ,t4^ Po K -,o Phone:
Contractor Name &Address: 17
LT12/C Ilk,
State License Number: t= l2 000iC3�p____
Phone & Fax: Contact Person: Phone: 3ai-363-30a (t
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer: Phone:
Address:
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 o Florid ien w, FS 713.
Signature of Owner/Agent Date Signature of Contractor/ ntt ' Date
Print Owner/Agent's Name Print Contractor/Agent's Name
Signature of Notary -State of Florida
Owner/Agent is _
Produced ID
Personally Known to Me or
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Special Conditions:
Date VSigh re ofNoTair -State= Daffi
X��r�
EEa9lE BMY COPdit✓,!SSIONL ppoNE{PIS' c.. 88491Con oPsoi9�Tljey�8p1AMe r
_Y.- FL+!u^trry Disco
Zoning: Utilities: FD:
(initial & Date) (Initial & Date) (Initial & Date)
CW' 3ay.;).,
]POWER OF ATj'OWay
Doe: lo -
1 hereby nme and appoiv —&4�G
oo be my InYAW attorney
in fact to ad for me and applied to the
Building Deparunew for a �/L C penmt
for work to be performed at a lowtion described as:
Section To"=MPL t Block
Subdivision _
-- ►�9-rI nQA
(Adz�c of job)
(OwwerofpropanywW )
and to sign my name and do all t dnp necessary to this appointment.
This forgoing imtrnmmt was acknowkdged befbre me this Day of 20 D q,
by G -Qt 4
Who is personally knimmto me r wbo pmikwed_ _ L� Slo-
es identification and did not take oath.
State of Florida
Coumyof Se>'hOLEE
.�t�j3Y PV6�.
Eric D, Huss
Commission #DD187432
*=
Expires: Feb 24 2007
Bonded Thru
' nn Atlantic Bonding Co., Inc.