HomeMy WebLinkAbout717 Locust Ave (3)CITY OF SANFORD PERMIT APPLICATION
vPermit #: te ` Date:y/
Job Address: % I 1 OCv,
U Description of Work:
Historic District:
z 15-^v k-e U
Zoning:
Kwde 'a k{ &,"OL-e—
Value of Work:
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS S O 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 losets Plumbing Repair - Residential or Commercial _
Occupancy Type: Residential Commercial Industrial Total Square Footage: .56-0
Construction Type:
T #
of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel N:
Owners Name & Address:
Attach Proof of Ownership & Legal Description)
Phone:
i'Contractor Name & Address: 5ft ic-e AemGC
State License Number:
Phone &Fax: gol, d / -7 Sir p ayi sea Contact Person: yr. 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. 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: 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 coning. 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.
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 water management districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the require ents of lori ien Law, FS 713.
Signature of Owner/Agent Date ignal of Contractor/Age to
Print Owner/Agent's Name PrinA Contra to /Agent's Name
AL 0
Signature of Notary -State of Florida Date SignaturF;OfiV-Sra Date
A1Y CCMMISSICN 11 DD 164280
t EXPIRES: November 12, 200ErhniRndwtNrOrvgyW
Owner/Agent is _ Personally Known to Me or C tractor/Agent is Persona lIy Known lo e or _OProducedID Produced ID ' Yy •
APPLICATION APPROVED BY: Bldg:
initial & Date)
Special Conditions:
Zoning:
initial & Date)
UliiliiP3 126
Initial & Date) (Initial & Date)
POWER OF ATTORNEY
Date: Z y O cP
I, SCE Ae , do herby authorize '34 M C% { i ycX; to
pull the L1ce n,,,4 permit for 711 LOC.u-
Type of permit
rG
Sigtature
Personally knowft-t+o-w -er-
State of Florida, County of
20&4 .
job address
Noory Pubk . sfa19; Fbfida
i OD Aug 17, T1COnM"
Banded By NOWW NoW, A.
license #y g6-G 93` 0 ,
ke on yW day of
CITY OF SANFORD PERMIT APPLICATION /
Permit #: Date: ! U
7
Job Address:
Description of Work:
Historic District:
0a 1 e,
Zoning:
Permit Type: Building Electrical
Electrical: New Service — # of A
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures _
Value of Work:
Mechanical Plumbing Fire prinkler/Alarm Pool
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Calc. Required)
of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction Type: # of Stories: I # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Name & Address:
Attach Proof of Ownership & Legal Description)
00 Phone,
Contractor Name & Address: A'1'` r
State License Number:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer
Address:
Contact Person:
Phone:
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.
OWNERS 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 agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the
Signature of OwneriAgent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg: Zoning:
Special Conditions:
LT
f Fop a Lien w, FS 713.
114aSiUatdreofontractorAtDate
Signature of Notary -State of Florida Date
I rt l l
DEBBIE BLANTON
tI 11•co;r, Contractor/A ent'rs PcisonlallyUt Wn%o a or
1 Produced ID-' 'rs_1: bru ry 25, 2JC7
r ;: •.no nr: FL,JO,.y LjZCOc6t A: cc,
Utilities: FD:
Initial & Date) (Initial & Date) (Initial & Date) (Initial & Date)
CITY OF SANFORD PERMIT APPLICATION
Permit # : 6 v Z Date: "o
Job Address: 7/ i L0C Q 5'T' AV97 Si}Nfo.Pn. c e-
Description of Work: SO-SrQ,t '1' •3- 70A) 13 -TEAM Al/c SYS7,LbrM IJ Oy CTCyo.PyF.4T Historic
District: Zoning: Value of Work: S Permit
Type: Building Electrical echanical Plumbing Fire Sprinkler/Alarm Pool Electrical:
New Service - # of AMPS Addition/Alteration Change of Service Temporary Pole Mechanical.
Residential t/' Non -Residential Replacement New f/ (Duct Layout & Energy Calc. Requircd)PA01AX4404p W/ BC Ys .
CM='T 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 Industrial Total Square Footage: 03 T Gi2o.CS Construction Type: #
of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: . 9 ^
3 O " 4E 4& . "45 S A E " O/e 44 (Attach Proof of Ownership & Legal Description) Owners Name &
Address: _ AFA.> 4D X T 6A X-4 a& A- o 140 IC 9 / 6 Y0 3 3 A
7 9 / Phone: YO% 22! f "O !rS C0472 G 4 6V— C40AT-mu ContractorName &
Address: Cc &—a A '4 A /(7 e3 R Ar a 7 0/? G
0943000 _ F4. ?a 61/ O State License Number: C *C ,ef /$/,? V V Phone & Fax:.'/
f. y0 7^8S3'- S'%3 o F"OX ft7 `t-a.?- C?Zac 1person: At e o Phone: f'0 7 Bonding Company:
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 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 In be found in the public records of this county,
and there may be additional permits required from other governmental entities such as water management distric , late agencies, or federal agencies. Acceptance of
permit is verification that I will notify the owner of the property of the requirements of rida Lien w, 3. Signature of
Owner/Agent Date Signalu o Contractor/Ag t Date C.9
L A4 Print Owner/
Agent's Name Print C ractor/Ag r Signature of
Notary -State of Florida Date Si a otary- ate nda Ellie My CotM
Wsion DD328778 Aa Expires
June 14. 2W8 Owner/Agent
is _ Personally Known to Me or Contractor/Agent is t! Personally Known to Me or Produced ID _
Produced ID APPLICATION APPROVED
BY: Bldg: Zoning: Utilities: Initial & Date) (
Initial & Date) Special Conditions:
FD: Initial &
Date) (
Initial & Date)