HomeMy WebLinkAbout1100 Pine Ridge Cir (3)•
CITY OF SANFORD PERMIT APPLICATION
Permit #: 03_0q4LJ` Datg:
Job Address: ngo /dine /Ci P a"41'.,
Description of Work: Z-oAc?rey
Historic District: Zoning: Value of Work: S
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 # 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 rT��ype: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than x)
Parcel #: 4?—, ZO e 300, 7 �.—&&&ZP (Attach Proof of Ownership & Legal Description)
Owners Name & dress: S r--. C
/ ✓� r% 2 ®� Phone:
Contractor Name & Address: / C
State License Number: CQC 01q 55,57
Phone & Fax:(Affl
Bonding Company:
Address:
Mortgage Lender:
Address: _
Architect/Engineer:
Address: A
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.
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
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,
this county, and there may be additional peEpfis SWire
Acceptance of permit is
of
of Notary -State of Florida
Owner/Agent is XPersonally Known to
Produced ID
the y be additional restrictions applicable to this property that may be found in the public records of
�r governmental entities such as water management districts, state agencies, or federal agencies.
owner of the property of the requirements of Flo'ameA
Date Signature of Con ctor/Agent Date
Melissa
re of Notary -State of Florida /T
elissa De La �i4�' U
Commission # DD144575
Expires Aug. 25, 2006
Bonded Tht'ttontractor/Agent is Pfrsonally Known to
Atlantic Bonding Co., Inrproduced I D
Melissa De La Cruz
Commission # DD144575
Expires Aug. 25, 2006
Bonded 7hru
Atlantic Bonding Co, Inc,
APPLICATION APPROVED BY: Bldg..DMF t _Z1 -o3 "Zoning: 7-160 Utilities: FD:
(Initial & Date)__11 Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions:�ernp0+'dr�—M90'_0n O 0%
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� PARING
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p \ -44- FOUND 5/8" IRON ROD
$ 65 4 I WBH1595 STAMPED co RElE WmK
0 45 1
,B SQ, 89 O ,ef E 6.
-1 -c 8gQ ,� g 3a ` FOUND 5/g' IRON ROD
2 WI �5CAP
5 STAMPED
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CONCRETF COLUMNS
N
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N 79'07'59" W 288.86' 1
288.90'(WO)
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Permit #0 Q LO T
Job Address: T' �'� Y I
Description of Work:
Historic District: Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date: _
of Work: $
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. Requi d)
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:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: (!G • gC_4PJ v ��� ' I --.v (Attach Proof of Ownership & Legal Description)
Owners Name & Ad cess:
002f )�trll ✓ P h o n
Contractor Name & Address:
State License Number:
Phone & Fax: Contact Person: Phone:
Bonding Company.
Address: 6
Mortgage Lender: I AIA
Address:
Architect/Engineer: Phone:
Address: N, 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.
V
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 7SC713
, state agencies, or federal agencies.
Acceptance of permit is veri that er of the property of the requirem is of Fl Lien La.
_03 7 /9/v 3
og'ignature of Owner/Agent Date Stgn ture of Con ctor/Agent Date
MAX 5 of R C L f� �M 07-K4_70 6SCi1e t (ZA L
,-1rr% Vwner/bgent's Name/'\ A I Print Contractor/Agent's Name -6vs I S Y-, S
Signature of Notary -State of Florid
$bv4;14Agent is Personally 4
_ Produced ID
APPLICATION APPROVED BY: Bldg:
(I
Special Conditions:
D3
Date" Signature of Notary
Melissa De La Cruz
Commission # DD144575
F.zpireonded Thnts Aug. 25, 2006 Contractor/Agent is
-ltlantioading Co., Inc. — Produced ID_
Zoning:
(Initial & Date)
Utilities:
7 Ar/03. stj C_
G.E. BAILEY
Notary Public. State of Florida
�aII1VX01P1IJ.AJR WS Aug. 4, 2005
No. DD25766
FD:
(Initial & Date) (Initial & Date)
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MENT I
N 8z�g•�,•o6 5
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TYPICAL 1.4'S0.
CONCRETE Coll,uu_
N 79'08'4 W
N 79'0-7'59" W
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