HomeMy WebLinkAbout1108 Grove Manor Dr (2)Permit #: CA0_
Job Address:
Description of Work:
Historic District:
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CITY OF SANFORD PERMIT APPLICATION
Date: t s
Zoning: Value of Work:
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service TemporaryPole on-
Residential Mechanical: 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 #:
3 -14^.3 - Owners
Name & Address: 1r 1_+ Contractor
Name & Address: Phone &
Fax: 9,
111191 WWII "Pa"I Bonding
Company: Address:
Mortgage
Lender: Address:
E
py 0 (Attach Proof of Ownership & Legal Description) Phone:
4" -) - 3"— I.) State
License Number: L /1C—U. Person: '
JC_Z/') Lie _ Phone: 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. I 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 ro.giiialing 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 requirements of Florida Lien Law, FS 71V. Signature
of Owner/Agent Date Signature of Contract U/
AtDate
iqe
1. Print
Owner/Agent's Name Prina ContracrFrtAgent' Name Signature
of Notary -State of Florida Date ature of Notary -State of Florida Date O ,;, ,,
1.• ,: nr. a ;,nor. Owner/
Agent is _ Personally Known to Me or Contja gent is A er-s", gown to Me or Produced
ID Pr;; Gced-ID`` APPLICATION
APPROVED BY: Bldg: Zoning: Utilities: FD: In)
kkI & Date) (Initial & Date) (Initial & Date) (Initial & Date) Special
Conditions: