HomeMy WebLinkAbout813 Valencia CtPermit #: OS —am -39 3 0
c
Job Address: 1J 1 3 Vcd
Description of Work: tt
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Zoning:
Date:
Value of Work: $ 3 b oor 00
Permit Type: Building Electrical Mechanical Plumbing 1,1/1 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 0 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 #: 3 1 ~ / r
Owners Name & Address:
,(4 3a'
Contractr am`e & Address:
0 -f i 3J -
Phone & Fax: L
Bonding Company:
Address:
Mortgage Lender: -
Address:
Architect/Engineer:
Address:
) / S D � ~ �WD T /��� (Attach
e/ic.ka F- ee o-
7 -1r
L b &'-
v�^1r16�C . lc—
of Ownership & Legal Description)
Phone:
). r,
State License Number: L f— L-- U,) / r) 0 b
Contact Person: ;
Jo''e Phone: L/C>7—'7'F4— 90U(,
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 pennit 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: 1 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 pen -nit, 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
Signature of Owner/Agent Date Signature of Connector/Agent Date
Print Owner/Agent's Name P IC n or' gent's Name
Signature of Notary -State of Florida Date ignatur e of Nota -St "51oridarJf f3rli Date
BL4NTON
My C C; :'±-i,'USICN � DD ?88491
i R1r{(,': F=ebruary 25, 2007
1 -800 -3 -NOTA.:
?y
b ^'
Owner/Agent is Personally Known to Me or Contractor/Agent s'�-�-�•k'ersollghy Kri wn=to�9e�ontassoc. Co.
Produced ID Produced ID
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Special Conditions:
Zoning:
Utilities:
FD:
(Initial & Date) (initial & Date) (Initial & Date)
05 -=3�3o
Permit #:
Job Address:
Description of Work: S
Historic District: Zoning:
CITY OF SANFORD PERMIT APPLICATION
VN C'1
Date
S --
Value of Work: $ \ '::�Cv
Permit Type: Building Electrical Y Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential Commercial
Construction Type: # of Stories:
Parcel #:
Owners Name & Address:
Addition/Alteration
Change of Service Temporary Pole
Replacement
New (Duct Layout & Energy Calc. Required)
# of Water & Sewer Lines
# of Gas Lines
Plumbing Repair — Residential or Commercial
Industrial
Total Square Footage:
# of Dwelling Units:
Flood Zone: (FEMA form required for other than X)
(Attach Proof of Ownership & Legal Description)
Phone:
Contractor Name & Address: C S' Z3 ( j < n"Jl ( 5t }—yet m Q Y A, (c F1,3 '3 2, )q 2
State License Number:C t� `3 I -)CSL`
Phone & Fax: Contact Person: Phone: O ' C, f
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. 1 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: 1 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 Flori S 713.
Signature of Owner/Agent Date Signat Contract' Date
-bmocL. Q Nc-w's
Print Owner/Agent's Name Pont contraactor/Agents ame
-F— L
Signature of Notary -State of Florida Date Signature of Nota -State of Florida Date
DEBBIE BLANTON
MY COM"'li psi -
Owner/Agent is Personally Known to Me or Contractor/Age tis�',�„ .rso a]]y�Known to 94DR-188491
Produced ID Produced Dr. �Ai- -� rebruary25,2007
y Discourt Assoc. Co.
APPLICATION APPROVED BY: Bldg: Zoning: Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions: