HomeMy WebLinkAbout1503 Travertine Ter (2)CITY OF SANFORD PERMIT APPLICATION
Permit #: 4p+ -1 9
mob Address: 1 3 ( rc- V A.., _- _ Q.i /
Description of Work:
Historic District: Zoning:
Permit Type: Building Electrical
Electrical: New Service - # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential Commercial
Construction Type: # of Stories:
Parcel #:
Owners Name & Address:
Date: - -I - 1 g - O 4c-,
1;;--\ - 3 Z7-7 /
Value of Work: S ^7S-6 r
J
Mechanical Plumbing _,,/ Fire Sprinkler/Alarm Pool
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Calc. Required)
of Water & Sewer Lines # of Gas Lines
Plumbing Repair - Residential or Commercial _
Industrial Total Square Footage:
of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Attach Proof of Ownership & Legal Description)
Phone:
Contractor Name & Address: 6 Ira. . n -' C_;L . a /
ale License Number: (2-1Z C fly If 4) 7,S
Phone & Fax: Contact Person: ,Phone: %7 - 380 -
Bonding Company:
Address:
Mortgage Lender:
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 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 COMMENCEMENT.
N TICE: 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 1 will notify the owner of the property of the requi ents of Florida Lien Law, FS 713.
I - I i
Signature of Owner/Agent Date t mature of Contractor/Agent
1
Date
Ct,(OS 1-X -Oto
Print Owner/Agent's Name Pri ont ctor gent's Name
Signature of Notary -State of Florida Date Signature of Notary-Stat"PFlorida-Date-•-M+
DcSBIE BLANTON
14Y COr-£:pP•J ;/ DD 1&A91 Owner/
Agent is _ Personally Known to Me or Contractor/Agent is -Personally Known to Me or' e:
MY r 'otvi ua:aA , ProducedID _ Produced ID ' ,: APPLICATION
APPROVED BY: Bldg: Initial &
Date) Special
Conditions: Zoning:
Initial &
Date) Utilities:
FD: Initial &
Date) (Initial & Date)
Jan 19 06 11334a City of Sanford Building 407 328 3859 P.1
POWER OFA7TORN)N V
Date- _Janyar-y 1 9 ` 0 0 6
I, David E. Tellier doherby authorize Carlos A. Bucholz tci
pull
the_lumbing permit for 1 503 Travertine Terr, Sanford 32771 TYIX,
of pcn"ii pal, al drw lipultorg
DIANE
M. BUCHOtZ NOTARY
PUBLIC - STATE OF FLORIDA COMMISSION #
DD408"i M
iary EXPIRES 10/20/2008 BONDED
TMRU 1485-NOTARYI Personally
known to r drivers license Il Slate
o on tt, ,aunty of Seminole on 1 9th clay of January 20_
a6 — .