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CITY OF SANFORD
JAN 2 8 2013 BUILDING& FIRE PREVENTION
PERMIT APPLICATION
74
Application No., r)% Documented Construction Value:$
JobAddress:
Historic District: Yes El No
Description of Work:
Plan Review Contact Person: I C_t'l
Phone; ±> 1 411 1191 Fax:
Zoning:
r i S Title: C) vi
E-mail:
Property Owner Information
Name
Phone.
Street: (n
Resident of property?:
City, it , State 0.
Contractor Information
Name Phone:
Street:
City, State Zip:
EM
State License No.:
Arch itect/Engineer Information
Name: Phone:
Street: F.
I St Zip- <
CitY9 9 L E-mail:
Bonding Company: Mortgage Lender-
1�
Address: � y ev) z
, -Af
Address:
r/V'
PERMIT INFORMATION
Building Permit 0
Square Footage:
No. of Dwelling Units:
Electrica I---
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Construction Type: No. of Stories:
Flood Zone:
New Service — N'Q. of AMPS -
Mechanical 0 (Duct layout required for new systerils)
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Fire Sprinklea-/Alarm 11 No. of heads:
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