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290 Town Center Cir - BC08-001463 (TENANT BUILDOUT) DOCUMENTSCITY OF SANFORD PERMIT APPLICATION Application # :08 — Submittal Date: 11 Lo 3 Job Address: 24f i7 , e( ,r. SA2,ce GOS Value of Work: $ 000 Parcel ID: n / Zoning: I Historic District: Description of Work: Ei !c'u. d i` Lt I t— /iii (i r Square Footage: Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Sign Electrical: New Service — # of AMPS QU 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 Commercial 1i' Industrial Occupancy Use Group(s): Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required) Property Owner: Contractor: G Address: Address: K Lam„ 327o Phone: E-mail: Phone:4a7-26o.2,p62State License Number: ECC4703r)i 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' 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 will notify the owner of the pro rtfthcquirements of Florida Lien Law, FS 713. Signature of Owner/Agent Date ignature of Contractor/Agent Date Print Owner/Agent's Name Signature of Notary -State of Florida Owner/ Agent is Y Personally Known to Me or, Produced ID APPROVALS: ZONING: Special Conditions: Rev 07.07 Print C ac r/Age ame O O O Date ignat vG o+aStaign181l iid3•.....wa.w. Date FRANK RAMOS, _ lpr rr,. CannV4 00ryS11 0 rigs Expraa plt/10 a „ ilondsd 1Mv Contr i •. a or Produced ID UTIL: FD: ENG: BLDG: