HomeMy WebLinkAbout2401 S Park Ave (2)CITY OF SANFORD PERMIT APPLICATION
Permit # -. 0 (" -"
Job Address: it
Description of Work: ALI
Historic District:
Date: c';',,
Z 771
Zoning: Value of Work: S / &00r
Permit Type: Building Electrical V
e Mechanical Plumbing Fite Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS OO Addiboo/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Dud Layout & Energy Cale. 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 %O Industrial Total Square Footage:
Construction Type: # of stories. # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Address:
MortgageLe Address:
Attach
Proof of Ownership & Legal Description) ArchitecVEngineer: '= '; ,~'•?%
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 mod standards of all laws regulating construction in this jurisdiction I understand that a separate permit
must be segued for ELECTRICAL WORK, PLUMBING, SIGNS. WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and AIR
CONDITIONERS, de. OWNER'
S AFFIDAVIT: I certffy Clot all of the foregoing information is accurate and that all work wig 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. 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 mtitia such as water management districts, state agencies, or federal agencies. Aooeptanea
o p veriS i 1 w otffy the a propertof the requirem f Flopda Lien Law, FS 713. r7/
u irmature
of /Ag Date Sigggtyle of Contractor/Agent Print
OwnedAgent's Name of
Notary -State of des Date or
Oamer/Agent 0.2007 Poi.onally Known to 1 0 or Produced
ID Z1U 3 - n 2 • 5 • .% V APPLICATION
APPROVED BY: Bldg: Zoning: Initial &
Date) Special
Conditions: Signature
of NotaryState of Florida ateMOV4a S Nunn V
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MY
Comnxasion OWS M3 JarExpiresOctober05, 2007 ontactodAgentisPersonallyKnownorproduced
IDU42.103.E &- ? • v Initial & Data)
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Initial & Date)