HomeMy WebLinkAbout333 Gordon St (2)Permit # : C_S `
v —) —)
Job
Description of lVork:
Historic District:
CITY OF SANFORD PERMIT APPLICATION / %
Date: a 11 E
Zoning: Value of Work. + •. s'a
Permit Type: Building Electrical —,I(— Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole _
Mecbanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing! New Commercial: # of Fixtures # of Water & Sewer lutes # of Gas Lines
Plumbiug/Ne• 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 'Lone: (FEMA form required for other than X)
Parcel
IIMn ——
Owaers Name & Addrcas: 1) ; FR 11 hid Contractor
Name & Address: Phone &
Fax. **' Bonding
Company: Address:
Mortgage
Leader: Address:
Architect/
Engineer. Address:
Attach
Proof of Ownership & Legal Description) State
License Number: r
i =
vQ Person:
17JI/!'IIM Phone: 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 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 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, :utd there may be additional pemtits required from other govemntenral entities such as water ntanagetnew 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, FS 713. A//
Signatu'•_
of Owner/Agent Date Signature i5f Contractor/Ag t Date J-
ru Print
Owner/Agent's Name t rector/ ni's Name Z-/-
oJ Signature
of Notary -State of Florida Data Signal of No tate of Florida Date Owner/
Agent is _ Personally Known to Me or Produced
ID APPLICATION
APPROVED BY: Bldg: Zoning: Initia
te) Special
Conditions: Contractor/
Agent is ersonally Known to Me o Produced
ID Utilities:
FD: Initial &
Date) (Initial & Date) (Initial & Date)