408 S Virginia Ave - BR08-000587 (REROOF) DOCUMENTSCITY OF SANFORD PERMIT APPLICATION
Application #: ' 5407 Submittal Date:
Job Address: V rQ Value of Work: $
Parcel ID: Zoning: Historic District:
Description of Work: c 00 YQ 6 ' L d -P 01%{ 4IAO Square Footage: T117 Permit
Type: Building Electrical Mechanical 0 Plumbing Fire Sprinkler/Alarm Pool Sign Electrical:
New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole Mechanical:
Residential Non -Residential 0 Replacement New (Duct Layout & Energy Ca1c. 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 Industrial Occupancy Use Group(s): Construction
Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required) C'.
j........................................................................................... Property
Owner: 11 v J L.,N! Contractor: IViCOC C Od f, Ar Address: `(
0 fy.I P
r r Al a a V —( Address: 4 0() tAFTh.
4,J221711 f/
a6
4 T25-
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Phone: E-mail: PhoNVIT
7. i.Cf tate License Number: C C (d 2 Zr 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. 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, stZagencies,eralagencies. Acceptance of permit 's verification
that I will notify the Qwner of the property of the requireme of FI da Lien La S 713. Signature of Owner/ t Date
6 i r Con or/Agent Date e is nontor/Ag,s
Name Signature
o ary-
to a
of Florida Date Signature o otary-State of Florida Date Notary Public State of Florida °
AMON9 Paul A Olesen MY COMMISSION #
DD629096 My Commission DD516629 EXPIRES: February
25, 2011 p Expires 02/09/2010
1-e00--3 NOTARY Fl. Notary Disco= Assoc. Co. Owner/AgentOwncr/Agent is ersona
nex _ Contractor/Agent is ersona y own to a or Produced ID ii t Zr13(/, r
Q J (p 0' DcJ _ Produced ID 5-0Z-1 APAROVALS: ZONING: UT1L:
FD: ENG: BLDG:
Special Conditions: Rev 02/2007 ,/