800 Santa Barbara St - E08-001010 (CHANGE OUT MOBILE HOME UNIT) DOCUMENTSCITY OF SANFORD PERMIT APPLICATION
Application #: 08 — / C)) -
1
Submittal Date:
p
Job Address: ay /Q i h,Ql 199 ---Value of Work: $
Parcel ID: // Zoning: Historic District:
Description of Work: hhA/ Q DUT/ 0 0il &,-A-L !iP I / Square Footage:
Permit Type: Building Electrical Mechanical 1,..Plumbing Fire Sprinkler/.Alarm Pool Sign
Electrical: New Service — # of AMPS
Mechanical: Residential 10 Non -Residential
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Cale. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential ® Commercial Industrial
of Gas Lines
Plumbing Repair —Residential Commercial
Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
1/^ ..............................................................
Property Owner: /—as eat=o l bQ T l-/CSrLT/1 (y j7 Contractor. / / "Tl2QTiiiQ /
Address: (
r` / <
f 1 / , Address: % 015 710
S&MI
tGa
ie J Phone:
3 %' / y6 ' 8 3_2- E-mail: Phone n -a. Y< State License Number: GI II ') D 91 Bonding
Company: Address:
Arch
itect/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 I will notify the owner of the property of the requirements of Florida Lien Law, FS 713. c
alal'7/`
8 Signature
of Owner/Agent Date Signature of Contractor/Agent Date Print
Owner/Agent's Name Print ntr ctor/ ent's Name Signature
of Notary -State of Florida Date Signature of Notary -State of Florida Date Owner/
Agent is _ Personally Known to Me or Produced
ID APPROVALS:
ZONING: Special
Conditions: Rev
07.07 UTIL:
FD: DBBBT'
MY
COMMISSION # DD62 0 6 Contractor/
bdf Ji3n llAtge Produ
A AARY Fl. Nota y Discoun ENG:
BLDG: 0
0