HomeMy WebLinkAbout711 E First StArmit # : O5 -/ O t) a7
Job Address: / 1 11I
Description of Work:
Historic District: I
CITY OF SANFORD PERMrr APPLICATION
Date:— motor C'k 161, 0
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool SIsA "---
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
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 Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parccl #: 3 0 _ 1 "1 ' 3 i — 5-0-7— V / r 00 Attach Proof of Ow ership &
Owners Tame & Address: I U W rn It L A4,w- v vtn a.• r t rnr ) • arj /' ' S "
EL —- `` // Phone: 'f O
Contractor Name & Address: Z ho a MO A- C!hA S'- CO -A X1C
Phone & Far: `1 V -7
Bonding Company: _
State Liccoste-Number:
Contact Person: D'eQ4 r V h0C/haj0w—Phone: 0 -? (N —for 1
Address:
Mortgage Lender:
Addrms:
Architect/Enginecr. n! _ 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, ctc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicoblc laws regulating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT 1N YOUR PAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY, IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTiCF.: 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
Vis
verif pbn that 1 will notify the owner of the property of the requirements f Florida 'er) Law, FS 713.
Sign rc o r/Agent
3
ate Signature of on[ r/,Agent /D c
Name
1*01010A MANN
ta a of Flo a: :+r M MCOY WSS10N / DD 099327 gnature of Notary -StateSignatureofNotary-S
y EXPIRES: April 5, 200S
Boded Tft worry public Undnwiaeta
Owner/Agent is Personally Known to Meor
Produced ID
R
Contraclor/Agent is _ Personally
Produced ID
APPLICATION APPROVED BY: Bldg: j) F- v _ f-? -0L ng• #r 4 3-1&-of Utilities:
Initial & Date) (Initial & Date)
Special Conditions:
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1'ATFOGIA A MANN
MY COMMISSION # DD 099327
EXPIRES: Apol 5, 2o0e
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Initial & Date) (Initial & Date)
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2-0 2-0"
I SIGN (M $50.00 1 SIGN (@ $50.00
8'-0"
2 SIGNS @ $200.00 EACH
TOTAL PRICE $500.00 NO INSTALL INCLUDED
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