4100 Stonebrook Dr 12-1450S1.;:!.-:
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
lApplication No: le�q - J 41—S-0 Documented Construction Value: $
,Job Address: - _ / , y o S-+)rxe (yL a-,'(/ Historic District: Yes ❑ No ❑
Parcel ID: Zoning:
�cription of Work: 4e�i4c� 1jG»�/i-G1 1S � ll�i 5�, 67 /m'? 4Q�� ✓D�irJG
Plan Review Contact Person:
Phone:
Fax:
E -mail:
Title:
/ > Property Owner Information-
Na iiiJCY� ,� L Phone: (9y 5r63T�
Street:./ OO S z 7y -_Lr L Di^�'vQ, Resident of property?
City, State Zip: ""r'l �-
— Contractor Information — ,
Name�h�crS7��e�er�c�U� g
f �-�O✓,oa ,r/1C. Phone:��'''1 �►�
I✓ 6 e-1/e Fax: ((S"77'Z)
City, State Zip: &�4 �� �rir�, �� -�? a/-/ 9 �' State License No.:(' C> C_ 0 60 J 6t '`I
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Building Permit ❑
Square Footage:
No. of Dwelling Units:
Electrical ❑
New Service - No. of AMPS:
Phone:
Fax:
E-mail: _
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type: No. of Stories:
Flood Zone:
Plumbing ❑
New Construction - No. of Fixtures:
Mechanical 13 (Duct layout required for new systems) Fire Sprinkler /Alarm ❑ No. of heads: