17000 Stonebrook Dr POOL AND SPA (NO PERMIT #)SANFORD PERMIT APPLICATION
j
67
Permit No.: Date: 6
Job Address:
Permit Type: Building Electrical Mechanical Plumbing Fire Alarm/Sprinkler
Description of Work:. e,-,01,,f
Additional Information for Electrical & Plumbing Permits
Electrical: —Addition/Alteration —Change of Service —Temporary Pole —New AMP Service (# of AMPS
PlumbingfResidential: Addition/Alteration New Construction (One Closet Plus Additional)
PlumbingtCommercial: Number of Fixtures— Number of Water & Sewer Drainage Lines Number of Gas Lines
Occupancy Type: Residential Commercial X Industrial Total Sq Ftg: Value of Work: S x g!F
Type of Construction: t'zy4e_4_L&-r4=- FloodZonc: Number of Stories: Number of Dwelling Units:
Parcel No.
Owncr/Address/Phonc:
Contact Person:
Title Holder (If other than Owner):
Address:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer
Address:
Phone & Fax Number:
Attach Proof of Ownership & Legal Description)
lla,cLiccnscNumbcr:
Phone No.:
Fax No.:
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 %ill be done in compliance %ith
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 goverrimcrital 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 requirements of Florida Lien Law, FS 713
Ac
i ire of Ow 0Date iSignature of Contractor/Agent Date n _
Print
Owner/Agent's Name Print Contractor/Agent's Name t
Ddtc
Sign ture of Nat -State of Florida Date vnd/
QQis 'Personally Known to Me or APPLICATION
APPROVED BY: PATSY
FRIES. Notary
Public, Stale of Florida q
iAMycomm. expires June 28, 2004 MPcomm. No. CC950525 c
o gent is Personally Known to Me or Co)E:::ij Produced
ID Date:
Special
Conditions:
REVISIONS
t ,e, r ,," J, t' PERMIT #, ,2 L-
ADDRESS e/670o tt,)
CONTRACTOR (4,1(0 eK rV- PH #
FAX# Z—L545--;/2Z:2 DESCPRITION
OF REVISION: UTILITIES
1A FIRE
Z
B
L D G