1200 W 8 St - E08-001094 - SERVICE UPGRADE AND REPAIRSCITY OF SANFORD PERMIT APPLICATION
Application # : Submittal Date: 1,
CPJobAddress: / L1Jl J !N v OY Value ofWork: $
Parcel ID: Zoning: Historic District:
Description of Work: 041 44ji¢-C > /jl; Square Footage:
r......
Permit Type: Building Electrical %Y Mechanical Plumbing Fire Sprinkler/Alarm Pool -Sign
Electrical: New Service — # of AMPS f 21@1V Addition/Alteration Rr'f Change of Service W"*'
f
Temporary Pole
Mechanical: Residential Non -Residential O 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)
0.............. 0.............
Property Owner: Contractor: G GTIr'! CC
00,
Address: p Address: I / h' Z ?.,Z
Phone: E-mail: Phone: ' ZZ[5(0Ztate License Number: 6C/oOd 3
Bonding Company: 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 and that all work will be performed to meet standards ofall 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 ofthis 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 ofpermit is verification that I will noti the owner ofthe property ofthe require of Florida Lien Law, FS 713.
Signature of Owner/Agent Date Sign re ofContractor/Agent Date
Print er/ gent's a
4CGr/
A t"
ignature ofNot -State of Florida Date otary-State ofFlorida sB ri Willick ii >
lli Commission #DD369931 omtnissi #
DD36 1 Expires: Sep 08, 2008 Bond
ExpireSep0820 ,, • o , Thru p
ndedThni oR FAtlantic Bonding Co., Inc. OwnirlAg• };
PFsonal own to Me or Contractor/Agent is Personally Known to Me or Produced
ID Produced ID APPROVALS:
ZONING: UTIL: FD: ENG: BLDG: Special
Conditions: Rev
02/2007