HomeMy WebLinkAbout719 E 8 St (3)1 ^ 1 CITY OF SANFORD PERMIT APPLICATION
Permit # Date: 1�
�0
Job Address: -7 kill
Description of Work: C`1f}hjilf-� Sr-eulce
Historic District:
Zoning:
Value of Work: $ Z()C)O .cc
Permit Type: Building Electrical X Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS _1,50 Addition/Alteration Change of Service x 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 if: 1 ,�n (Attach Proof of Ownership & Legal Description)
Owners Name & Address: 12OV-r N" M1 hArcl- Mf—VV
Phone: A4*6W-1361
Contractor Name & Address: 'PI FJT11:TW t7fl lC, x{J C,
State License Number: ec ffio fsbT
Phone& Fax: 0-1 330-5831 Contact Person: ED Phone: Ltd 2 330-583]
Bonding Company:
Address:
Mortgage Lender: .
Address:
Architect/Engineer:
Address:
Phone:
Fax:
Application is hereby made to obtain a pennit 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 requirements of Florida Lien Law, FS 713.
10
Signature of Owner/Agent Date Signature of Con ractor/Aggeent D to
W s}2D �►1 at�3LS lq
Print Owner/Agent's Name Ptjrtt-ContractyF/Agent's Name
Signature of Notary -State of Florida Date Signature f No �r State of0I,0ntta;E BLANTON Date
491
MY cc) v,pi SSION t/ DG 20s}7
�S.zM aP' EXPRES. February 25,
Discouni
Owner/Agent is Personally Known to Me or Contractor/ � gent -i .-NOTPI'Persoii 41yWKnow rto-Me Drco.
Produced ID Produce�l'ID`�P
APPLICATION APPROVED BY
Special Conditions:
B Zoning:
(1 itial & 'ate)
(Initial & Date)
� �S
ov
Utilities:
FD:
(Initial & Date) (Initial & Date)