401 W Seminole Blvd - P08-001647 (SAILPOINTE) (METER RESET) DOCUMENTSI
Application #: 09 (,,,
CITY OF SANFORD PERMIT APPLICATION
Submittal Date:
Job Address: HDi w, temi npic Nyd 24a Value of Work: $
Parcel ID: ,
J i,, M 1
Zoning: Historic District:
Description of Work: e r I T Square Footage: .
Permit Type: Building Electrical 'k 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 Cale. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential Commercial Industrial
Plumbing Repair —Residential Commercial
Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
j.....................................
Property Owner:' +dg_ 1 li l L(1 ' Contractor: 1 i
Address: LU W. Address:
I
FL 2)a-i I+a
Phone:40 I `) iM, I E-mail: Phone.4677A6 State License Number: Bonding
Company: Address:
Architect/
Engineer: Address:
Plan
Review Contact Person: Mortgage
Lender: Address:
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 ICwilill notifythethhee owner of the property of t requirements of Flida Lien Law, FS 713. S 0
SiMat of
O ne /Agent Date Si nature Co tr t A t D to T Lr
V+ Pri er/
Agen 's Name Print Contra r/Agent's N 0& Si
State
of a Signature of tary-State of Florida ate Owner/Agent
is Produced lI
APPROVALS: ZONING:
Special Conditions:
Rev 07.
07 wn _ _ - 1511"
01 Elotlb A/Mlt,.'
sonally Known
to Me or UTIL: FD:
TRACY L.
RIVERA NOTARY PuBuc -
STATE OF FLOFM A COMMISSION # DD446W
EXPIRES 6/
29/2009 BON V
1-388-NOTARYI Contractor/A
is _ P rsonally Known to Me Prodfed ID
ENG: BLDG: