HomeMy WebLinkAbout4250 Sharpes Settlement LnCITY OF SANFORD PERMIT APPLICATION
Permit # : Wk_7,
Job Address:
Description of Work: i" G I`Wle L
Historic District: Zoning:
Date: a — % 1 —&
Value of Work: S al:
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Clo ets' s Plumbing Repa' — Residentia r Commercial
Occupancy Type: Residential Commercial —industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for tither than X)
Parcel #: I(Attach Proof of Ownership & Legal Description)
Owners Name & Address: l 'eh Ln ]
U
r kC Phone:
Contractor
Name & Address: 3a)15 State
License Number: L r L os7aay Phone &
Fax: q&-? n lrl Contact Person: nova ol 4.4 r L &C Phone: y6i -7&7 i 5 SfBonding
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. 1 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: 1 certify that all ofthe 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. 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 agencte A'A.!.!rb,; Acceptance
of permit is verification that 1 will notify the owner of the property of the requiremen ida Lien Law, FS 713. e; Signature
of Owner/Agent Date Sign re of Contractor/Agent ate Y r o co)
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w :3 Owner/
Agent is _ Personally Known to Me or Produced
ID APPLICATION
APPROVED BY: Bldg: Initial &
Date) Special
Conditions: C
rector/Agent is _ Personally Known Me ol,, roducedlD
cat b , b gL150 Zoning:
Utilities: FD: Initial &
Date) (Initial & Date) (Initial & Date)