HomeMy WebLinkAbout2201 Oak Ave10
�1
Permit #: ou -j
Job Address: 0.1 (901r—
CITY OF SANFORD PERMIT APPLICATION
'S,
s,
'_ —
Description of Work: 4*\'Q-{LSX'iN L ti
Historic District: Al Zoning:
Permit Type: Building Electrical
Electrical: New Service — # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential / Commercial
Construction Type: 4tj wz# of Stories: /
RECEIVED
Date: " ola ` 05
Value of Work: $ �� 000. °U
Mechanical Plumbing Fire Sprinkler/Alarm Pool
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Calc. Required)
# of Water & Sewer Lines # of Gas Lines
Plumbing Repair — Residential or Commercial
Industrial Total Square Footage:
# of Dwelling Units: Flood Zone: >< (FEMA form required for other than X)
Parcel #: 3 - / 9 - 00 -,6-3.;)- 'J- DO®a — 00 / 0 (Attach Proof of Ownership & Legal Description)
Owners Name & Address: Liz �1 N r
10 Skaqe-n Ct . SA r FL. 3a 7/ Phone: 1107- 3 :;t - l5"5"✓''
Contractofrr�Nam & Address: e Ce i GI -6 e - /O sr ie
S a n N r� , �G . -3,3L State License Number: COC— O L O P% 5
Phone & Fax: � 7 - IJI3^^ � - 02% 7 % Contact Person: / (/H? CA -son Phone:
Bonding Comaanv: >�/J'T
Address: AJIA-
Mortgage Lender:/�A
Address: ,I A-
Architect/Engineer / /�i Phone:
%
Address: !� l' 1 Fax:
Application is hereby made to obtain a pen -nit 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: 1 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.
Acceptant of perm Is veritication that Ip oltify the owner the property of the requir en of Florida Lien Law 713.
r u o mer/Ag nt Date azure of ", 'u tor/Agent Date
�zh r� rJCC� `' koMAs I(L— GInScn!
Print Owner/Agent's Nat Print Contractor/Agent' ame
Signature of Notary -State of Florida Date Wggnatuota - e of Florida Date
mrrrrs��.
M : LINDA C. FOWLER MARY J. HART
:? MY COMMISSION # DD 172122
ES: A nl 14, 2007 MR�,Q�„M Ion+ u>748
Owner/Agent is `�' Pets to NU P Contractor(` en Pe li�� enn to
t3a WThruNotmPubkUnderwriters 5. Penn
12, 2007
ProducedlD Pftt” Prodticd,[�
'�'- ovary Discount Assoc. Co
APPLICATION APPROVED BY: Bldg: Zoning: Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions:
n
dJ
A SC\
fV
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: 'Doyt✓ 8tnJ0` &S
50,�, rGt . FL- `3x77 3
Owner: LrZ�{' ��. �Gt✓he�,
name
address
#07- Mi-2�3�
phone
License #: CbC- 0 0 K I? 3
Project Information
Permit #:
Subdivision:
Lot #:
I, MAA- A +A-3 t2 CAS, c5� , affiant, hereby affirm that I am the duly licensed
contractor of record for the above referenced permit, that all the foregoing information is true
and accurate, and that the dry -in, flashings at the above referenced address or lot has been
installed in accordance with the applicable codes and standards.
Contractor: 6--)
signature
- -A s C C -ng o-ri
printed name
STATE OF FLORIDA
c
COUNTY OF
This instrument was acknowledged before me this day of4—f 20(/. by the
above referenced individual, —Mo -m Ag Z , who acknowledged that he/she is a
duly licensed contractor with u«0o F CW. FL I Nc. and who acknowledged that
he/she was autho' ed to execute this document. He/she is eithe erson=ynown to me or
produced ZZI a.� as valid identificaton-
— A
WITNESS my hand and seal this day of
43
, 20
MARY J. HART
MY COMMISSION # DD 183748
WEXPIRES: February 12; 2007
1 -8Z3 -NOTARY ` -L Notary DiscOunt Assoc
Co.