1016 Mangoustine Ave 03-1072 wood replacement and repairsCITY OF SANFQRD ,PIE RMIT APPLICATION
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Permit No.: � 4) �' �U�, Date:
Job Address:
Permit Type: L Building Electrical Mechanical Plumbing • Fire Alarm/Sprinkler
Desctx�t onof-WorkA
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Additional Information for Ebpctrllal OR Plumbing Permits
Electrical: Addition/Alteration Change of Service Temporary Pole New AMP Service (# of AMPS )
PlumbinOlkesidential: Addition/Alteratioh New Construction (One Closet -Plus Additional)
Plumbing/Commercial: Number of Fixtures Number of Water & Sewer Drainage Lines Number of Gas Lines
Occupancy Type: _Residential Commercial Industrial Total Sq Ftg: Val etlo rk-,$� IrJ0
Type of Construction: Flood Zone: Number• of Stories: Number of Dwelling Units:
Parcel Igo.: (Attach Proof of Ownership & Legal Description)
Owner/Address/Phone:--:)-'3 G /,t /•t i" 4, .7 S'4 LA
E r V
Contractor/Address/Phone:
7 State License Number: C(,-C D'(, 20 1 0
Contact Person: GjGc7JT DVS Phone & Fax Number
Title Holder (If other than Owner): ZG�G 7 tf.
Address:�r�-��
Bonding Company.
Address:
Mortgage Lender:
Address:
Architect/Engineer Phone No.:
Address: 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 acid 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 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 regords of this county, and there may be additional permits required from other governmental entities such as
water management districts, state agencies, or federal agencies.
Accep o£pe it is ve a�onatll notify the owner of the pVtintractor/Agent
Ill uire is of 1 r' , a Lien Law, FS 713,
Si of Owner/Ag • • Date Sign, Date
Owner/Au.,wt'
Sigihattwe-oFj qi; S the of Fl rich
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pF" , �Counawsxon -# DD07WIS
tQ' Iiapires Dec. �0, 2005
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Atlantic BondlugCo.,Lac.
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int ContractoF/Ager tts Na.�ne ,
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Atlantic Bonding Co;, Lac.
Owner/Agent is Personally Known to Me or Contractor/Agent is Personally Known to Me, or
\,0 Produced IDQI�p •- 0 k Q -..$ 0- 3O ► -C) � Produced ID ly0 ' - >.S -J (j.
APPLICATION APPROVED BY Date:
Special Conditions: -
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L,=PT .,9YATION
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permit Don Not armint'My
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RIGHT ELEVATION
REAR ELEVATION
FRONT ELEVATION
SCOPE OF WORK
GENERAL'REPAIRS TO EXISTING STRUCTURE LOCATED AT 1016 MAGOUSTINE AV.
SANFORD, Fly. THESE REPAIRS ARE TO INCLUDE REPLACEMENT OF ROTTEN WOOD
AND REPAIRS TO EXTERIOR FINISH OF STRUCTURE.
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