HomeMy WebLinkAbout3849 Enterprise Way 09-375 Service on lift stationCITY OF SANFORD PERMIT APPLICATION
Application #0q--315 y Submittal Date: �/
Job Address: / �Q`7 !�n Value of Work: $ o2 / 00
Parcel ID:
te" 0 0 Zoning: Historic District:
Description of Work: —0f Lt' 1 -' 4vvj
Square Footage:
........................................................................................... ...............................
Permit Type: Building ❑ Electrical I- Mechanical ❑ Plumbing Cl Fire Sprinkler /Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service — # of AMPS 1^ 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
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑
Construction Type: # of Stories: # of Dwelling Units:
Plumbing Repair— Residential ❑ Commercial ❑
Occupancy Use Group(s):
Flood Zone: (FEMA form required)
........................... ......... ..../ ........./.................... ............................... (. .......... .....
Property Owner: C: � ��% �/el c)j2x "? T �• Contractor: /�P// �t��ez e C� e
Address: _3 -7 1U, Address• U/ (O L50414-11 / ✓✓�• f!
-__T
Phone: 407 22 4 ' �V//E -mail: Phon /67 5, State License Number: 4 eI - 0, . 37c�_-�
Bonding Company:
Address:
Architect/Engineer:
Address: c36� SP4On ��7 // �(YII
Plan Review Contact Person: '1 t11 C4,,�e/1r✓1 Phone:
Mortgage Lender:
Address:
Phone: 3 -5yy
S� 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
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 prop of the requirements of Florida Lien Law, FS 713.
Signature of Owner /Agent Date Si e of Contractor A ent Date
Print Owner /Agent's Name Pint Copimzi q gent's bhp_ �
Signature of Notary-State of Florida Date
Owner /Agent is _ Personally Known to Me or
Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 07.07 D /
FD:
Florida Date
STEVEN C, HEAPE,JR.
P,1Y COMMISSION # DD774779
EXPIRES April 01, 2012
Produced ID
ENG: BLDG:
POWER OF ATTORNEY
Date:
I hereby name and appoint L V14 A y
to be my lawful attorney in fact to act for me and apply to the CJf� %�i r✓ /JJi� %O/ Ld .
Building Department for an Electrical Permit for work to be performed at the location described as
Address-
Subdivision or
and to sign my name and do all things necessary to this appointment.
MICHAEL M. DEESE FLORIDA LICENSE #EC 13003724
STATE OF FLORIDA
COUNTY OF VOLUSIA
n
The foregoing instrument was acknowledged before me this day of ,
2008, by MICHAEL M. DEESE who is personally known to me and who did not take an oath.
STEVEN C. HEAPE JR.
NOTARY PUBLIC, STATE OF FLORIDA
STEVEN C. HEAPE,JR.
MY COMMISSION # DD774779
EXPIRES April 01, 2012
(407) 399 0153 FloridallotaryService.com
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