HomeMy WebLinkAbout2811 S French Ave (3)N
Job Ad& ss
Description of Work:
Historic District:
0
CITY OF SANFORD PERMIT APPLICATION
Date: hllo .
AU
v
Zoning: Value of work: S %
Petrmit Type: Building Electrical "'A'— Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service TemporaryPole 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 — Residential or Commercial Occupancy
Type: Residential X Commercial Industrial Total Square Footage: Construction
Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than x) Parcel #: (
Attach Proof of Ownership & Legal Description) Owners
Name & Address: S 14 A W IU7U A ALL/ O v31
Bonding
Company: Address:
Mortgage
Lender: Address:
Architect/
Engineer: Phone: 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 issuance
of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. 1 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: 1•cer* 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 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 1 will notify the owner of the property of the requirements of F ida n Law S ZZL Signature
of Owner/Agent Date Signature o Contractor/Agent Date NR
Print
Owner/Agent's Name Prin C ntractor/Agent's Name Signature
of Notary -State of Florida Date Signature of Notary -State of Florida Date Owner/
Agent is _ Personally Known to Me or Contractor/Agent isL ersonally Known to M Produced
ID _ Produced ID APPLICATION
APPROVED BY Special
Conditions: 1—
Bldg:
ipk I Zonin Initial &
Dale) Initial & Date) Utilities:
FD: Initial &
Date) (Initial & Date)
LIMITED POWER OF ATTORNEY
I hereby authorize
or 61,UCw
Date
to sign his/her name on my behalf in order to apply for a sA/U t`dkl7 permit for
the work to be performed at: Lot
Subdivision Address_:
5. G14 ,q i NEiy9Y
AC- LL'c I-I2 /C COM RIAI y jfR o0i0.736 Type
or print name of comnanv and License # of Contractor Signature
of Licensed -Contractor STATE
OF FLORIDA ORANGE
COUNTY Zhe
foregoing instrument was acknowledged before me this ,Z- y of M name
of person acknowledging). o
W Signature
of Notary Public -State of Florida) @"
rl Duns M Parks My
Commission DD040050 p,
Expirss August 1 Q 2005 Print,
Type or Stamp Commissioned Name) Personally
known_ OR produced identification Type
of identification produced