HomeMy WebLinkAbout123 Reel CtPermit #
Job Address:
Description of Work: Il Ll' Lfta— a- —(a,,
Historic District: Zoning: Value of Work:
CITY OF SANFORD PERMIT APPLICATION
4
Date: V d CA
3
5
Permit Type: Building Electrical Mechanical -X- Plumbing Fite Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential -b!C_ Non -Residential Replacement _V _ 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 _ V Commercial Industrial Total Square Footage:
Construction Type: —— # of Stories: of Dwelling Units: Flood Zone•. (FEMA form required for other than X)
Parcel #: ® 0000 — O N (D (Attach Proof of Ownership & Legal Description)
Owners Name_& Address:
Address:
Phone & Fax:
Bonding Company.
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Phone:
Ja` / State License Number. C4-L 0
03 a,3 Contact Person: Lt!W Phone:
Phone:
2 7S"z
Address: Fax:
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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. 1 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 RESULTIN 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.%ch 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 Signature
of Owner/Agent Print
Owner/Agent's Name Date
Signature
of Notary -State of Florida Date FS
713. CA
eL T,, Contractor/
Agent's Name Notary -
State of Florida 1-/
B•6(P Date
ANGEU
CARISON KDAf
P COMMISSION 015 489083 EXPIRES:
December 3, 2009 BagM
7tsu trolery t+ublk undaiwrswt Owner/
Agent is _ Personally Known to Me or Contractor/Agent is Y ~
Known
to .or Produced
ID _ Produced ID , t. APPLICATION
APPROVED BY: B9W97— Zoning: Utilities: _ ' FD: Initial &
Date) (Initial & Date) (Initiil & Date)_ (Initial & Date) Special
Conditions: ` } m
0