HomeMy WebLinkAbout1750 Elm Ave 09-335 ElectricalCITY OF SANFORD PERMIT APPLICATION
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Application #: � —� Submittal Date: I t . t O U
Job Address: J So /�) ,q 1/� Value of Work: S /.S�61
2 �
Parcel ID: ` 3 � )O5 - 0000 -0j,oO Zoning: Historic District:
Description of Work: ZCG xl ��.�' //� G -C i a,14 -Ye,� r h
r•IQ6 i AZ ,'% Square Footage:
Permit Type: Building ❑ Electricals 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 Cale. Required)
Plumbing/ New Commercial: # of Fixtures # of Water &Sewer Lines # of Gas Lines
Plumbing/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: (FENIA form required)
.............................................. ...............................
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Property Owner: I C .11J i/ r' � Contractor: �+ �L - -c —rry G 45w c
Address: / 3� J tr �R ct� i/I/%1�C Address: /GG -3
�A XI r-nk-w �7
Phone:6? �'y'L C�7 -mail Phone% t�icen�e Number: C,' 3i�I/
Bonding Company: `s - �b ° °--r�'r: _ _ 3a�7,5_
Address:
Architect/Engineer:
Address:
Plan Review Contact Person:
Address:
Phone: Fax:
Phone:
Fax:
E -mail:
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 J d�
issuance of a permit and that all work will be performed to meet standards of al I 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 propeW(9f1h wre ments of 'd Lien Law, FS 713.
Signature of Owner /Agent Date Signature of Contractor /Agent Date
Ri c h ri r&/ Sc A y
Print Owner /Agent's Name Prin ontractor /Agent's Name
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Signature of Notary-State of Florida Date Signature of Nota -State of Florida Date
`DEBBIE BLA RTOlV'
Itil v MY COMMISSION # DD629096
EXPIRES: February 25, 2011
�OF ti0
6R j-- 1XCTARY Fl. Notary Discount Assoc. Co.
' -�v;a ^7 S• :> mrt1,�`AIAfM�,fa� �'4.fiR.:C•
Owner /Agent is Personally Known to Me or Contractor /Agent is _ Personally Known to Me or
_ Produced ID _ Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 07.07
UTIL: FD:
ENG: BLDG:
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POWER A*TER-BASE
(REFERENCE}
COMMERCIAL POWER
INDICATOR LIGHTS
(RED)
I AMP, 250V FUSES
(CLASS CC RISES)
FOR COFAM POWER
INDICATOR LIGHTS
SURGE SUPPRESSOR
NEUTRAL DISCONNECT
rMN aclowe JUMPER
WHEN USED AS
SERVICE EQUIPMENr
GROUND E.EC7RO -- - 1!
CIONDUCTORTERMINAL
635409-007
Vemian 0, May 2001
G-GROUNDING BUSHING
INSLUA70 GREEN WIRE
fMM BREAIM� LOCI ARWGEMEff
YMSUDEMONGDEVICE
C-SqERATOR RECEPTACLE
SURGESUPPRESSC
HOWER'S
i4
dAI AMP FUSES
r=91 RECEPTACLE
120 VOLT, 20 AMP
-176'
12 POS ndON LOAD CETna-,,
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