1102 Lake Jennie Dr - E08-001056 (Addning new security lights) Documentsa
CITY OF SANFORD PERMIT APPLICATION '
Application #: Submittal Date: 3- 14'06
Job Address: 1 AcG K 9 =(? Q i i u 2 UCL a 1 D I Value of Work: $ lD0 o• o u
Parcel ED: Zoning: Historic District:
Description of Work: 6td C.I i I q ec U ( i 11,E I." h 1' hD ,C t C)- b U + Ol A Square Footage:
0............... o..... ....... ............. .o... 0.... ...0.... 0... .... 0.0.0.... o.... o. 0.... 0... .............
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alann Pool Sign
Electrical: New Service - # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures _
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Calc. Required)
of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential Commercial Industrial
Construction Type: # of Stories: # of Dwelling Units:
Plumbing Repair -Residential Commercial
Occupancy Use Group(s):
Flood Zone: (FEMA form required)
a
Property Owner: Ci ri'1[ ' i .t Ian Contractor: f Q_LJW4,-. CE lcct((L \n c -
Address: I IAddress: 2LA Cc, 1 i R 1 0 . a
ord PIDftd-cam. Phone:
gLy -- Say- -D-3 E-mail: Phone: yO 0I State License Number: PC 13 0 019 7 & Bonding
Company: Address:
Architect/
Engineer: Address:
Mortgage
Lender: Address:
Phone:
Fax:
Plan
Review Contact Person: _ 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 COS 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 requited from other governmental entMes such as water management districts; state agencies, or federal agencies. Acceptance
of permit is verification that I will notify the owner of the property a requireme - of Florida Lien Law, FS 713. Signature
of Otaner/Agent Date Signattire of Contractor/Agent Date Print
Owner/Agent's Name r/ is ame Signature
ofNotary-State of Florida Date ature ofNotary-State of Flo fidaDate Notary
Public SateofFlorida Owner/
Agent is _ Personally Known to Me or Produced
ID APPROVALS:
ZONING: Sdan
Walewski Q
My Commission DD621809 4COF
F1,°Ex ires 02/24/2011 ; Contractor/
Agent is _ ally Kno Produced
ID UTIL:
FD: ENG: BLDG: Special
Conditions: Rev
07.07