HomeMy WebLinkAbout1201 Mellonville Ave 03-2943 Flag poleCITY OF SANFORD PERMIT APPLICATION
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lPermit #: Date:
Job Address: 1 ok U t l"t r\ 1 M V t
Description of Work:
Historic District: Zoning:
e—(
Value of Work:
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 Calc. 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)
Parcel #:
Bonding Company:
Address:EGO! d3S
Mortgage Lender:
Address:
Architect/Engineer: -t
Address: 1 31 L
Attach Proof of Ownership & Legal Description)
Phone: J4 6 7 `- LI oc' iS ` 06-3 F3X:
2,r_,{ YS 061.4 3 F L 07
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. 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
it s verification th I will notify the owne of the property of the requirements of Florida Lien Law F S 713. Signature
of Ow*,,tof&
S
nature of Contractor/Agent Date x_
o n 5a vl E 5 ten- 7
b AA
N s Print O gePrint Contractor/Agent's N e o o
CoJtAAM 9 a Cn .y
y •o S gnature of NotFlorida Dat Signature of Notary-Staidof Florida Date U E n• ,.•'''
r'prr.,, Timothy S. Carson 1 U caw ¢ =or"-& '--SCotntnission #
DD110479 c . ° No,.'% Owner/
Agent is _ Personally Known to Me or Contractor/Agent is Personally Knq'a}t eft' Expires May 5,`2006 m 6u' Produced
ID-• Bonded Thiit Produced ID gi4tnsNNAtlanticBonding
Co., Inc. SAP, r j-
2Z -0 3 IA' 4LICATION APPROVEDBY: Bldg: Zonin0: Utilities: FD: Initial & Date) (Initial &
Date) (Initial & Date)_ (Initial & Date) Special Conditions: V3
bi-19
J'E(L SIGNS
SINGLE SHEAVE CAST ALUMINUM,
REVOLVING, NON -FOULING, INTERN
HALYARD TYPE TRUCK
1/8 7X19 MIL-C-5424
STAINLESS STEEL AIRCRAFT CAI
STANDARD FLAG ARRANGEMEI
PLEASE SPECIFY SIZE FLAG
TO BE FLOWN: _X—.
NEOPRENE COATED Z DIA. STEEL
COUNTERWEIGHT
NYLON BEADED RETAINER RING
DES1604 W iNo I
LOADS N CONF00140(E
v l Fge. Zoo I "
12,0n, L_ a LIo0
1(-1Zo
Cvk .45
a7-ps
GEARLESS, SELF LACKING UIHECP
UHIVE WINCH WITH SIX TUNIULEH
CYLINDER LOCK
0x - Z
SPUN ALUM, FLASH COLLAR
3000 PSI CONCRETE
HARDWOOD WEDGES
DRY SAND TIGHTLY
TAMPED AFTER ALIGN-
ING POLE
BLACK ASPHALTUM PAINT
ON OUTSIDE SURFACES
OF POLE BELOW GRADE
FOUNDATION SLEEVE-16 GA.
HOT DIP GALVANIZED STEEL
O
V
STEEL CENTERING WEDGES
3/16STEEL BASE PLATE
3/16 STEEL SUPPORT PLATE
WELDED TO GROUND SPIKE
EC70IR
4it O>e - ZS ''e Top
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s =
4
CD
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0
X
t
1
I
A,
REVOLVING NON -FOULING INTERNAL HALYARD
TRUCK; CAST ALUMINUM BODY, 26 STAINLESS
STEEL BALL BEARINGS B 2-1/2' DIA. PLATED
STEEL SHEAVE.
RtLVrcsiu r
6o—T(v
1
WINC11 DLTJIIL
t
ALL SHAFTS WITH OVERALL
LENGTH OF MORE THAN 36-0 ry ARE SHIPPED IN TWO SEC-: I
TIONS.
I
I
EACH SECTION MATCH MARKED j
FOR FIELD ASSEMBLY. EXPOS- II
ED PORTION OF JAM SLEEVE fl
MUST BE WELL LUBRICATED -
PRIOR TO ASSEMBLY. _
I f
I
1-I/2 MAX SHOP GAP ALLOW- RICRARDSON 0
ED FOR FIELD FITTING ( RAM
FOR TIGHT JOINT). ENGINEERING F
131. ZELNIA S'C,
ORLANDO ILL 32803
407)-425-4002
D# Ell 011011373 / LIC# PE 0012380 `
1
LPLAM
ATY OF SAMFO"
Serving Orlando Since 1978
Christina Haynes
JR Signs
SERVICE, INSTALLATION & CRANE RENTAL
Phone (407) - 295-8907
Fax 407-295-2436
316 Goodland St., Orlando, FL 32811
jrsigns@cfl.rr.com
CITY OF SANFORD
Contractor Registration Application
P O Box 1788
Sanford, F132772-1788
407-330-5656 or 407-330-5660
Fax 407-330-5677
Date:
Business Name: --
Business Mailing Address: 22) (,7 'd t) [)a— n d
City: i0 42 n ,-i 0 State: i . Zip: 32 8 1
Business Phone: L4 01 a 5— Z q 0-7 Fax: ti 1) 5 - 3
Name of Qualifier on State License: 50 r'h Q S - -f r
State License Class and Number(s): D 0 0 0 '? -
Applicant's Signature: f
Contractor Requirements
Certified: Must provide a copy of current Stat icense, Occupational License, workers
compensation waiver affidavit or certificate of workers compensation insurance
with the City of Sanford listed as the certificate holder.
Registered: Letter of reciprocity must be sent from jurisdiction where H.H. Block exam was
taken, hand carried copies are not accepted. A competency card will be issued.
Also provide a copy of current state license, occupational license. A workers
compensation waiver affidavit or certificate of workers compensation insurance
with the City of Sanford listed as certificate holder, and original $2,000 Surety
Bond.
Specialty: Must provide a copy of current occupational license, a waiver affidavit or
certificate of worker's compensation insurance with the City of Sanford as
certificate holder, and an original $2,000 Surety Bond. A $10.00 registration fee
is assessed for all specialty contractors not licensed by the state.
11 `;t L_A1'lACS UHANUL (;UUPJi Y OCCUPATIONAL LICENSE 2600_.CIL1 sirz14ALuy/:3U12UO3 ,, Earl K. VVood, TAX COLLECTOR.
ORANGE COUNTY, FLORIDA
THIS LICENSE tS,!N ADDITION FO AND NOT IN LIEU OF ANY OTHER LICENSE REQUIRED BY LAW OR MUNICIPAL ORDINANCE. IT IS SUBJECT TO REGULATION OF ZONING, HEALTHANDANYOTHERLPWFULAUTHORITY. IT IS VALID FROM OCTOBER 1 THROUGH SEPTEMBER 30 OF LICENSE YEAR DELINQUENT PENALTY IS ADDED OCTOBER 1.
i..Y. Wii4o[tiu`'I.i , rrrF t. !klf" 48 \I', '....i , a tL I •r tid[tiJ4W:3rkY 1 { t(k, 1 J•k! { itF xk icy U„ 4;r`r n", :f! r '' !' M I „;7Y :.''v: .. GVFG—S iGiV.S ` 30.001 JOi2K1_ft ELECTRICAL1Wf3KKEF2 . TOTAL
TALC 60.00 T. TOTALP&iD .O,.UU-- ( CL-t TOTAL'
DUE .00' 1 1E 3 #
UOLA ST RC.
ANDR F'L 3" " 11-1511 GOODLAND
5T." OKLANOO
SPENCE
JAMES PA11JZ.
60.00 3.1-r306241 O LJ'LiU•!J'"'< THIS
FORM BECOMES A RECEIPT WHEN VALIDATED BY THE TAX COLLECTOR. j
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