HomeMy WebLinkAbout813 Pecan AveTAW
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Permit # :
Job Address:
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Date: &'.0 -03
(Rl /"z) <� 1zZo4e-a-,
Zoning: d~ Value of Work: S 5704aa
Permit Type: Building Electrical /" Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service – # of AMPS Add ition/Alteration /< Change of Service Tempot'aiy 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 –4— Industrial Total Square Footage: FOV
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: (Attach Proof of Ownership & Legal Description)
Owners Name&
�'a.►1ir/a�('�w:�rdS o�f'`a.�1`p/X.� ��ieS' rttc
Contractor Name & Address: `I - —` Ci I19WT 9--r.
���(�d 52-77„?i .�State License Number: eI-G 31
Phone& Fax: 2lZZ X30 -/7W Contact Person: �iK f1lT Phone: *:;),Z—%/7 "0?./7
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer: if/�/'1F 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. 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 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 requireme f F Law, FS 13.
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Signature of Owner/Agent Date ignatu of Co etor/A en t Date
Print Owner/Agent's Name P Contractor/Agent'WNa e
Signature of Notary -State of Florida Date tipature of Notary -State of Florida Date
FF BARBARA HUBLER
A v My Comm fxp. 1/1105
Owner/Agent is _ Personally Known to Me or Contractor/Agent is Zrsonall.y or No. Cc 990570
Produced ID Produced ID Wtvrm 1IOthal.D.
APPLICATION APPROVED BY: Bldg:%qEZoning:
(Initial Date)
Special Conditions:
(initial & Date)
Utilities:
FD:
(Initial & Date) (Initial & Date