HomeMy WebLinkAbout1460 Rinehart Rd (2)Permit # : �� �� �•
Job Address: /4160
Description of Wo
Historic District:
Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date:
, 9D
Value of Work: $6(41.44 eE cv of ccd-
rt, A iCTVtL)
OCT 19 2009
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)
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Owners Name & Address;/ /i/Y ! � �6 �E{���/%%%�j�6 %6d3 44J*A1/T 6PCV&-
iCQfFiZl.�79 7 e"r %/%?n Phone:
Contractor Name & Address:
lt.?% elAlvz rr Z4
�tit' State Lice se Number: G.3 -,00r) C70 3
Phone & FaN-31,74 /-�/ � •i yz? ;W ✓ T7-77yy7Contact Person: ' r l Phone: 7az7
Bonding Company:
Address:
Mortgage Lender:
Address:
Architeci
Address:
Phone: 6S3---?—?aR
Fax: v� S3' = 6 / C
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 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
pennit 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 pe t is v - 'ficatioon that I will notify the owner of in property of the req ui em nts lorida er Law S 713.
7 e� � `1 01 ll jCJ i 0 S'
Signature of Owner/Agent//'� ate Signature of Contractor/Agent Date
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Print ner/Agent`s Ndnie P tit Contractor/ e is Name
IU 1�10r
[WI
g "' ' otaty- to e-• ri Dat Signature of Not ry-State of Florida Date
N.. if Publiq - 810A oaf f=loridemti�t�8 20a.�...COtriitttn L'D125522 .°v GARYHICK3Ea % fQV� �( nyMY COMMISSION # DD 168159 rut is m dr Contractor/Agent is Personally Kri�Dr EXPIRES: Jan 10, 2007
Produced ID G---••'oBon dadThruNotaryPuCrylkUndenvrters
APPLICATION APPROVED BY: Bldg: ' ° Zonin€!^�C Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions:
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