HomeMy WebLinkAbout1501 Reinhart Rd (2)CITY OF SANFORD PERMIT APPLICATION
Permit # : Def 9 Es Date:
Job Address: ISD/ / ,9F1Af 4,1- .,Q l iii MA,1 W OrA 2.2I'>
Description of Work: X/tr,TeiG A&e re 2djQ Uf/Gt� SGS✓�L a2�, �t
Historic District: Zoning: Value of Work:
Permit Type: Building Electrical _X– Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service – # of AMPS *1W Addition/Alteration Change of Service Temporary Pole —
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Reggired)
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: '818.5 A s.Soc//f ues SG L°-
Arial rr ,Ac Il *9VA SvffE X,90 MIAMI* AA 33131 Phone: _3AZs.. 321- IFO V/
Contractor Name & Address: 4a/Area X14a?'riaA 4 JMG • aj% nV 4yAs24fAVZ dAU/14&22 FL s3AAVk—_
State License Number: eeav "'R_�__
Phone & F "e", d9n, Contact Person: Scan 1"I"I", Phone: 40i• z.r;!! "13
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 lawn, rr:; ;tlatiag
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAY l'TJG
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AA?
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 p tion th 1 t 1 tify the owner of the property of the requirement f Florida Lien Law, FS 713.
-04
i e of Owner/Agent _ Date Signature of Contractor/Agent Date
P t OwnU42tz
gn ure o Notary -State of F
friler/Agcrit is Persona
roduced iD lL
APPLICATION APPROVED BY: Bldg:
Special Conditions:
`F4077' a M05i /Jy-of/
Print Contractor/Agent's Name
ioth d% Q.— !J
A VILLALBA Si = ature of Notary -State of Florida NOTARY PUBO SIAT�E OFfFLOR
Notary Public - State of flodd COMMISSION # D0118290
MyCa=WDnEVk%Ocl l 4, M EXPIRES 05/16/2006
Commission # DD 363034 BONDED THRU 1-NMOTARYI
vkkkedByNationalNotaryAs�flP ractorAgent is Personally Known to Me or
Produced ID J�i�f�itiws�E
(Initial & Date)
Zoning: _
Utilities:
PD:
(Initial & Date) (Initial S_ Date) (Initial & Date)