HomeMy WebLinkAbout500 Center Park Dr12-17-28.3 1 1 - 30At-1 FPGN1 r' P. I
Yob Address: Sod
Description of Work: lLI u!
Historic District; Ny zoning:
C"TY OF SANFORD PEsRINU b APE'LICAT ION
IN
Date: -_ / L' I ) - t
Value of work:
Pcrtmit'ilypt:. Buiidind:—_
EICOAW
Mechattioal__ plumbing_
ireSprinkir..r larrn Pooh_
New Setvitx -
# of A141PS
Addition/A temion __
Chmise of Service -- Temporary Pole i
Mechanic
Mechanical, Residetrtial—
Non -Residential
_ FzpLicerretit _,__ New,_
(Duct Layout & Eucrgy Calc. Poquired)
Flumbl aW New C:adimercial: # of Fixtures _ # of Water & Smer Litres__ # of Gas Lines --
Plumbinglt ew iteaidenft: it of Water Closets Plumbing repair - Rcsidential yr Commet'eiai
Occupancy Tym Residential C.ontttiercial-,Xq— Industrial 'Cote( Square Footage:
Coustructioea Type: # of Stories:.# of Dwelling Units: _ Flood zone: _ (PENIA form rtaulted for cthcr than x)
Yarcci #: (AMA -Ch l'a'de[of Ownership & Legal (inscription)
tlwners .Nam¢ & Address.
Contractor Ienroed & Address: y //1 S. �~�G�GCN MY • ---- - —_
GfI C State License Nuanber: [2 Si�%l/G'%! 9 0
Phone at gar: _ - 3332 - hunt.y�
)'vendingnmpany: -
Address:
Mortgage; Lender:
A.Adrcss:
Architoat(Engincer: - ,-Phone:
Address:--'�-
' :Txx t
Application is Hereby made w obtain a permit to da Ot`Work and g l tins ce hat no work Pr it st3llation hes Commenced
prior to the
issuance of a permit and &,at all work will be pct*rmod w meet s all 1 " i action in ibis jurisdiction. 1 undorstnod that a separate
permit must be scCurod for ELECTRICAL WORK, PLUMBING, I Ll S Cf -R. BOILERS, HEATERS, TANKS, and
ATR CONDITIONERS, etc,
¢ ER' S AFrIDAVIT: (Ceatify that all of the foregoing information is atcmtc and that all work will be done in Compliance with all applicable laws regulating
o0a6ttucti0n 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 FINANCrNG, C6NSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
d TICS: In addition to dee additional
ircmenly perm
this pern"t,here ma
there be addilional mstrictibrts applicobk to this pr MlY that may be found in the public records of
this county, and there maybe ditional permits required from other governmental entities such as wmf m3ttggement districts, state agencies, or federal agencies
A=cptanoc of permit is verification ti,at I will notify the owner of the propery ofthe
Signature ofOwnedAgcnt
Print Owner)Agmt's Name
Date
ti is of Florida Lien Law. FS 713.
&-�
Signatu etor' � r/A
Date
�iA P �2arf—
Print
Signature of hlotsuy-Brett of Flatida 'J;tte Signature of D9 ry- ; t� I` t�� • s pa
Notarypubric-�itel Honda
M'yC0rrn*-1bn Ep;resjan 2.2(>fl,5 .
Owner/Agent is __ Personally Known t0 Me or Commission # CC983065
Coruwtor/Agent is ersonatiy Known to Me or
Produced ID )__ % Produced ID --�nJ
APPLICATION APPROVED 13Y: Bldgc�-( Z.-(� �{ yon;,tg; T��_-� Uiilitir.3: _- - - �U. _ ► r I l� d
Initial & Date) ( a e? lintttal Date} (Inirial 3e DBte) (initial &late)
Spzcial Condition3: �_ _ _
2
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JAN 0 7 2004-f-
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PLANS REVIEWED
CITY OF SANFORD
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JAN 0 7 2004-f-
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PLANS REVIEWED
CITY OF SANFORD
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