HomeMy WebLinkAbout2101 Lily Ct (4)1's^w.—.—+r;�•r�!W+tr. �.r .�.•rit�!Ai�•^,C•':«�"^3'•Y'�!°'�„t�jTS'.S�P.►i}°'04"''T,"t+.'•'^."¢.^:.,,;R71,'.r.^.�,;..�.nrt,�4�... ,.
Permit # : \J
Job Address:
Description of•Work.
Historic District:
CITY OF SANFORD PERMIT APPLICATION
ll�Date: _
Zoning:
. & ID
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)
` t
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines 1pe
--s
m kff �� _ Water Closets Plumbing Repair Residential r Commercial
OccupIF ancy Type: Residential _X Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Name &'Addr'ess:1
i
`Pho�x: �3
Bonding Company:
Address:
Mortgage Lender: .
Address:
Architect/Engineer:
Address:
1
(Attach Proof of Ownership & Legal Description)
Phone:
_ pppp
Skte ' se 'tuber O� U
_ _ qlContact Person: �� d� CP�� ��'^ � Z
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: 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.
Accentance of nermit is verification that 1 will notifv the owner of the nronertv of the reouireruertts of Florida Lien La*. FS 71 .
Signature of Owner/Agent Date
DatV-
/ 1,
�.�UjA
Print Owner/Agent's Name (Pr tracioi/A ent's r
Llbs--/03
Signature of Notary -State of Florida Date ry §s91%rV)Unklin Date
? ' ' Commission #016313
'a•• rJ.,� Ex fres.
�, P 'Dec 20, 2005
o ii Bonded
Owner/Agent is _ Personally Known to Me or C/o�ntractEh+�kg1'nt is i nown to Me or
_ Produced ID �Producec ID IT y ' 9nL/ j/O50
APPLICAI'ION APPROVED BY: Bldg: Zoning: lltaities: FD:
(Initial & Date) (Initial & Date) (Initial & Dale) (Initial & Date
Specia! Conditions: