HomeMy WebLinkAbout1105 Laurix AveCITY OF SANFORD PERMIT APPLICATION
Permit #: C) S -I 8 1 - Date: --- l C,
Job Address: t1 D ; k Ay rtt L 6%42 r%Y 9 2-7`-11
Description of Work: K L- K t IyL
Historic District/V Lp Zoning:
LMMM
of Work: S_ tv c )
Permit Type: Building Electrical Mechanical 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 Water Closets Plumbing Repair- Resi4ntial or Commercial
Occupancy Type: Residential!/
WaCommercial
Industrial Total Square Footage: Construction
Type: # of Stories: of Dwelling Units: Flood Zone: (FEMA form required for other than X) Phone &
Fax: Bonding
Company: Address:
Mortgage
Leader: Address:
Architeet/
Eagineer: Address:
State
License Number. G rC--0 Contact
Person: QS ,1 ^1..JD 1, a=-_ Phone: Pboue:
4'V?-32i —F, 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 pernit, 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 govemmental entities such as water istricts, state agencies, or federal agencies. Acceptance
emit is veri cation that I will notify the owner of the property of the roqui Florida Lien , F 713. re
of Owner/Agent Date of Contractor/Agent Date Print
Owner/Agent's Name Signature
of Notary -State of Florida Date Owner/
Agent is Personally Known to Me or Produced
ID APPLICATION
APPROVED BY: Bldg: initial &
Date) Special
Conditions: Contractor/
Agent's Name i
Stat6
TON MY
CON. ;!ISSION DD 1ti8491 EXP!
iiE^: Fabruary 25, 2lK)7 Produced
b_e fhr zoning:
Utilities: _ Initial &
Date) 00
Initial &
Date) sue-
ash- o FD:
initial &
Date)