HomeMy WebLinkAbout273 Magnalia Park Trl7
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Permit #
Job Address:
Description of Work:
Historic District: Zoning:.
Permit Type: Building Electrical
Electrical: New Service—#fAMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential j— Commercial
Construction Type: # of Stories:
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CITY OF SANFORD PERMIT APPLICATION
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Work: $O, 1
Mechanical / Plumbing Fire Sprinkler/Alami Pool
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)
Parcel #: (Attach Proof of Ownership & Legal Description)
Owners Name & Address: '
Phone:
Contractor Name & Addres . AM •
LO COS WEE STMET, SUITE 114.1e Licen-Al DI41 lN RUW
Phone & Fax: IM Fu RY, FLORIDAneW.74fi! ns( 1
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer: Phone:
Address: Fax:
Application is hereby made to obtain a pennit 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 he performed to meet standards of all laws regulating construction in This jurisdiction. I understand that a separate
pen -nit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: I ccrlify 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 maybe additional restrictions applicable to t s rop • that may b li and in the public records of
this county, and there may be additional permits required from other governmental entities such as waler.nn n g t districts, sfat gencies, or federal agencies.
Acceptance of pennit is verification that I will notify the owner of the property of the requireme eof F a en Law F 713 /
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Signature of Owner/Agent Date ' 0 Si, C actor/Agent Date
T G. DELLO RUSSO
Print Owner/Agent's Name Pri Contractor/A nt's dame
Signature of Notary -State of Florida Date Signature of Nolary-State of F orida Dale
2005
Owncr/Agent is_ Personally Known to Me or Contractor/Agent is Personally Known to Me or
Produced ID Produced ID
APPLICATION APPROVED BY: Bldg: Zoning: Utilities: FD:
Initial & Dale) (Initial & Date) (Initial & Dale) (Initial & Date)
Special Conditions:
MIRINDA C. TURNER
MY COMMISSION # DD 2128W
EXPIRES: June 14 2007
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