95 Pamala Ct - 08-001571 (2008) (A) ENTRY LETTERS ON SIGNSCITY OF SANFORD PERMIT APPLICATION0-
Application #: -
7 y, Gin y Submittal Date: _
Job Address: `!5 A04a-Q. 6[k d/ L Value of Work:
S- - 19 ,.p p
Parcel ID: Zoning: Zoning: Historic District:
Description of Work: ,taef C2I bLT0(, Ll1S Ok fff 0S /U fs' S` S Square Footage:
Permit Type: Building Electrical g Mechanical Plumbing Fire Sprinkler/Alarm Pool Sign
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ 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 Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
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Property Owner: AzYMk"1A OK& x6w oarx.,nr xnb. Contractor:
Address: elokeA wirlh A-0.152zz 45'3S-49 Address: 2s`u so A, l
to kO FL 2.70- 3Z773
Phone: 7 11 -r?12-0 E-mail: Phone: 1 State License Number:
Bonding Company: _ &_9 Mortgage Lender:
Address
Architect/Engineer
Address:
Plan Review Contact Person:
Address:
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 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 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. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
FIRST INSPECTION. 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 governmental entities such as water management districts, state agencies, or federal agencies.
Acceptance of permit is verification that 1 will notify the owner of th r rty of the requirements of lon ien Law, FS 713.
Signature of Owner/Agent Date Si re of Contractor/Agent V Date
Print Owner/Agent's Name Print ntractor/A ent's Name
Signature of Notary -State of Florida Date Signature of Notary -State of lorida Date
MY COMMISSION # DD629096
OF EXPIRES: February 25, 2011Fl
I-800-3-NOTARY FI. Notary Discount Assoc. Co.
Owner/Agent is _Personally Known to Me or Contractor/Agent is _ ersona n 0 or
Produced ID _ Produced ID
APPROVALS: ZONING: UTIL: FD: ENG: BLDG:
Special Conditions:
Rev 07.07
N en -I I'l 00, L,; H - v. A ,
VPSALA
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