HomeMy WebLinkAbout2921 Orlando Dr 08-2241CITY OF SANFORD PERMIT APPLICATION
Application # : t/nn� - ° \ 3Z.Smittal Date:
lob Address: (ac� �rL f ?r? /� s � l� � �%G'� Value of Work: S
Parcel lD:
Zoning:
Historic District:
Description of Work: (_-heeZY 4- ( (4 G Footage:
Permit Type: Building ❑ Electrical K, Mechanical ❑ Plumbing ❑ Fire Sprinkler /Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service - # of AMPS Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
Mechanical: Residential ❑ Non - Residential ❑ Replacement ❑ New ❑ (Duct Layout & Energy Calc- Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Numbing/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)
..................................... ................................................ . .................. ..............
roperty Owner. 56/4%�' � ,0 f,4 Z
c 4,-VC1 Contractor
lddress: Pla
6121( 5� Address:
'hone: E -mail: Puoft / /S-Z/ /S-Z/v State License Number:
3onding Company: Mortgage Lender:
'Lddress: Address:
trchitect/Engineer:
\ddress:
'Ian Review Contact Person:
Phone: Fax:
Phone:
Fax:
E -mail:
1pplication 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
ssuance 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 scpandc
xamit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
SIR CONDITIONERS, cic.
)WNER'S AFFIDAVIT: t certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating
onstruction and zoning.
VARNING TO OWNER. YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENT'S TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE
IRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
JOTICE OF COMMENCEMENT.
IOTICE: 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
-tis 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 1 will notify the owner of d
Signature of Owner /Agent Date
Print Owner /Agent's Name
$ignaturc of Notary-State of Florida - Date
Owner /Agent is _ Personally Known to Me or
_ Produced ID
PPROVALS: ZONING:
pecial Con"ons:
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UTIL: FD:
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Contractor /Agent is eLrsonill,�Kngwrt tzrdr�it
Produced ID _' {a �y�.. d r,., S
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ENG::� - - BLDG:
LIMITE) POWER OF A'T'TORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: May 10, 2008
I hereby name and appoint: STEPHEN J. SIEGEL
an agent of: ELECTRICAL CONTRACTING BY BILL BRYDGES
(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):
X All pen-nits 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: DECEMBER 31, 2008
License Holder Name:
State License Number:
Signature of License Holder:
WILLIAM C. BRYDGES
STATE OF FLORIDA COUNTY OF VOLUSIA
The foregoing instrum nt was ackq
200 by
to me or _ who has produced
identification and who did (did not)
(Notary Seal)
(Rev. 3/27/07)
before me this day o ry)CLQ
i
' who is ersonally kn wn
Print or type name
Notary Public - State
Commission No.
My Commission Expires:
as