HomeMy WebLinkAbout2459 S Palmetto AvePermit # ds — `
Job Address: is
Description of Work:
Historic District:
CITY OF SANFORD PERMIT
APPLICATIO13 Date: A)-5
fA' e
c-ir ar!Y-e Zoning:
Value of Work: $_ Permit
Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Electrical:
New Service — # of AIjyI'S Addition/Alteration 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 Plumbiug/
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) aim --- — -- - -
Parcel #:
110- - 30 - sck ll --
0 •
u % sV (Attach Proof of Ownership & Legal Description) Owners
Name 4Addres_: 00 ilw- m r t ( (J_Q.'"^ i Contractor
Name & Address: Phone &
Fax: Bonding
Company: Address:
Mortgage
Lender: Address:
Architect/
Eugineer: Address:
Phone:
Y'y/' C>/'J -.7 Contact
Person: E n1 Y Phone: Phone:
Fax:
Application
is hereby made to obtain a permit :o 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 worst 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 Y-JITH 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 Florida Lien Law, Fo 3-
1645of
Contractor/A ens Dace Signature
of Owner/Agent Date Signature g Print
Owner/Agent's Name r, aCont.
At
A et `s Name W
Signature
of Notary -State of Florian Date Owner/
Agent is'__ Personally Known to Me or T
ProducedID APPLICATION
APPROVED BY: Bldg: Zoning: Initial
Uate) Special
Conditions: itW*- {
Ii BSlE1TFfl D 164280 Date XPIRES:
November 12,2006 3OFF
Oonded Thru Budget Notary Services Contractor/
Agent is crsonally Knows, to Me or Produced
Ill Utilities: _ _
FD: _ tiuitial &
Date) (Initial & Date) (Initial & Date)