HomeMy WebLinkAbout8100 Cardinal Cove Cir 12-1578 MeterCITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: ).a / U Documented Construction Value: $ 2US -. w
Job Address: L C "r, ILCG; fl Historic District: Yes ❑ Mo
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Parcel ID: szr" - ryyn Zoning:
Description of Work:
Plan Review Contact Person:
Phone:
Fax:
E -mail:
�1 j Property Owner Information
Name ��IJeS�CG. � 3c") C'A A sc( . LLC Phone:
Title:
Street: LJL1 P(r "/� �% Resident of property?
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City, State Zip:
Contractor Information
Name ��. �i�`l.P r- 7 lore Phone: Y ✓'7 (/l; iC�� X % %�
Street: 2W 7" ) /_Son A-yc Fax: ou
City, State Zip: � ;U '� �e r� ��Ar �� �/ _ % ': t State License No.: � C. a%r3((i '6
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Building Permit ❑
Square Footage:
No. of Dwelling Units:
Electrical A'
New Service — No. of AMPS:
Architect/Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type:
Flood Zone:
Mechanical ❑ (Duct layout required for new systems)
No. of Stories:
Plumbing ❑
New Construction - No. of Fixtures:
Fire Sprinkler /Alarm ❑ No. of heads:
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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.
The City of Sanford requires payment of a plan review fee. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released.
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Signature of Owner /Agent Date
'On t'1 \-Z1GL 0r,��cdwLk\ S c l �,
Print Owner /Agent's Name
4A�o P evvd�_ slg 1 i�-
Signature of Notary -State of Florida Date
JODIE P. BUCK
Notary Public, State of Florida
Commission#[ EE 168811
y MY Comm, expires Mar. 8, 2015
Owner /Agent is ° 4
Produced ID -X Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Rev 11.08
to Me or
UTILITIES:
"'-Signature of Contractor /AAg�ent rDate
�" k clef c�c� Vl
ngent's ractor /A Name
Pte—
Sign t e of Notary-State of Florida Date
R Notary Public State of Florida
Jessica Mitchell My Commission DD835877
%fires 11/09/2012
Contractor /Agent is Personally Known to Me or
Produced ID Type of ID
FIRE:
WASTE WATER:
BUILDING:
SEMINOLE COUNTY MULT/%URISDICTIONAL
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 03/02/2012
I hereby name and appoint: Shawn Workman
an agent of: Palmer Electric Co.
(Name of Company)
to be my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all things necessary to this
appointment for (check only one option):
❑✓ All permits and applications submitted by this contractor.
❑ The specific permit and application for work located at:
(Street Address)
(Parcel Identification)
Expiration Date for This Limited Power of Attorney:
License Holder Name: Scott Easterbrook
State License Number: EC0003096
Signature of License Holder:
03/02/2013
STATE OF FLORIDA
COUNTY OF 0 r.A= s
The foregoing instrument was acknowledged before me this 07- day of
20 LP—, by �� G,�, (� j� who is CL{aersonally known to me or
❑ who has produced
and who did (did not) take an oath.
Signature of Notary
Notary Public State of Florida
Jessica Mitchell
p� My Commission DD835877
�aFVc� Expires 11/0912012
as identification
aP J 5; G+� M�_��
Print or type Notary name
Notary Public - State of x /C>l�l�
Commission No. 9 3 -
My Commission Expires: