HomeMy WebLinkAbout124 W Woodland Dr (3)Permit #
Job Address:
Description of Work: G V5 l ' ^3 414
Historic District: Zoning:
CITY OF SANFORD PERMIT. APPLICATION//),
Date: V'--
Value of work: S 76 6'
Petriuit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS AdditioalAlteratioa Change of Service Temporary Polc
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Eaergy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Wager Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential 7 Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Uhits: Flood Zone: (FEMA form required for other than X)
Parcel #: 12 - Ze - 3 y v - 6/ -Qd ob y,-_— (Attach Proof f Own/rrsbi`& Legal/ option)
Owners Name & Address: J
12 32 -773
N e / L ci a! rci i
Contractor Name A dress:—
J
eK If 3._7 J 2
y 'y ls y0J g CoinelPhone & Fax:
Bonding Company:
Address:
Mortgage Leader'
Address:
Architect/Engincer:
Address:
ME
State License Number.
A...I i rl Phone:
Phone:
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. 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: 1 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 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 COMhiFNCEMENT.
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 t is verification that I will notify the owner of the property of the re ' emenIs of ' ien 713.
1/10/06
Si caner' gen^
I tDate
M
Sign cofContractor/Agent Date
P ' ent's Name Pr' cat nor/ gent'3Namc
Signature of otaryState 6 Date Signature of Notary -State of Florida Date
0—.
i'AtllltllCOON"
OwnedP Ae o Contractor/Agrnt' Pe ly KnowntoOProBanodadii (1i00K72IiM _Produced IDrXn ' d. 1 d (p
3..........................
M ia
APPLICATION APPROVED BY: BI Zoiing: Utilities: FD:
1 i1w ate) (Initial & Date) i (Initial & Date) (Initial & Date)
Special Conditions:
53
111897
LEMMD POWER OF ATTORNEY
I hereby name and appoint 6 l '_. J
1
Date: 01 1 1" a 6
of Tro t
L \ I o (r rn fra / r1a r, Jc to be my lawful attomey
in fact to act for me and apply to 't e C ' y a F 5 1 for
a /V1 ec a/\ . c-g ( permit for work to be performed
at a location described as: Section Township Range
Lot Block
1 2 `( 4/ 1.od/s,;4
Subdivision
S„ /"-/, /71 ? z
AddressJof Job) /
J 32 773
Owner of Property and Address)
and to sign my name and do all things necessary to this appointment
T,_ _ iL C/f c IF— 513a 7
or Print Counc or and License #)
of Certified Coattacitor)
v -
Acknowledged:
Sworn to subscribed before me this
LDay of lqfl 0 G A.D.
Notary Public, State of Florida
Seal)
my Commission F—vi=
DIANA RENEE RANGEL
MY COMMISSION M DD458993
EXPIRES: Aug.7,2009
407) 39"153 Flatda Notary Swvica.com