HomeMy WebLinkAbout1000 Stone Brook DrCITY OF SANFORD PERMIT APPLICATION
Permit # • 0(D ^ 1 014
Job Address:
Description of Work -
Historic District: Zoning:
Date: 1 1 1 4'0 0
Value of Work: $ 11 - 46M . op
Permit Type: Building Electrical Mechanical Plumbing Fite 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 Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair - Residential or Commercial _
Occupancy Type: Residential Commercial -.11—C Industrial Total Square Footage:
Construction Tyep e:; # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: V 2 V _ S 1 l _ d 4 5>5> ^ CXXDCZ> (Attach Proof of Ownership & Legal Description)
Owners Name & Address: IN AA I tAW& AlUbee. t. T 0 e QCLcA PIS • 0 Zo $
tPUPS A). ST H§&" tl#t S/TG UND Mwee: t'Vei13R TX-nposiT
Contractor Name & Addmss: ?= _ L . Nt% l& l.-Oa3 royk- V ZZ 3 5, ftf el etAr6r • Oil -
IN*00 State License Number: _ Ctt—* OTS-7
Phone & Faz: Q151 AW-frP0401l cir / Contact Person: •hiL0Qrt; ,ai %CaI V Phone: r`[ O7 - a35'Y"I A,..p Bonding
Company: Address:
Mortgage
Leader: 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, 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 PAYD;G 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, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. Ait
is verification that I will notify the owner of the property of the requirements of Florida Lien Law, FS 713. g 1,
p /p / I { % /`l (a r............... 3 uro
w i
y S SiMature o ne gent Date Signature of Contractor/Agent IDate ;ajit•wp Z Print Owner/
Agent's Name Pri Contractor/Agent's Name q" Signature of Notary -
State of Florida U Date Signature of Notary -State of Flo d Date d Z fi ONE.: Owner/
Agentis _ Personally Known to Me or Contractor/Agent is Personally Known to Me or L'R14c r •. J Produced ID ED0- 141 (00 ,39i-U _Produced ID ww•nnwu •.••.t APPLICATION APPROVED
BY: Bldg (/ YJ Zoning:
Utilities: FD: Initial & Date) (Initial & Date) (Initial & Date) (
Initial & Dare) Special Conditions: