HomeMy WebLinkAbout114 Winterglen Dr (3)y ' Q
Permit # : v
Job Address:
Description of Work:
Historic District: Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date: ' T'
Value of Work: $ ":')Z) `f- J-
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Tempot°ary Pole
Mechanical: Residential _ZNon-Residential Replacement V-
1
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 #: 3,3 ( C - 3Q - 5()o - c)0c) ()
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Attach Proof of Ownership & Legal Description)
Owners Name & Address: sdfi m gs .So— 14J 1 I 1 z,,j,Wj ood j8VL
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Contractor Name & Address: - 9 f --A) ^ _ n 9 Comm vC e _ l 4 - . L&, G e /' 1 Q r, . Ft. 3-2
State License Number: " L` A C oL/ 6 A. 1 4 X
Phone & Fax:Q 93I Z2-4 5 4N7 -33 3Contact Person: Tox jAe Phone:k O-uwo
Bonding Company: Aj ;A _
Address:
Mortgage Lender:
Address:
Architect/Engineer: /U k4k 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 regulating
construction and zoning. WARNING TO OWNER YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR 111A.1,1114G
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 notify the owner of the property of the requiremen lori v 13.
S atu V OK /Agent Date ature of Contractor/Agent Date
Robed C DeIIf)Ru'ssa
Print Owner/Agent's Name Print Contractor/Agent's Na e
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date
Owner/Agent is _ Personal]% Known to Me or Contractor/Agent is _ Personally Known to Me or
Produced ID Produces ID
APPLICATION APPROVED BY: Bldg:
Special Conditions:
Zoning: U; c ties:
Initial & Date) (Initial & Date) (initial & Date) (Initial & Date)
e iMIRIN'DA C. TURNER
P5-2-oo
EXPIRES: June 14, 2007
Bonded Thru Notary Public Underwriters