HomeMy WebLinkAbout2025 WP Ball Blvd 05-3089 (fr sp)9
CITY OF SANFORD PERMIT APPLICATION
Pis,
Permit # : C 30 - f Date: —
Job Address: 2 D %l cam, 44 6 7t-,06 sue.,` 14. 1-10, I=i ECEIVED
Description of Work: 1,qd !•- r C Iv rc TG .¢ v ,'S 7- .: r Pe- rr e- S/r; . /z r- llV 0HistoricDistrict: Zoning: Value of Work: S 4 ^ O 1 2005
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
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 or Commercial
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than x)
g
Parcel #: 3 / —%5 — -3 0 -3 U O + p ° 3 0 - 0,cC 0 e. (Attach Proof of Ownership & Legal Descriltrtnn)
Owners Name & Address: 5 e.A., c g
Phone:
ContractorContractor Name & Address: q Ft' ' r- - Z 0 — C - Ot-, (: " G .
10 / .I— Te — G— State License Number: O g 7 1 O'd d 4Lff 3
Phone & Fax: tyi- G T e, 2 / S ke r Contact Person: Qo //seop4 Pboae: f0 7 8 Bonding
Company: Address:
Mortgage
Lender: _ Address:
Architeet/
Engineer: Phone: Address:
Fax: Application
is hereby made to obtain a permit to do the work and installations as indicated. 1 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. 1 understand tr,at is ccparate 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 laver, regulating construction
and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT Ihr YOUR PAYING TWICE
FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDL-S.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 1',r,blic recnrds of this
county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or fiAeral agencies. Acceptance
of permit is verification that 1 will notify the owner or theproperty of the requiof Florida Lien Law, 13. C- (-- 0
Signature of
Owner/Agent Date Signature of Contractor/Agent ate Print Owner/
Agent's Name Print o tractor/Agent's Name 6 fos-
Signature ofNotary -State of Florida Date igna re of Notari-Staty of Florida I Date Owner/Agent
is _ Personally Known to Me or Contractor/Agent is X Personally Known to Me or Produced ID _
Produced ID S APPLICATION
APPROVEDBY: BIdR:4 Coning: Utilities: FD: 5J Initial & Date) (Initial & Date) (Initial & Date) (Initial & Date) Special Conditions:
LINDA L.
PHILLIPS Notary Public,
State of Florida My comm.
exp. Sept. 29, 2006 Comm. No.
DD 154192
EAGLE FIRE PROTECTION, INC. a:M:ff kI-b
1205 CROWN PARK CIRCLE • WINTER GARDEN, FLORIDA 34787 FAX: 407-656-9405
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS THAT MYRON B. HEATH, JR. HAS MADE,
CONSTITUTED ANQ APPOINTED AN BY THESE PRESENTS DO MAKE, CONSTITUTE
AND APPOINT & p j- A • Hon L TRUE AND LAWFUL
ATTORNEY FOR MYRON B. HEATH, JR. AND IN HIS NAME, PLACE AND STEAD FOR THE
PURPOSE OF: Sc hv'++ ) P,,'- Q (i Ccz,C 0ti ,ice
o -C-2. r co
GIVING AND GRANTING UNTO ,` o(-g4 A oo L- SAID
ATTORNEY HAS FULL POWER AND AUTHORITY TO DO AND PERFORM ALL AND EVERY
ACT AND THING WHATSOEVER REQUISITE AND NECESSARY TO BE DONE IN AND
ABOUT THE PREMISES AS FULLY, TO ALL INTENTS AND PURPOSES, AS HE MIGHT OR
COULD DO IF PERSONALLY PRESENT, WITH FULL POWER OF SUBSTITUTION AND
REVOCATION, HEREBY RATIFYING AND CONFIRMING ALL THAT AS SAID ATTORNEY
SHALL LAWFULLY DO OR CAUSE TO BE DONE BY VIRTUE HEREOF.
IN WITNESS WHEREOF, MYRO HEATH, JR. HAVE HEREUNTO SET HIS HAND
AND SEAL THIS DAY OF A g=xxo ,200S,
MYRON B.AEATH, 4". P1ER§bNALLY KNOWN TO ME AND DID NOT TAKE AN OATH.
JR.
STATE OF FLORIDA
COUNTY OF ORANGE
NOTARY PUBLIC - LINDA L. PHILLIPS
COMMISSION NUMBER - DD 15419
COMM ION EXPIRATION DATE S TEMBER 29, 2006
LINDA L. PHILLIPS
DATE
LINDA L. PHILLIPS
Notary Public, State of Florida
My comm. exp. Sept. 290 2006
Comm. No. DD 154192
CITY OF SANFORD FIRE DEPARTMENT
FEES FOR SERVICES
77
PHONE # 407-302-1091 * FAX #: 407-330-5677
DATE: (2J _P -
PABUSINESSNAME / PROJECT: '
ADDRESS: - —EU 00-
10
PHONE NO : 6-%J "" O" FAX -:— 2)
CONST. INSP. [ ] C / O INSP.:[ ) REINSPECTION [ ] PLANS REVIEW [ j
F. A. [ ] F.S. [ HOOD [ 1 PAINT BOOTH [) BURN PERMIT [ ]
TENT PERMIT [ ] ANKPERMIT [ OTHER [ ]
TOTAL FEES: $ <(-s , (PER UNIT SEE BELOW)
COMMENTS:
Address / BldQ. # / Unit # SQuare Footage Fees per Bldg. / Unit
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12. _
13.
14.
15.
16.
17.
18.
19.
20.
Fees must be paid to Sanford Building Department, 300 N. Park Ave., Sanford, FI. 32771 Phone a -407-
330-5656. Proof of Payment must be made to Fire Prevention division before any further services can take
place. I 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.
Sanford Fire Prevention Division Applicant's Signature