331 San Lanta Cir 07-1893 Roofa.I CITY OF SANFORD PERMIT APPLICATION % `]
Application # : 0-7— 1 d b Submittal Date:
Job Address: 3� /�� AM - A 1 Value of Work: $ d • ��
Parcel ID: Zoning: 7\ (' Historic District:
Description of Work: OK e
Square Footage:
Permit Type: Building Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm Q Pool ❑ Sign ❑
Electrical: New Service - # of AMPS Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
Mechanical; Residential ❑ Non -Residential ❑ Replacement ❑ New ❑ (Duct Layout & Energy Cale. Required) '
Plunbing/ New Commercial• # of Fixtures # of Water &Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair - Residential ❑ Commercial ❑
Occupancy Type: Residential Commercial ❑ Industrial ❑ Occupancy
cy Use Group(s
Construction Type. 0 of Stories. # of Dwelling s ng Units: d (FENIA town required )
... ................... ...............................I...............................................................
Property Owner: '11- / / t I
Address: ..133% -2'rl'y /
Contractor:
Address:
Phone: Ili F '�t "_ �E-mq�ail�: �d'l)��u�C"t7✓PPhone: " State License Number:
"'Bonding gCCo'mpany: G\1.,�1 Mortgage Lender:'_.
Address: Address:
Architect/Engineer:
Address:
Plan Review Contact Person:
Phone: Fax:
Phone:
Fax:
E-mail:
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 mid 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, eta
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 HOUR 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 q p y p tic 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 e it " verification that will-noti .t a ow er of le property of the requirements of Florida Lien Law, FS 713,
01
Signature gf e Agent Date Signature of Contractor/Agent Date
P in Owner/Agent's Nam — Print Contractor/Agent's Name
Signature of Notary -Stale of Florida Dale Signature of Notary -State or Florida Date
APPROVALS:
Special Com
Rev 02/2007
Contractur/Agent is _ Personally Known to Me or
Produced ID
BLDG:
SANORA BOULEVARD
01 IDD
al
P
iect LAt 10
OV SANFORD
CITY
THIS PRINT 15 LOANED SUBJECT TO RETURN UPON DEMAND AND UPON THE ElXPR"51,vrc. W. H000l I PLOT
CONDITION THAT IT 19 NOT TO BE: USED DIRECTLY OR INDIRECTLY' IN ANY WAY
DETRIMENTAL. TO OUR INTERZ!rTS.
BMW 's-, 12 07 ISCALA' 1-96 1 REF 00'G.
ROOM ADDITION F 0 f Ml, fff AND JUD Y' HA B TAM N
P
iect LAt 10
OV SANFORD
CITY
THIS PRINT 15 LOANED SUBJECT TO RETURN UPON DEMAND AND UPON THE ElXPR"51,vrc. W. H000l I PLOT
CONDITION THAT IT 19 NOT TO BE: USED DIRECTLY OR INDIRECTLY' IN ANY WAY
DETRIMENTAL. TO OUR INTERZ!rTS.
BMW 's-, 12 07 ISCALA' 1-96 1 REF 00'G.
ROOM ADDITION F 0 f Ml, fff AND JUD Y' HA B TAM N