HomeMy WebLinkAbout112 Kayis Canding Dr (2)quo? CITY OF SANFORD PERMIT APPLICATION
Permit # Date
Uob •iiddress:
vescriptiou of Worl_ 1 u.. FEB 1 6 2006
Historic District: ping: Value of Work: S
Permit Type: Building Electrical Mechanical Plumbing
Electrical: New Service — # of AMPS Addition/Alteration
Fire Sprinkler/Alarm Pool
Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Cale. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: Al 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 #: % 7 / 7
Owners Name & Address:
Contractor New & Address:
Jun
Phone & Fax:
Bonding Company:
Attach Proof of Ownership & Legal Description)
Phone:
Sta License Number.
Person: &0J40 &*VWPhone:
Address —" — --
t
Mortgage Leader,• T
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. 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 wgulating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOI )R I •A. Y ING
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 pnhlir n:co d:: ofthiscounty, and the y be additional permits required from other governmental entities such as water management districts, state agencies, or fcdcral agencies.
Acceptance of it is tion I will a owner of the property of the requirements of Florida Lien Law, FS
Signature of Oner entw/A
t
g 8 Date . Signature o on '°gent Date
Print Owner/Agent's Name Print cto gents Name
Signature of Notary -State WFlorida ate fV06 igniture of Notary- tate f Florida Date %O G
Owner/Agent is jef Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg: Zoning:
Initial & Date)
Special Conditions:
1................................I.,......1'
tarn "> WILLMM FLOYD LANF t
Ns %Commission # DD0157612
ti , Ex-iros 10/10/2006
F r' ; ' Do.1t cd through
i100-.t32.4254) Fierida Notaryy Assn., Inc.
qv ,a Susan L Metre -Harrison
My Commission DD215024
Contractor/Agent is _ Personally K UEl*ues July 12, 2007
Produced ID
Initial & Date)
Utilities:
Initial & Date)
FD:
Initial & Date)