HomeMy WebLinkAbout808 W 25 St (3)Permit # : 0S —
Job Address: q
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION Q
^ _ ` Date: ll OS
Zoning: Value of Work: $ 0,00
Permit Type: Building Electrical Mechanical V 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 Wate Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial Industrial Total Square Footage: 1
Construction Typed —aIf Stories: _rk— # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: \Q ` 1q- 3o_ S qh ^ Mv" 36%() (Attach Proof of Ownershi & Legal Description)
& Address: k -Ul I
Contractor
Phone & Fax: '!L_
Bonding Company:
Address:
Mortgage Lender: -
Address:
Architect/Engineer:
Address:
Address:
L(� Phone:
�dof�dcl. enc. 133 C' rlp
State License Number: . N k 41061?
Contact
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 UR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions appli a e to this prope be found in the public records of
this county, and there may be additional permits required from other governmental entities such term nagem t tri , state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirem nts f Flo a Li L 713.
Signature of Owner/Agent Date ig ture of Co frac /A e Date
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Print Owner/Agent's Name Print Cont-96or/Ag t' e 9`
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Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
_ Produced ID
APPLICATION APPROVED BY: Bldg: Zoning:
(Initr Date)
Special Conditions:
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Contractor/A'gent is P rsonall Known to Me
V Produced ID N�{5`p" \�n0- i 1 - 3V'
Utilities:
FD:
(Initial & Date) (Initial & Date) (Initial & Date)