HomeMy WebLinkAbout708 S Oak Ave (2)Permit # :
Job Address: -AU
Description of Work:
Historic District: Zoning:
CITY OF SANFORD PERMIT APPLICATION
Value of Work:
Permit Type: Building Electrical Mechanical Plumbing __z 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 # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair Residential r Commercial
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction
Typen #
of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: -1 - - ,5 l -,- 0&2 C? (Attach Proof of Ownership & Legal Description)
Owners Name & Address: /2, i4/L C-
Af / r n
Phone: 0 % - &lJ'3 -G `- 7 _l
Contractor Name & A tire
5 (- State License Number: C lei D 7Q f i
Phone & Fax:3u-W -1?09 Ag4-a./o • I b%_5 Contact Person: Vl.Phone:
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. 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. 1 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.
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 a encies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requiremeuo loriie a S 713.
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Signature of Owner/Agent Date Signature of Contractor/Agent Date
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Print Owner/Agent's Name Print Contractor/Agent's Name
Signature of Notary -State of Florida
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg:
Initial & Date)
Special Conditions:
Date Signature of Not* -State of Florida
Contractor/Agent is Personally
Produced ID
YRS
Zoning: R.6 2W51 Utilities:
Initial & te)
4a0/04
Commission N OD0134673
E,Vble 71210006
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I hereby name and appoint
Of to be my lawful attorney
in hwt to act forma and applyto for
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at a location described as: Section Township Range
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and to sign my name and do all tlin necessary to this appointment.
Acknowledged:
Swom to and subscribed bafm me this
Day of (- - A.D. Woo
NoWy Public, Starve of Florida,LATES-WEARY
mmission 0 DD0134673
5,C81 -= Expires 7/21/2005
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My Commlon Expues: