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Home My WebLink About1601 wp ball blvd 08-1755 (hood system),Monday, i-ebruary U4, ;=d V:1b I'M I ommy Johnson J1ldJaa /531 p.UJ 08/24/2013 24:42 FAX — i�j 5 CITY OF SANFORD PERMIT APPLICATION Application /I I �! I 1� Sabmii4al 13%to Jab Addresl: �K 1 {]� In) 3� 1\ a\ �1, -1 �'�1i Jd 1��1 `1 value of Work, S�--_e ©o„ - Parcel 1D1 `\ .Zip l J l � (� ' f�c7 17� Zoning; Alatoric District! Description of Work: �vwT a� Square Footage: . 1f.■ Y��e��F...., 1. .r.�...I's f..f..YYr.F.f......... ...... r..........f Yf.sf Y�f. uff�s. ff if �ff.ff.ff PerenitType_ Building ❑ Eleetlical C3 Mechanical 4 Plumbing 0 Firc Sprinkler /Alarm 0 Pool ❑ Siv 17 Electrical: I ]cw Sorvicc #F of AMPS Addition /Aharation E3 Change of Service ICI Temporary Polc CI Mechanicsti; Residential ❑ Non- Residem134 Replacamern E3 New 0 (Duct Layout & rmnerSy Calo. Rcquirod) Plumbing/ Ntw Commercial; N of Fixtures __,— N of Mater & Scwur Lines N of Vets Linea Plumbing/New Resicitntilsl', N of Wear Cluswr Pltrrnbing Ropnlr— ResidenrlsI 0 Commmlel 0 becuprancy Typc Residential 0 Commercial 0 Industrial 17 Constriction Type: ____,_ N Of 9toritu 0 Of Dw411111= U"itV Occupancy Use Group(e)r Flood Zone (FEMA form required ) ............ Y.•........f..f.f..a..... f. f• Yf.f.... f.. f. f/ .... ...........Y......IffY.1l..ff.f r.af fflf..lff1..........YY Contractor: - ��0 �i — ie- I A-tnC AdOrDJJ'��41 t -�f�� 1 \i'•� 1 n__i Add lE3i Ll N A L,� I� Y t Phone; E -melt - a5'LjitateLleenseNumber. Cif- y.�dS7(�aZ Bonding Company: Addrares; Morip ge L.entier: Addreca: ArcniteeVEngineer: Phone: Address: Pion Review Contact Pomon: Phone, - Far: Fax: — E-mail., Applloatinn is hereby made lu UbWn a permit tq do the woe[ acrd insullfdiota as indicated, I certify due no work er irstilldlion hU COm.nmmd prior ter the Issuance of A parmlt and that All work will be perforined to meet stmrtdards Df all laws repuieting ewiructien In this jurisdirtim. 1 underat><gd thief a saperttr¢ pornlit heist be sewed fbr GLECTRICAL WORK, PLUMMN0. SIGNS, WELLS. POOLS, FURNAC119, BOILERS, F4E4T6R5, TANKS, and AIR CONDITIONERS, cta, CfVMR'g AFPIDAVIT; t WIRY thit all of ncc ftwCgoillfl InfonitAilon Is itecurdie mid thm all work will be done f l eagplimlea wlih all applicable IAWR rd$ulatlnS construction grid 7crnlno. WARNNG TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT N YOUR PAYING TWICE FOR 1M>'ROVF:MY,N7'S 'I'p youk PROPERTY, A NOTICL' OF COMMENCCMENT MU9T B13 RLCORDL-D AND POSTED ON THE JOB SITE BEFORE 7'HIr 171RST INSPECTION. IF YOU iNFFNIJ TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE: RF.CORDINO YOUR NO'I'IC13 OF COMMENCEMENT NA'TICd: in addition to the regoiranmau of this pormn, tha9 Iney be addidvtial renrivc(aiie rlpp114014 to ihlo property rimy may be found in rho pubs to rtcordr of this county, end Ihcre may he additional permits required limn olher povdrnulertul ifAilits 6uCh as waler nilatiQdmdnl dWriG►, stela 44n6iti, ur fadend %cncieS. ACCepiance of pamlt is voc!Awllon that I will notify the vwnor of the propen be mrivircrmonts of Florida Lien LAw, FS 713. Stgnmure of Ownd'r /ATenl Deft tpnatufe of Conira=tor /Agent Data -1 T j � ZTC; It 0So* Print UwnadAgoot'¢ NAM6 Print Comuactor /Agmi''s Name 0 Signature Of NotAr Vito of Florida Date Signature of Notary - Sealy of FlortdA Dili: OwnWAgc01 is _ ri;rsonilly Knvwn w Me or GonunGtor /Agent is s4raonslly Kaown to Me or • -• _ praduted ID _Produced 1D APPROVAL$- TONINti uIIL; ru; t'NC1: DLDf3: Special C:ondltinns�ll Rey 07,07 DEBORAH L. PMDER -, " °"a•� ; Notary put*c - Slota of Fk . = Wly Cammistlioe E1�P n Feb 8,2W9 :� term #W 394182 aped 191 Motul NdM Alan. CITY OF SANFORD FIRE DEPARTMENT FEES FOR SERVICES PHONE # 407 -302 -2516 • FAX # 407 - 302 -2526 DATE:. BUSINESS NAME / PROJECT: ADDRESS: /60/ �✓' % I /�I /' PHONE NO.: 3 FAX NO.: PERMIT #: CONST. INSP. [ ] C / O INSP.:[ ] REINSPECTION [ ] . PLANS REVIEW F. A. [ ] F.S. [] HOOD ] PAINT BOOTH [ ] BURN PERM [ ] TENT PERMIT.[ ] TANK PERMIT (J OTHER [ ] TOTAL FEES; S _2C r7 (PER UNIT SEE BELOW) COMMENTS: Address/ Bldg. # / Unit.# 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11 12. 13. 14. 15. 16. 17. 18. 19. 20. Square Footage Fees per Bldg. / Unit Fees must be paid to Sanford Building Department, 300 N. Park Ave., Sanford, Fl. 32771 Phone # -407- 330 -5656. Proof of Payment must be made to Fire Prevention division before any further services can take place. 1 certify that the above is true and correct and that 1 will comply with all applicable codes and ordinances of the City of Sanford, Florida. v r ire Prevents n Division Applicant's Signature LIMITED POWER OF ATTORNEY Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford, Seminole County, Winter Springs Date:--! I hereby name and appoint: an agent of - C- 1_ wC 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) Expiration Date for This Limited Power of Attorney: f 7 - 3 i 7 e O Qj License Holder Name: �1 rim �A C % 3c) k k) State License Number: Signature of License Holder: STATE OF FLORIDA COUNTY OF�d/'-e, VQ The foregoing instrument was acknowledged before me this .� day of ��' -C= 200 , by [k(7m c, 5 who is<7--personally1Eown to me or ? who has produced s identification and who did (did not) take an oath. (Notary Seal) VICKIE L MAUST • Comm# DD0340016 rte, Expires BI20/2008 Bonded thru (800)432 -4254: FIr" 'a !dotmr) Assn.. Inc . ..............................i (Rev. 3/27/07) �v�r, Signature ' Print or type name Notary Public - State of Commission No. My Commission Expires: