HomeMy WebLinkAbout208 Woodmere BlvdPermit # : (2--3—
Job Address: I o
Description of Work:
Historic District: Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date: 1 V -2 ` -J,1
Value of Work: $ q C101W
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 Walter 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 #: 06 _;Z 0 " 31-5 05 "
Owners Name & Address: M "41a/VY1 vk
Contractor Name & Address:
Phone & Fax:..5`,3&
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
-/7i)y/3
Contact Person:
(Attach Proof of Ownership &
Phone:
State License Number: ( 7
(Phone: 7 J 96/2
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.
773
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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 requireme s of Florida Lt La S 713.
Signature of Owner/Agent Date \ ign re o o rac t Date
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Print Owner/Agent's Name Pr Contractor/Agent's N
Signature of Notary -State of Florida Date
Owner/Agent is -
Produced ID
Personally Known to Me or
loyAPPLICATION APPROVED BY: Bld w — � ®(XZoni
(Initial & Date)
Special Conditions:
of Notary -State of Florida Date
"' DEBBIE BLANTON
MY COMMISSION # DD 188491
Contractor/ ge PeLsRp*sK_ D X607
Produ d 1o�w"iJiV6ii , -, ,Y6cary DiscountAssoc. Co.
Utilities:
FD:
(Initial & Date) (Initial & Date) (Initial & Date)
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111897
I hereby name aad
Of
in fact to act for me and
a
at a location descn'bed
Lot Block
and to sign my name
Aclmowledge&
Sworn to and �subscn'bed
Day of
Notary Public, Stale ofFlonda
(Seal)
My Commission Expims:
Dae:—j0-5Z/-,/)L/
Township Range
Subdivision
(Address ofJob)
'k-- " AY j X YY G`A`�'1 %Yt /) " ,
(Owner of Pmpesty and A&hew)
all things necessary to this appointment.
°f ed�Ontracoo� aid License t>�
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r,a"""'pa NNNEA M. POIIZZI
? i Commission a DD0100657
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Expires 3/17/2008
Bonded through i
:(800-432-4254)
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Florida Notary Assn., Inc.
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