HomeMy WebLinkAbout409 Springview DrCITY OF SANFORD PERMIT APPLICATION
Permit # : o('0— C? &!
Date'
Job Address: —1" o 9 SDr i ncky e-t,t_) (' V Description
of Work: Ll)`IIFr'+f_C 1Z0-60.Cernp—, n t Historic
District: Zoning: Value of Work: s 300•00 Permit
Type: Building Electrical Mechanical Plumbing —X_ Fire Sprinkler/Alarm Pool Electrical:
New Service — # of AMPS Mechanical:
Residential Non -Residential — Plumbing/
New Commercial: # of Fixtures Plumbing/
New Residential: # of Water Closets _ Occupancy
Type- Residential Commercial r
Addition/
Alteration Change of Service Temporary Pole Replacement
New (Duct Layout & Energy Chic_ Required) of
Water & Sewer Lines # of Gas Lines Plumbing
Repair— Residential or Commercial Industrial
Total Square Footage: Construction
Type: # of Stories: # of Dwelling Units: _ Flood Zone: (FEMA form required for other than X) Parcel #
I0 QQ d 0 5D Owners
Name & Address: 1 y1o_fA I DOOR
OD I V rej N •
A nd ersoN Attach Proof
of Ownership & Legal Description) kn Si
rinC(Jiew -t>e.i\fe. SGr40rc4 _ 3ZJ'1'Q Phone:(3917a31- Contractor NName&
Address: Por dka, Vv_kt0. YN^N_cAAan- cc_\ 3 Cp
a 1 a3]
tar 0. ea t r Phone. Fax: '
la`s 545-Z 15 Q-1 •
ar V 33-1/ e7 7017 `5t4&
R31 Contact Personmlt'k State License
Number: CF GAIedOf .ember
4a5q i
Phonet ')r7
y5-_7`757 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 penmit 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 nVICE FOR
IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE OF COMM f_NCEM ENT. N TI
E: 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 ova management districts• to agencies, or federal agencies. Acccpt3nce of
permit is verification that I will notify the oNner of the property of the requirements f F rida Lien I w, F 7 W an
Signature of
Owner/Agent Date Signature of C tractor cm Date + A o irnIre- (3obky '"-
Q Print pN91er/Agent'
s Name Print Contractor/Agcm's Nanx _ C o $ JN Signature ofNotary -
Stale of Florida — -- DarC Signaturc of Notary-Sta f Plonda Date •= rs cQ = ONiicNAgcni is _ _
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