HomeMy WebLinkAbout3512 Orlando Dr 04-489 fire supression systemt
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CITY OF SANFORD PERMIT APPLICATION°
Permit # :� � I Date: %®" 1—
Job Address:
Description of Work: 1 �� -3aaD WeT
Historic District: Zoning: Value of Work: $--
Permit Type: Building Electrical Mechanical Plumbing Fire lamer Pool
Electrical: New Service — # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures _
Plumbing/New Residential: # of Water Closets _
Occupancy Type: Residential
Addition/Alteration Change of Service Temporary Pole __
_ Replacement New (Duct Layout & Energy Cale. Required)
# of Water & Sewer Lines # of Gas Lines
Commercial Industrial
Plumbing Repair — Residential or Commercial
Total Square Footage:
Construction Type: # of Stories: ,� # of Dwelling Units: Flood Zone: (FEMA form required for other than %)
Parcel #: Y l C L " S 136 0 /< / L 1915�l% (Attach Proof of Ownership & Legal Description)
Owners Name & Address: 1'1 i !1
Phone:
Contractor Name & Address:
mil-® -2— 71 State License Number:
Phone & Fax: e ` 0 Contact Person: AL-l--W faI s—Phone(-Vl
Bonding
Address:
Mortgage
Address:
Architect,
Address:
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 lavi,, rx £ oar acing
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULTIN a�tJ1. R�q.,✓. CI x
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 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/pe mit is verific ion that t [ wi notify the owner of the property of the requirements of Florida Li Law, F S 7i3,
Signature
of Owner/Agent s� Date
Signature of Contractor/Ag it
Date
Pr�gens am
® U@c
�.
C��t ia7r/Agen�t'�s Nal�le
d
Date
May 25, 20P4
BONDED THRU TROY FAIN INSURANCE, INC.
Owner/Agent is ersonally sown to Me or
Produced ID
APPLICATION APPROVED BY: Bld �_ I Zoning:
(Initial & Date)
Special Conditions:
S g t ,Vf: l�?� � t � td�� GRAVE Date
* MY COMMISSION # bO 164260
s� Q EXPIRES: November 12, 2006 \
`O BoariedTputy 9�1 tAt%Wifem Me or Contrac[�i4FA�znt is V IIIVJJJ
C Produced ID TUNA F �oOL� "�I�Y `S�}
i y
Utilities: FD
(Initial & Date) (Initial & Date) (Initial &Date)
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DATE
2003
NOV
SCALE
1/42
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