HomeMy WebLinkAbout2431 Laurel Ave (5)OtT1' CITY OF SANFORD PERMIT APPLICATION (�
Permit # : ✓ �,/r Z� Date:
Job Address: 2431 3% L,4 u r e C 14 u c
Description of Work: G7'en lrapj ,Ono ✓r /Ac%iy40'✓
Historic District: Zoning: Value of Work: S OLAS4�0 sp
Permit Type: Building Electrical —e�—M echanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service – # of AIVIPS 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:L&I# of Stories: ewe # of Dwelling Units: _ 1/e Flood Zone:_ (FEMA form required for other than X)
Parcel #:
Owners Name & Address:
Contractor Name & Addr
C Fev,
(Attach Proof of Ownership & Legal Description)
Phone:
GS 2Z S tRoyal7liye ,jiQiyFort4 t"! 32973 State License Number: GG /JV01943
Phone & Fax: 442' 37,7.- 15(67— Contact Person: ✓ tlO�ldS0/v Phone: SAAJ 1n,
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
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.
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 req ' em nts of Florida Lie LawyyS 713.
Signature of Owner/Agent Date gnature of Contractor/Age Date
Print Owner/Agent's Name Print Co tractor/Agent's Na e
2 (.0's
Signature of Notary -State of Florida Date i nature ofNNptaYyttate of F rida Date
a� ; • •,• J ANN M. JOHNO(JN
* MY COMMISSION # DD 285622
'EXPIRES: March 23, 2008
Owner/Agent is _ Personally Known to Me or Contractor/A;Ii4isop�P )91'rr"��an§,4h9t1'lvdan6ftwr
Produced ID Produced'ID
APPLICATION APPROVED BY: Bldg: Zoning: Utilities: FD:
(Initial & Date) (Initial & Date) (Initial &Date) (Initial & Date)
Special Conditions:
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