HomeMy WebLinkAbout1609 W 7 St (2)CITY OF SANFORD PERMIT APPLICATION
Permit #: 6 (// a Date: Z g I D b
lob Address: 11009 -i th S f -C.+ I i S"
t Sck-n-Ec 3 Z-1-1
Description of Work: _'L00 e6 m n %Aqf, t, W/ v toaivf r Hook.ft.r.p CondQ1W -t-1 bk W Al4tA , C0I1C(NSat NMP,
Historic District: Zoning: Value of Work: S t 1, Q0 Q • Q O
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Al POW
Electrical: New Service - # of AMPS _ Addition/Alteration Change of Service / Tempoi*y Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
G+1=I @O,a1t*C6.
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 #: 2-5 - 19 - a'D " S Pr _ - Dq IQ - L) uI u (Attach Proof of Ownership & Legal Description)
Owners Name & Address: g r D 0 K•15 -- V l- r4- -r1 S In GA-r L7 Vh IC..
42,b mist'w Yr1 et>`dow Dr• , Oe o.Lt. FPhone: Contractor
Name & Address: D 0 11 O..-tr0J E hlttr pY 1 SAS L • L- C. 21
14 M i Mxr Rd t Dy i QAra F1 3'2-7 b State License Number: E C. 01D0 21-} pq I'
honc &Fax: Fg.)G (HSM 3Nolo-LJ14?k4 Contact Person: C OVA f i Y trH ll%% %0.y d Phone: CH O% % 3 (o , 9 5e; Bonding
Company: u
Address:
Mortgage
Lender: Address:
Architect/
Engineer: address:
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 issuanceofapermitandthatallworkwillbeperformedtomeetstandardsofalllawsregulatingconstrictioninthisjurisdiction. I understand that a separate permitmustbesecuredforELECTRICALWORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIRCONDITIONERS, 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 constructionandzoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICEFORIMPROVEMENTSTOYOURPROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEYBEFORERECORDINGYOURNOTICEOFCOMMENCEMENT. 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 thiscounty, and there may be additional permits required from other govemmental 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 requiremen of Florida Lien La FS 713 _ 10
Signature
of Owner/Agent Date Signature of Contractor/Agent Date Print
Owner/Agent's Name Print Contractor/Agent's Name Signature
of Notary -State of Florida Date Signature of Notaroate of Flobda DaN00 Owner/
Agent is _ Personally Known to Me or Produced
ID ITLIC'
A'I'ION APPROVED BY: Old g-}it \ "Zoning: Initial &
Date) Conditions:
Contractor/
Agent is Personally K own to Me or Produced
ID Initial &
Date) Utilities:
FD: Initial &
Date) (Initial & Datei