1200 W 8 St - BR08-000119 - DEMO PARTITION WALLSCITY OF SANFORD PERMIT APPLICATION
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Application # : it IIqAL Submittal Date: S[ 20
Job Address: 2o6 o 9 s+12 S" 164 .'JL Value of Work:
Parcel ID: 0 1 `012; fling: ((SSIAOJx Historic District: S
Description of Work: ii'YI C% f Yid i/1>'IAS' • Square Footage: , V q G
Permit Type: Building X Electrical Mechanical Plumbing El 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 Cale. 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 0 Industrial 0 , . Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
Property Owner: (-JL )AA M t Contractor:
A)Jdress:_? 1 Sh P4OnS [^ V WCA) Address: _
Ph ne:]0$) / ` 321 E-mail:
Bonding Company:
Address:
Architect/Engineer:
Address:
Plan Review Contact Person:
Phone: State License Number:
Mortgage Lender:
Address:
Phone: Fax:
Phone:
Fax:
E-mail:
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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 I will notify the requirements of Florida Lien Law, FS 713.
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SignAtof wn`er/Agent Date 'o .!Q ig ,4 of C 'ttractor/Agent Date MY
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i ' 'ontr `c'` r/A ent's Name PrintOwner/A enl's e / / . I tt,1,L p tg _,g OI
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iature f Notary; tate o414L4eridfi t ( 1 n tDate +•.,,jp,;3atUre of Notary -State of Florida Date Ll
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33 , 6 Owner/
Agent is Person II Known to Ve or Produced
lD-- 4 lCfi1S(L APPROVALS:
ZONING: UTIL Special
Conditions: Rev
07.07 FD:
Contractor/
Agent is Personally Known to Me or Produced
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