HomeMy WebLinkAbout228 E 1 St (2)Permit #
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Job Address: Z
CITY OF SANFORD PERMIT APPLICATION
Date:
Description of Work:
Historic District: Zoning: Value of W`ork:'S ,Q�O'9 CAN Aa I_qy I f ts�4
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 #:
Owners Name & Address:
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Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender: _
Address:
Architect/Engineer
Address:
Contact Person:
(Attach Proof of Ownership & Legal Description)
2�7 Phone: 7 — 1"'�'Z�
State License Number:
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
pen -nit 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.
hof pen t err ca 'on that I will notify the owner of the o erty of the requirements of Florida Lien Law, FS 713.
i re of O nt ate Signature of Conhactor/Agent Date
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Owner/A cut's N e _ Print Contractor/Agent's Name
(�_�.s
Signature ofNotary-State of Florida Date Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID Produced ID
APPLICATION APPROVED BY: Bldg: Zoning:
Utilities:
FD:
(Initial & Date)
(Initial & Date)
(Initial & Date) (initial & Date)
Special Conditions:
X
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CITY OF SANFORD HISTORIC PRESERVATION BOARD
APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS
P.O. Box 1788, Sanford, FL 32772-1788
Phone: 407 330-5672 Fax: 407 330-5679
TO: THE HISTORIC PRESERVATION BOARD OF THE CITY OF SANFORD, FLORIDA
nDowntown Commercial Historic District ❑ Residential Historic District
❑ This application is filed in response to a notice from the Code Enforcement Department
ADDRESS OF PROPERTY: .212;i z6-- Z57 S/
Property Owner
Signature: Print Name:
Mailing Address:
Phone: Fax:
A licant/A e _
Signature: v 1 , " Q�{�� Print Name: C 2_ y 5a L-
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Mailing Address: 0204" W, IM 5T SA 1,L) 32-7 71
Phone: W 7 / q y �' Fax:
I certify that all info ation co tai ed in is application is true and accurate to the best of my cnowledge.'
Applicant/Owner: S Date:
Please use the attached riteria checklist as a guide to completing the application. Incomplete applications cannot be
reviewed and will be returned to you for more information. You are encouraged to contact the preservation planner at
407-330-5672 to make sure your application is complete.
Description of Proposed Work/Application Category: (Check all that apply)
❑ Site Improvements/driveway/waljcway
❑ Storage shed
❑ Moving structures
❑ Replacement windows or doors`
❑ Underskirting
❑ Awnings
❑ New construction/additions
� Signs
❑ Demolition
❑ Roofs/gutters/downspouts
❑ AC/Mechanical
❑ Fences/Gates/Pergolas
❑ Replacement siding/flooring/porch
❑ Paint
❑ Other
Completely describe the entire scope of work: all changes in material, color or location to the exterior of the building,
where on the property the work will occur and how the work will be accomplished. For large projects, an itemized list is
recommended. Attach additional nages'if necessary.
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A Certificate of Appropriateness is valid for six months unless otherwise noted
Historic Preservation Board MDate:
Application is Approved eeti
Conditions:
Signed:
OFFICIAL USE ONLY
Staff Review Date:
Approved with Conditions
Date: I.
Denied
***This Certificate must be prominently displayed on the building when work is in progress***