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HomeMy WebLinkAbout515 E 25th St 08-1955 ElectricalCITY OF SANFORD PERMIT APPLICATION Permit # : � � Date: lD OY Job Address: -_ 11 S. 2�!5�%X S!969e T,l Description of Work: A60 -%#*.e Move L1 21" Historic District: Zoning: Value of Work: S US 00 Permit Type: Building Electrical V 14echanical Plumbing Fire Sprinkler /Alarm Pool Electrical: New Service —# of AIMPPS Addition/Alteration Change of Service Temporary Pole _ Mechanical: Residential Non - Residential Replacement New (Duct Layout & Energy Calc. Required) Plumbing/ New Commercial: m of Fixtures # of Water & Sewer Lines 7 of Gas Lines Plumbing/New Residential: n of Water Closets Plumbing Repair — Residential or Commercial Occupancy Type: Residential Commercial _� Industrial Total Square Footage: COnStrIICtlOII Type: p rfti # Of Stories: of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: Owners Name & Address: (Attach Proof of Ownbrship & Legal Description) Phone: Contractor `lame & Address: SIi( A&b &R-47— 60 A ' o-'es H ©C'& y State License Number: A! C. IS60,19,4+3 t' ?hone ..;c Fax: 400- ip" I te02, Contacr Person: _� �,rry 'hone: 4017 ZZ— t547- 3onding Company: —� - Address: Mortgage Lender: .'address: sc ;aitecrlE:;:;;nee -hone: riur. ^s: ^,uccaor. a ::N ^ °,• ' macle io •; na::. ^nit :o tae . oi;:: ;,a is:aiiauo:r: muica[::. ni y tna: or,:..r :.srallauon i issuance :;r a ;ermit _nd mat aii ,nrK •:: iii i;e per;oitned c, :reef standards or ..ii laws re_uiarir ,z - onsrruct :on in -.i.is junsdic - -on. :n uerctana star _ ceoamte permit must bo secured'ior ELECTRICAL -VORK : LUTABING.: IGNS, 'HELLS. POOLS, U RP:ACcS. 301LSRS. HEATERS. TANKS, ana AIR CONDITIONERS, etc. OWNER'S AFFIDAVIT: I certify that all ofthe 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. 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 maybe additional restrictions applicable to this property that maybe 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 re' i is of Florida Lien La S71 Signature of Owner /Agent Date Si ature of Contractor /Agent Date Print Owner /Agent's Name Print onttactor /A is Name Signature of Notary-State of Florida Date Signature of Notary-State of Florida Date F?Zl,c DEBBIET' ANTON ' = MY COMMISSION # DD6*96 nIRF. • P Owner /Agent is _Personally Known to Me or Conrracto Agentis EPersot�2hl9RAUQ•tNe _ Produced ID i„ ' ' �'oTaer Fl. Notary Discount Assoc Co. _ Prodficed.ID„�., - APPLICATION APPROVED BY: Bldg: Zoning: Utilities: FD: (Initial & Date.) (Initial & Datej (Initial & Date) (Initial 3c Date) Special Conditions: