HomeMy WebLinkAbout2601 County Club Rd46
Permit#
Job Address: Z(o0I COQl- ira
Description of Work:Z*jd1fALA- -Sp4
Historic District: IMA Zoning:
CITY OF SANFOR- PERMIT APPLICATION
Value of Work;
Date: 1— 4 • 2.,%:6
Pt¢.E u to
Permit Type: Building Electrical Mechanical Plumbing Fire SptinkierFPdarmj!!:,_ Pool
Electrical. New Service - # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout &Energy Calc. Requir gc��li
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;
Parcel 507m �6-4 (Attach Proof of Ownership & Legal Description)
Owners :Name & Address: Mts�,-a rJg �' ea _uB�a�T` C�wax%�
7-.ti01 Ca.►&-%l�C C"W6 Q.Q Phone: A&1 - SZZ'S844
Contractor Name & Address: Ell MCIA x. 210, W. 5TH !&T9 -9z --r. S O.yGoQD %L asrrn\
honer4' 020.
\tortggY Lender NLA.
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LA. _ y
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Arc hitecvEngineer: N A s +Phone'!-
Address. NIA
Appi;cauon is hereby made to obtain a permit to do the work and installatioiA
hao ork or �staliation has co menced pnur r..:
issuance of a permit and that all work will be performed to matt s dards oljas+rt eguittit 4�n scoon in t�_,�tj;,yi,[is�fuion. I understand that a scpara:e
permit must be secured for ELECTRICAL WORK, PLUMB rNQQ LO! S, WEjLS.,.POOLS, FURPtACES, BOILERS, HEATERS, TANKS, and
AiR CONDITIONERS, etc. y...�. w�-_
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 tee,;i�ui
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
1 W'ICE 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
h;s county, and there may additional permits required from other governmental entities such as water management districts, state agencies, or federal agent cs
Acccptsncc of permj( is van k4, t II n the owner of the property of the requirements of Florida Lie La , FS 71 3.
i
Signatu« o?Ow (,lniyt O Date Sig atureofContractor/Age Dais
Pnnt Owner/A a c. Print ontractor/Age 's Name
S gra ofNotaryjS( T ate aty�rati*Ef ' D a i e
DEBBIE BIANTON
kran,�'
COMMISSION # DD 188491
/Q rabruary 25,21)07Owncrod cnt iSr� 9erstitaiy it{(o,yn to Me or nis Personally nownAssoc: M or 1 Produced I9�/�I F _ tJotary Discount Assoc. Go. )1 P�
APPUCo\TION APPROVED BY: Bidg:Wta
D Zoning: Utilities: FD:
te) (Initial & Date) (initial & Date) (Initial & Datc)
Special Conditions.
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REVIEWED
Sanford Fir, Prev Div,