HomeMy WebLinkAbout3010 Twinwood TrOCT -04-2005 11:10 PM
Permit #:0
—
eJob=Address: 3 V/ DN1t s o[3
,D.escriptlon of Work: v I r
P.02
CITY OF SANFORD-PERMIT APPLICATION
Date:
Historic District: Zoning:
eXiilne•of=Work: S X )
Permit Type: Building-- Electncal_
Mechanical _Plumbing,_..,.,.. _ Fire SptinkleriAlarm .. _Pool
Electrical: New Service – # of AMPS
Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential
Replacement New (Duct Layout & Energy Cale. Required)
Plumbing/ New Commercial: # of Fixtures _T
# 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:� ,t:: _ Flood.Zone: (FEMA form required for other than X)
Parcel #:
_/ i Attach Proof of Ownership & Legal Description)
Owners Name & Address:
-...------- --- - Phone.._ -7 �.
CContractor--Name &-Address: Ow
-- - c --__`,..._%- ----.�J..lV{._..__.._
'u' 'er:
-� -�e-4 c'fS
Phone &Fax 7'� dt 10 i� �
_, ::.. _ : . State`l:itcrise �111 1D
Contact Perso y�y��...`r� ��Phonc: 1a�¢s7r',.�/�
Bonding Company:
.Address:
Mortgage Lender: _
Address:
ArchitectlEnpneer:
Address:
Phone:
Fax
, Lf•
Application is hereby made to obtain a permit to do the work and insta!lations a:icindica(,ed, 1,certify;that no N;ork or installation has commcoc:ed prior to the
issuance of a permit and that all work will be performed to meet standards of rJl laws regulating construction in this jurisdiction. I unclerstand that a separate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS. WEI.:LS, POOLS, t.iJRNAC'ES, BOILERS. HEATERS, TANKS, and
AiR CONDITIONERS, otic.
OWNERS ULQAV IT: I certify that all of the foregoing information is accurate'and that ail work will be clone in compliance with all applicable laws regulating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A. NOTICE OF COMM ENCFMEN-I MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND -TO OBTAIN FIN'XNCING; 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'festnictions app'.icable to this' property that may be Lound in The public records of
this county, and there may be additional permits required from other govcntmental entitie>. suchps watermanagement districts, state agencies, or federal agencies.
Acceptance of pennit is verification that I will notify the owner of the property of the requirements of
Signature of Owner Agent date CStgnaturr oi'Ce racto A Da
Print Owner -Agent's Name Print .ontac,tor Agents Na le
Signature ofNotary-State of Florida Dale ` "iSrgtiarure if VotaryState of FI d. a
Owner: ALent is Personally Known to ,? titnc'titr'.A'grni is V Personally Known to Me or
Produced ID .-P roduc,xt W
APPLICATION APPROVED BY: Bldg: ---_—... _oning;-_-----.......------ .. _ _-. Utilities: ...... _._..- FD:
(Initis c - (tribal•&'t`)3ii•)'•"- '" (initial & Date) (Initial & Date)
Special Conditions:
- �r ptt4 Notary Public State of Florida
Taryn Legh Falls
My Commission DD459182
OF a Expires 0810712009