HomeMy WebLinkAbout103 Monroe View TerCITY OF SANFORD PERMIT APPLICATION
Permit # : ri
l '
c 5 Date: I I IQID ( i
Job Address: 103 - m on roe, yl t" M
Description of Work: I rIS11CLU YLQm _Sti' Vi u -( r 0ond a. fil'Ct,"r -
Historic District: Zoning: Value of Work: S 100. 01D
Permit Type: Building Electrical -( Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS I DD 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
Construction Type:
Parcel p:
Name & Address:
of Stories: # of Dwelling Units:
Total Square Footage:
Flood Zone: (FEMA form required for other than X)
Attach Proof of Ownership & Legal Description)
VIV I1.1 ICA IUu I Vt t bl 'TlUlAPhone: Contractor
Name & Addt;ess:1 rl -%L`I: b4wrI [ t l /rorrrmmr y.3o v l.r fir. G1 1 Sin n d1 3a-iy fan
P.0 & r cle n a is State License Number: EC D 0 0 0 Phone &
Fax: _4DI_72?3SZ)0 u07799AD% ContactPerson:c—knmkrEG.Y_Lrt Phone: 9V78935o0tx4//gel Bonding
Company: Address:
Mortgage
Lender: Address:
Architect/
Engineer: Address:
Phone:
Fax:
Application
is hereby made to obtain a permit to do the work and installations as indicated. 1 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: 1 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 PAYING 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 oun in public records of this
county, and there may be additional permits required from other governmental entities such as water management districts, to ag ties, or federal agencies. Acceptance
of permit is verification that 1 will notify the owner of the property of there ments o on s Lien Law, FS 7 Signature
of Owner/Agent Date Signature of Contractor/Agent ate Print
Owner/Agent's Name Signature
of Notary -State of Florida Date Owner/
Agent is _ Personally Known to Me or Produced
ID APPLICATION
APPROVED BY: Bldg: Initial &
Date) Special
Conditions: Zoning:
fan
m bordCrlclL Print
Contractor/Agent's Name Q
tiru,Q . ,- I I LRIA gnature
of N ry-State of Florida Imate towroe
Jennifer
A Eakin Commission
DD060390 Contractor/
Agent is 2— Personally Known`''' es
February 8, 2008 Produced
ID Initial &
Date) Utilities:
FD: Initial &
Date) (Initial & Date)