125 Lakeside Cir - E08-001517 (ADDING THREE OUTLETS TO PORCH) DOCUMENTSD—
CITY OF SANFORD PERMIT APPLICATION
Application # : ay - ! S-/ l Submittal Date: 5 / L6 / 0 u
Job Address: Cam; Value of Work: $ 07 a
Parcel ID: Zoning:( Historic District:
Description of Work: 1l. ,34d% yv (,t^E 1 , I-e-ct a Square Footage:
Permit Type:Building 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 q Commercial
Occupancy Type: Residential Commercial Industrial Occupancy Use Group(s):
Construction Type: # of Stories: of Dwelling Units: Flood Zone: (FEMA form required )
Property Owner: -^ 1 Contractor: 1 1J C`-tom ''„
Address: 1'L.' L-- a Address: OA 01t
Phone: _ E-mail: Phone: t^' ^ ` to License Number: LZ
Bonding Company: Mortgage Lender:
Address: Address:
Architect/Engineer:
Address
Plan Review Contact Person: I 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: 1 certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulative
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 owner of the property of the regoiremen f F]vSa Lien Law, FS 713.
Signature of Owner/Agent Date Signature 6ontracto /Argent Date
Prim Owner/Agent's Name- Prin ntrr/A is Name
Signature of Notary -State of Florida Date Si ature of_ otary- tate of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID
APPROVALS: ZONING: UTIL: FD:
MY COMMISSION ?# DD629096
d' EXPIRES: February 25, 2011
1-RGO-7-IiR`JTARY FI. Nctary Discount Assoc. Co.
Contractor/Agent is _ P sonally Known to or /./
Produced ID
ENG: BLDG:
Special Conditions:
Rev 07.07