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Home My WebLink About115 E 18 StPermit # :© "' � 0 Job Address: Description of Work: CITY OF SANFORD PERMIT APPLICATION Date: &Z4-05 Historic District: Zoning: Value of Work: S ,0'l/S0 °O V 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 #: (Attach Proof of Ownership & Legal Description) Owners Name & Address: Phone: Contractor Name & address: S�iV/�'Dv ✓ r Ca, r✓V C 7522— ,S —. �'/��r_�✓/� ��J%1 State License Number: FSG 1r�-�, 943 Phone &Fax: 1^ 3Z2''_ Contact Person: GY �Sr y�� Phone: 40-3-22 a/ Bonding Company: Address: -Mortgage Lender: . \.ddress: ;rcnitect,'Engineer: :hone: address: _ as: opiicauon is ereov -Made .o obtain i;armr, :o Co r ne _ orK d ins[ailauons as inuu- eu. . czrmv c .at nowork or ;nsiaila[lon ;:as commenced anor w Tne ssuance d a ccrmu and That all work will be neriormea [o meet standards of ali laws ; eguiating construction in this jurisdiction. i understand that a separate oermu must be secured for ELECTRICAL 'YORK, PLUMBING. SIGNS, 'YELLS. POOLS, FURNACES. BOILERS. i-fEATERS._ TANKS. and AIR CONDITIONERS, etc. OWNER'S AFFIDAVIT: I certify that ail 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. O-aSos Signature of Owner/Agent Date*nature of Contractor/Agent Date �Ta�res �C Print Owner/Agent's Name PriRt Co act nt's Ndme Signature of Notary -State of Florida Date Signature of Notary- t n lEtkder r,„ ;' Date 4Y COMMISSION # DD 16428' 4% :XPIRE&November l2 20C Owner/Agent is _ Personally Known to Contractor/Agent is`peisoMi i fy ii0"" to Me or Produced ID Produced ID APPLICATION APPROVED BY: Bldg: ning: Utilities: (Inti & Date) (Initial & Date) Special Conditions: FD: (Initial & Date) (Initial & Date)