HomeMy WebLinkAbout2433 Annceton AvePermit #
Job Address: c
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Zoning: Value of Work:
Date:
Permit Type: Building Electrical Mechanical Plumbing=Service
arm Pool _
Electrical: New Service – # of AMPS Addition/Alteration ChaT porary Pole
Mechanical: Residential Non -Residential Replacement Ne Energy Calc. Reggired)
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
# of Water & Sewer Lines # of Gas Lines
Occupancy Type: Residential 'Y Commercial Industrial —
Construction Type: # of Stories: _J_ # of Dwelling Units:
Parcel #:
Owners Name & Address:
Plumbing Repair – Residential or Commercial
Total Square Footage:
Flood Zone: (FEMA form required for other than X)
(Attach Proof of Ownership & Legal Description)
I I Phone: 41 a $ X16 36
Contractor Name & Address: ,yy W A lJs'mv 'eS m C
\ State License Number: E G ooi� -Its ,�yy
Phone & Fax: i � —I ) `a � 5S '40 3'+i 0�64ontact Person: ) gyp, r�, rib.. Phone: Bio � Zl q V y Z
Bonding Company:
Address: 10 « LL°AA � CV 1, Ik VVe,,S E
Mortgage Lender:
Address:
Architect/Engineer: Phone:
Address:
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. 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.
Acceptanc permit is verifi atc`ionn�thwill notify the owner of the property of the requir ents of Flo a Lien L FS 713.
4 5 �3
Signature of Owner/Agent ate Sitature of Contractor/Agent 1, Date
Print Owner/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:
Print
?AIC13
DateSi nature of Notary -State of Florida Date
Melissa Dunklin
_2 `� =Commission #DD163723
,.
Contractor%f� nS l5 ' ets� � 20;aQ§
Produce'd1VFt'
tconding Co., (no.
Zoning:
(Initial & Date)
Utilities:
FD:
(Initial & Date) (Initial & Date)