478 Kays Landing Dr 07-2362 pool enclosureay5y
CITY OF. SANFORD PERM1"I' APPLICATION RECEIVED
'rniit #5200
: �—
w -'Job Address: 147 c6 1QA QS ta, tyl B �/`1� t -�r <: 7 J f) ��1' rrr. /�i ] %
Description of Work: Dr`I -Drill oUf'f
Historic District: Zoning: Value of Work: S '(/ o nio
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service -- # of AMPS Addition/Alteration __ Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Cale. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines it of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair -- Residential or Commercial
Occupancy Type: Residential Commercial Industrial �. "Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood 'Zone: (FEMA form required for other than X)
Parcel#: %7"/—"/`7 .�)U . Dlz
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Owners Name & Address: 61
�I LA 71D• r
Contractor Name & Address: Dl,I I/f Yl A
Phone & Fax: -IV,
Bonding Company:
Address:
Ntortgage Lender:
Address:
Architect/Engineer:
Address:
A 2 1-7 CA-1 (Attach Proof of Ownership & Legal llcst�ription)
phone.• /
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State License Number:7i i' ��,.'�7.,7•_/!J �@
(Contact Person: o -P FrV] r)ro K) Phone: Neon -&a r
Phone:
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. l 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 ofthe foregoing information is accurate and that all work will be done in compliance with all applicable hww: trj;ulatinl,
construction and zoning. WARNING TO OWNER: YOUR FA[LURE'I'0 RECORD A NOTICE OF COMMENCEMENT MAY RESUL [N -,/f)I )1;_ I'?, YiN0
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR 1 E13NDER Oft 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 ir.e(uds of
this county, and there may be additional permits equired from other govemmental entities such as water managernent districts, state agencies, or tcderttl agencies.
Acceptance of permit is ver�ti4 cati � tat 1 otify the owner of the property of the requirements of Florida Licn Law,
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Signat�urJe of Owner/Agent bate Signature of Contrnctor/A ent
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(PTtirit tier/Ages Name �'iggtta`tu
nto ractor/Agent's Name
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Signature of Notary -State of Florida e reof Notar State of Florida DateRONa�DI.�S C. HdMaPBy-`
A:OTARY PUBLIC -STATE OF FLORIUA /
COMMISSION # 00228953 //
�� ..�_..��-- EXPIRES 9/6/2007 p�YPvi� Susan L Matra -Harrison
Owner/Agent is �"'�['ersonally Known to Me WNUEUTHRU t"8e3•NOTARYt Contractor/Agent is rsonally Known to �t It� My Contrnission UD218024
_ Produced I _ Produced ID mow Expire; July 12, 2007
APPLICATION APPROVED BY: BldgA(Z Zoning:AM 0 Utilities:
(IniL al & Date) (Initial & Date)
Special Conditions:
(Initial & Date)
FD:
(Initial —&-Date)
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QL
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OFFICE