HomeMy WebLinkAbout120 Borada Rd (2)CITY OF SANFORD PERMIT APPLICATION
Permit # : ®ZS S
Job Address: A O
Description of Work: 'ek-O
Historic District:
Date:
GL- t' C t GQlti,
Lf +Dv c-DhA e+\z o v -+- . X e- con 9..0 l^a-
Zoning: Value of Work: $ ii 01r
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration V-"' Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Cale. 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 #:
Owners Name & ddres:
II `'A0 bor
Contractor Name
Phone & Fax:
Bonding Company:
Address:
Nfortgage Lender: _
Address:
Architect/Engineer:
Address:
rAMPYWA
NEW®R ii1
1., 3a- 7
Contact Person:
Attach Proof of Ownership & Legal Description)
Phone:
State License Number:y c-o 0 0 a y
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 corrunence>d.17ci.or to t:lle
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 INT YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AR)
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 requiremen of Florida Lien FS 713
Signature of Owner/Agent Date Signature of Contractor/Agent Date
Print Owner/Agent's Name Print Contractor/Agent's Name
D-V/0
Signature of Notary -State of Florida Date Signature of Notary- ate of Fl da Date z
Owner/Agent is Personally Known to iVte or
Produced ID
APPLICATION APPROVED BY: Bldg:
Initial & Date)
Special Conditions:
N
4 z
YC u
2I .
Contractor/Agent is Personally Known to Me or
Produced ID u' 1° w
IL
Zoning: Utiiities: FD: -E m`
Initial Date) (Initial Date) (Inoitial & Date)
do
0
CITY OF SANFORD PERMTI APPLICATI
Permit # : o J I Date
Job Address:IA20 slao L:Z
1 1 / t
D,ription ofeWO
Iisforic Dt strZoaing: Value of Work: $ Permit
Type: Building Electrical Mechanical %,/ Plumbing F1 Electrical:
New Service — # of AMPS Addition/Alteration Change of 01
Mechanical:
Residential Non -Residential + Replacement New (D Plumbing/
New Commercial: # of Fixtures # of Water & Sewer Lines # of Plumbing/
New Residential: # of Water Closets Plumbing R, Occupancy
Type: Residential Commercial Industrial Total Squar, Construction
Type: # of Stories: # of Dwelling Units: Flood Pared #:
ZU jr
Contractor
Name & Address: State
Phone &
Fax: M Bonding
Company: Address:
Mortgage
Lender: Address:
Ambitect/
Engineer: Address:
Application
is hereby made to obtain a permit to do the work and installations as indicated. I certify that nc issuance
of a permit and that all work will be performed to meet standards of all laws regulating constructic permit
must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, AIR
CONDITIONERS, etc. ler/
Alarm Pool Temporary
Pole it &
Energy Calc. Required) J.
Residential
or Commercial FEMA
form required for other than X) XW...
o Phone:
Fax:
or
installation has commenced prior to the ds
jurisdiction. I understand that a separate ERS,
HEATERS, TANKS, and 11
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 constructionandzoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF CO CEMENT MAY RESULT IN YOUR PAYING TWICE
FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING 1 C NSULT.WITH YOUR LENDER OR AN , ATTORNEYBEFORERECORDINGYOURNOTICEOFCOMMENCEMENT. NOTICE:
In addition to the requirements of this permit, there may be additional restrictions applicable to this
county, and there may be additional per» is required from other governmental entities such as water Acceptance
of permit is verification that I will notify the owner of the property of the requirements of Fle Signature
of Owner/Agent Date Print
Owner/Agent's Name Signature
of Notarystaw of Florida Date Owner/
Agent is _ Personally Known to Me or Contractor/ Agent Is ProducedID _ Produced IDI oil /
A 215APPLICATION
APPROVED BY: Bldg: Zoning: Utilities: Initi
Date) (Initial & Date) 1 Special
Conditions: that
may be found in the public records of districts,
state agencies, or federal agencies nt
Date me
Y
R{
da Date . hY?(%'
Maria I, , res. commission
Cnownc
Al Then DFF p A[l nn^ ior=ina Cp Inc. FD:
tial &
Date) (Initial & Date)