1102 Lake Jennie Dr - E08-001058 (Adding new security lights to rear of building) DocumentsCITY OF SANFORD PERMIT APPLICATION
Application S _ Submittal Date: 3- "y# : " • '
D Job Address: (4. i (ln 1 e f J Value of Work: $ (190 0 ° o u
Parcel ID: Zoning: Historic District:
Description of Work: Rd d i f) D JeG / o7 - b u l !u 6Square Footage:
0................... ............ ........................ ............... 4........... .............
Permit Type: Building 6d' Electrical 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 13
Construction Type:
Commercial Industrial Occupancy Use Group(s):
of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
0.....................•
Property Owner: c Contractor: ' 1 E'C` \ L \O C
Address: I I &-,/ C'- Address:
a,-,LpLd, odl o. 3?-)3 Gnc-lJ f=.
Phone:q0- 3Qy-7773 E-mail: Phone: q -9211 i19 State License Number: 3 0 0 0 76D
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 i
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. r
I
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. i
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 govcramentat entities such as water management districts, state agencies, or fWaai agencies.
Acceptance of permit is verification that I will notify the owner of the property f e requirements of Florida Lien Law, FS 713.
Signature of Owner/Agent Date Signature of Contractor/Agent Date
E
Print Owner/Agent's Name PrinlJ errtracta 's Name
Signature ofNotary-State of Florida Date Si otary-State o orida Date
fR k?L^+.SS ,.>,arev ,.: ryfsutilic'Sfate'of'Fl tla 1
1809(
Owner/Aged is _ Personally Known to Me or Contractor/Agent is Personally Known o
Produced ID Produced ID
APPROVALS: ZONING: — UTIL: FD: ENG: 13LDG:
Special Conditions:
Rev 07.07