HomeMy WebLinkAbout1144 N Virginia AveCITY OF SANFORD PERMIT APPLICATION
Permit # : O (o " 1)-- LC
Job Address: //V Al ripfidti F
Description of Work:
Historic District:
ti
Zoning:
Date:
Value of Work: S G "
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS %VO4 Addition/Alteration Change o ervice _ Gk 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 Total Square Footage:
Construction Type: of Stories: of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel ii: (Attach Proof of Ownership & Legal Description)
60&%• • -- —• • 4- -V L 773 State License :Number: dr'C- /,740 - /P {/ 2_
hone x Fax: 9107" 32.7- 7037i 7 390 /%6)VContact Person:
7 -
0ft 'hone: %07- MV7-&2V7
3ondinq Company:
address:
Ylortgage L,:nder: t
ddress: Of
rcnirecrrlr.::_ nee:: hone:
unrc-s:
c :nccaor.., ::c: __ :-taae w •,u:,..: _ .:...^tt :_ :u me +r,r:.:nu ,..,;ailauu::. ., tnuic¢:ac. . ,rt • ..... , :r.r.•r :-„aria:;;;• ......r.il:;-oncer; -r„tr .; :e
issuunce w : cerma and mat ail mrK •:: ui e pe::onmed -,, muet standards o:..0 laws rcguaau,,. construction in .::is junsaicaon. ..auer:;;anu c:at _-epurcte
permu must ce Secured for ELZC-RIC.AL WORK.: LUMBMG. SIGNS. WELLS. POOLS. Fi.JRNACZS. 301i.ERS.:iEATERS.:AwKS. uto1 .SIR CDNDITIONERS, etc.
OWNER'S AFFIDAVIT: I certify that all ofthe 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 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 req ire tu of Florida Lien Law, FS 713.
Signature of owner/Agent
Print Owner/Agent's Name
Signature of Notary -State of Florida
Owner/Agent is _ Personally Known to Me or
Produced ID
Date
Date Signature
APPLICATION APPROVED BY: Bldg: I J). J(1 a b — Zoning:
nitill & Date)
Special Conditions:
T'
s
Date
Date
ocpDEt33IE BLAW —
Contracto /Agent is- Pers6hally.Known t a^Po49r
Produced ID'
Utilities: F D::
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Initial & Date) (Initial & Date) (Initial & Date)
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