HomeMy WebLinkAbout1701 Lowe Ave (5)po-'l - aT
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CITY OF SANFORD PERMIT APPLICATION
Permit',:
Job Addtte
l \ Date: - 7"6S
Description of Work:-TrJSTA// 41/ fAZ,Y -ARoS d l!/leup j'c, pvs /
Historic District: Zoning: Value of Work: S 70•%
Permit Type: Building Electrical X Mechanical Plumbin g Fire Sprinkler/Alarm pool
Electrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary PoleMechanical: 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
Occupancy Type: Residential Commercial
Construction Type: # of Stories: # of D
Parcel #
Owners Address: C; % a F ...4n td,
y rL it z: /--78a Plumbing
Repair - Residential or Commercial Total
Square Footage: Urfits:
Flood Zone: (FEMA form required. for other than X) Attach
Proof of Ownership & Legal Description) Y. /
7Bf , r-
Phone: Contractor
Name & Address: -Qz' ¢(/y-d G leGTri PG /j(/z : - YrVy L S l"77 Z State
License Number: GCG' '0P/3Gt(j / 1r1/3 hone <
Sax: _5 G1- j22-/,SC Z 3 7/117 y Contact Person: i/!V 'hone: e167- y/%-e2V7 3ondingCompany: . Address:
Mortgage
Lender: A/± Address: ----
architect/
Engineer: /y - hone:
Address:
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 issuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. I understand that a separate permitmustbesecuredforELECTRICALWORK, PLUMBING,SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIRCONDITIONERS, 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 constructionandzoning. WARNING TO OWNER YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICEFORIMPROVEMENTSTOYOURPROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEYBEFORERECORDINGYOURNOTICEOFCOMMENCEMENT. 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 thiscounty, 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 requireftteiqts of Florida Lien Law, FS 713. _ Signature
of Owner/Agent Print
Owner/Agent's Name Date
Signature
of Notary -State of Florida Date Owner/
Agent is _ Personally Known to Me or Produced
ID APPLICATION
APPROVED BY: Bldg: 0 1Zoning: Initial "
ate) Special
Conditions: 7 -
0-5- Date
of
Notes Sial f F`,g6JWMISSIDN # DD 2 EXPIRES:
March 23, 2008 Bonded
Thai Budget Notary Services Contractor/
Agent is v Personally Known to Me or ProducedlD
Initial &
Date) Utilities:
FD: Initial &
Date) (Initial & Date)