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`=f r�►j �'' ' �4'rfi•r'. ,.+.- CITY OF SANFORD PERMIT APPLICATION
Permit # : "`` Date
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Job Address: o
Description of Work: ,
Historic District: Zoning: Value of Work: S
Permit Type: Building Electrical Mechanical V Plumbing Fire Sprinkler/Alarm Pool .
Electrical: New Service — # of AMPS Addition/AlterationKI— Change of Service Tempot*y Pole
Mechanical: Residential )0 Non -Residential Replacement New (Duct Layout &Energy Cali. Required)
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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 Tyne: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: 1_J —r7AW
Owners Name & Address:
Contractor Na a &'Addr
Phone & Fax: It"
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Contact Person:
(Attach Proof of Ownership & Legal Description)
State Licens lNumber:
Phone:
Fax:
Application is hereby made to obtain a permit to do the work and installations as indicated. l 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 AFFIDAV ff: 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, st*e agencies, or I
Acceptance of permit is verification that 1 avill notify the owner of the property of the requirements of Florida Lieg LaW„ FS 713.
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Signature of Owner/Agent Date Signature of Contactor/Agent Date
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Print Owner/Agent's Name _Xrint Contractor Agents -1st me
Signature of Notary -State of Florida Date (jlignature of Nory-State of Flo da Date
Oaa•ner/Agent is _ Personally Kno%%m to Me or
_ Produced ID
AITLIC ATION APPROVED BY: Bldg:`' n �L�
un i ng:
IInitial & e)
S,%cial l.onditions:
Contractor/Ac:-: is I'ersona1-1y Known to Me or
Producer ::)
FD:
(Initial & Dalt) (Initial & Date) (Initial & Dam:
Seminole County Property Appraiser Get Information by Parcel Number Page 1 of 1
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1
GENERAL
Parcel Id: 12-20-30-503-0500-009A Tax District: S1-SANFORD
Owner: LAWSON JAMES E & BARBARA I Exemptions: 00 -HOMESTEAD
Address: 300 ROSE DR
City,State,ZipCode: SANFORD FL 32773
Property Address: 300 ROSE DR SANFORD 32773
Subdivision Name: FLORA HEIGHTS
Dor: 01 -SINGLE FAMILY
http://www.s.../re web.seminole county_title?PARCEL=1220305030500009A&cdor=&cmap= 6/2/03