HomeMy WebLinkAbout105 Aldean Dr (2)CITY OF SANFORD PERMIT APPLICATION
Permit #: 0
Job Address:
Description of Work:
Historic District:
V
Date: /0 0
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e-&1 I h S && S c.b ba,t eL +—
Zoning: Value of Work: S
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration
Mechanical: Residential Non -Residential Replacement New
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines
Change of Service Tempol*y Pole
Duct Layout & Energy Calc. Required)
of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair— Residential or Commercial r_
Occupancy Type; Residential —>L Commercial Industrial Total Square Footage:
Construction Type:Q9dfidftf Stories: —L— # of Dwelling Units: _ Flood Zone: (FEMA form required for other than X)
Parcel #: 34 1 3'' 0 ('g D Q Q 0 — Q Q A (Attach Proof of Ownership & Legal Description)
Owners Name & Address: _ 1-H b e S , e U t in -L. A IV sC e 1C
Phone:
Phone & Fax: Contact Person: Phone:
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 theissuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstructioninthisjurisdiction. I understand that a separate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, andAIRCONDITIONERS, 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 regulatingconstructionandzoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYINGTWICEFORIMPROVEMENTSTOYOURPROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR ANATTORNEYBEFORERECORDINGYOURNOTICEOFCOMMENCEMENT.
NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that maybe found in the public records ofthiscounty, 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 Florida ien Law FS 71
Signature of Owner/Agent Date Signature of Contractor/Agent Date
F- b v l Licvl
Print Owner/Agent's Name Print Contractor/Agent's Name
I
Signature of Notary -State of Florida Date Signature of Notary-Slwe of Floffida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
1'1'1 IC ATION APPROVED BY: Bldg "Zoning:
lnitia & ale)
peci.:! Conditions:
Contractor/Agent is _ Personally Known to Me or
Produced ID
Initial & Date)
Utilities: FD:
Initial & Date) (Initial & Date
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