HomeMy WebLinkAbout220 Town Center CirCITY OF SANFORD PERMIT APPLICATION
Permit h, — \ ✓
Job Address: Z.. O t d {,on Cay'
Description of Work:. Am �
Historic District: Zoning: i Value of Work:
Date:
U .
Permit Type: Building _,__ Electrical_....____ Mechanical Plumbing Fire Sprinkler/Alarm Pool
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 Lincs
Plumbing/New Residential: # of Water Closets
Plumbing Repair — Residential or Commercial
Occupancy Type: Residential
_ C'onunercial
Industrial
Total Square Footage:
Construction 'Type:
# of Stories:
#E of Dwelling Units:
Flood Zone: (FEMA form required for other than x)
Parcel #:
Owners Name & Address:
Contractor Name & Address:
(Attach Proof of Ownership & Legal Description)
Phone:
/ / ``/ S; tate License
—Number: -03 ? "i j L1/�(�Q/ ?(��/
Phone & Fax: �/n�'`Z3.5� �IUC) 7U7 Zb l%S U Contact Person: Phone: /� % l ✓,a ���
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, I1EATERS, 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 ail applicable laws regulating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVFMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NO'T'ICE: 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 I will notify the owner of the property of the requirements of For' a Lieu aw, F'S 713. '1
Signature of Owner/Agent Date Signature of Contractor/Agent > to
r
Print Owner/Agent's Name Print (yt'jrtc r/A ent'. a e
l (// Ell `«i rh
Signature of Notary -State of Florida Date Signature of Notary -State of Flo d Y o i6r< 237997
?m, r,d� , Expires August 16, 2007
Owner/Agent is Personally Known to Nle or Contractor/Agent is :personally Known to Me or
Produced ID Produced It)
APPLICATION APPROVED BY: Bldg: Zoning: _ _ _ Utilities FD '
nidal &Date) (initial &Date) (initial &Date) (lninal & t )
Special Conditions: _ y
@ 2004
'NOTICE: This drawing and the data thereon shall not be duplicated, used, or disclosed to others for
procurement or mgmfocluCiog purposes, except as otherwise authorized by contract, without the written
permission of 5implex8rinnell. All reproductions shall bear this notice.'
. . . . . . . . . . . . . . . .
. ....... ............ ..
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LEGEND
:z ►7-1 1 EXISTR ING P.ENDENTS TO REMAIN
EXISTING UD RIGHTS TO BE REMOVED
ii
RELOCATED 1/2" 155* PENDENT, 11
ST
ORALE :z SALE
TOTAL 11
1 _
EXISTING P11 -1E
BATHROOM
NEW PIPE
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