HomeMy WebLinkAbout1526 S French Ave 04-175 revision to fire sprinkler0
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AFx0rSANFORDPERMrrXPP CAT
Permit # Date:
Job Address:
Description of Work:
Historic District: cZoning: ValueofWork:$ "23
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 CaIc. Required)
Plumbing/ New Commercial: # offixturcs — # 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 #: 2 4 — of - 0 — .5.7-17- - o q (0 C) - [Att h P f of n 6. R, T I n
Owners Name & Address: 1240-tC-c.) JS 04
1:24 L,-, ,rz-: 16(e)
Contractor Name & Address: A4 P C) -F 4e-4, &
Phone & Fax: Contact Person:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
ac roo wners p ega esc p on,
V- Wo 4t E1.4Lo/- , (,D /-..
t02--7Le0--7J61 -
License Number: 4 40(000
Phone:
Phone:
Fax:
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 ofthe foregoing information is accurate and that all work will be done in compliance with all applicable laws repulatina
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 ofthis permit, there may be additional restrictions applicable to this property that may be fWnd 'in the public records of
this county, and there may be additional permits required from other governmental entities such as_w:aie nagement districts, 4&agencies, or federal agencie,
Acceptance ofpermit is verification that I will notify the owner ofthe property of the requiroKents of
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
S-17,5—at.re tary-Statc of Florida Date
FLORENCE A. DE GRAVE
MY COMMISSION # DD 164280
EXPIRES: November 12, 2006
is WMkosMe or
C-1(Produced I D
i
APPLICATION APPROVED BY: Bldg CY2-0-0-3 Zoning: Utilities:
Initial & Date) (Initial & Date)
Special Conditions:
Initial & Date)
11
131,-)3
iclFD. I'd
1, (initial& Date)
OCCUPATIONAL LICENSE 2004 04-10432
EXPIRES: 9/30/04
License renewal violations will be reported to the
C6de'Enforceinent Board. LEESBUNG,
AeIaLft6nt City *FOR THIS LOCATION ONLY* The City of Leeshurg expressly reserves the right to revoke or cancel
LOC:1412 BRYANT this license in case the licensee or any person doing business under
CLS,:CONTRACTOR.,- UNSPECIFIED it so conducts such business that it constitutes a nuisance, disturbs
SUBCLASS:` the peace and tranquility of the community, or threateris the public'
health, safety and wellare.
LIC FEE A 0 00
PEN/LATE FEE:, 00
MIDFLORIDA FIRE PROTECTION LLC - - - - - - - - - - - - -
P 0 BOX 4901 ' 54 TOTAL: 40.00
LEESBURG FL 34749-0154
LICENSE MOST BE CONSPICUOUSLY DISPLAYED -
STATE OF FLORIDA
DEPARTMENT OF FINANCIAL SERVICES
DIVISION OF STATE FIRE MARSHAL 2!
TALLAHASSEE, FLORIDA
CERTIFICATE OF COMPETENCY
THIS CERTIFIES THAT: RANDY G HUNT
1412 BRYANT ST_
LEESBURG, Fl- 34748-
BUSINESS ORGANIZATION: NIIIJ FLORIDA FIRE PROTECTION
CONTRACTOR 11 IS LINIITEDTO THE EXECUTION OF CONTRACTS REQUIRING THE ABILITYTO LAYOUT. FABRICATE, INSTALL. INSPEC I-, ALTER. OR SERVICE WATER SPRINKLER SYSTEMS, WATER SPRAY SYSTEMS. FOAM -WATER SPRINKLER SYSTEMS. FOAM -WATERSPRAYSYSTEMStSTANDPIPES. COMBINATION STANDPIPES AND SPRINKLE R RISERS, EXCLUDING PRE-ENGINEERED SYSTEMS.
Chief Financial Officer
0' 2112 111 1 1 41 .. 00'"" 9' 11011 25111 11 10 20,04
D zn, T P Cl C.i.,y P nna Nurn
AAC CSR SB DATE (MM/DD/YY0RD_ CERTIFICATE OF LIABILITY INSURANC IDFL-7DUCER 08/29/03
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIONThomasECorkhillInsAgcy,LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEP-0. Box 539891
HOLDER. THIS'CERTIFICATE DOES NOT AMEND, EXTEND OR, 120 south Bumby Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
j0rlando*FL 32853
I.Phonle:407-898 8891 Fax:407-89878813 INSURERS AFFORDING COVERAGE
hNSURED
INSURER A: Everest Indemnity Insurance Co.
INSURER B: Auto-Ownets Insurance PL/CL
Mid Fl Fire'Protection LLC INSURER C: AmCompPOBox490154
INSURER D: Leesburg FL 34749-0154
INSURER E:
COVEIIAGES
Ll I tU tlt:LL)VV HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIRE ' MENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO.WHICH THIS CERTIFICATE MAYBE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDEDElY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCHPOLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
NSRF_
LTR TYPE OF INSURANCE POLICY NUMBER' POLICY EFFECTIVEDATE (MMIDDM) I PDOALTICEY(MMED15/01 ION LIMITS
A
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
51GLO01143-031 08/29/03 08/29/04
EACH OCCURRENCE 1,000,000
X
FIRE DAMAGE (Anyone fire) s 50,000
MED EXP (Any one person) s 5,000
PERSONAL & ADV INJURY 1,000,000
GENERAL AGGREGATE s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY
PRO -
JECT LOC
PRODUCTS - COMP/OP AGG 1,000,000
3
AUTOMOBILE LIA61LITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
43-925820700 08/29/03 08/29/04
COMBINED SINGLE LIMIT
Ea accident) J,000,000X,
BODILY INJURY
Per person)
BODILYINJURY
Per accident)
PROPERTY DAMAGE
Peraccident)
GARAGE LIABILITY
ANYAUTO
AUTO ONLY - EA ACCIDENT
OTHER THAN
EA ACC
AUTO ONLY: AGG
EXCESS LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
AGGREGATE
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
7020046 01/01/03 01/01/04
AXTWOMYLA-S I ER
El. EACH ACCIDENT 500000'L
E.L. DISEASE - EA EMPLOYEEI 00000
E.L. DISEASE - POLICY LIMIT 500000
OTHER
SCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSlOkS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
ERTIFICATE HOLDER- ADDITIONAL INSURED; INSURER LETTER':' CANCELLATION,,
CITYO-1
City,of Sanford
PO Box 1788
Sanford FL 52772-1788.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, -THE ISSUING INSURER WIL , L ENDEAVOR TO MAIL,' 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO, THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE, NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPR E,SENTATIVE
Scott Corkhill #A054965
ORD 25-S (7/97) @ACORD CORPORATION 1988
XL eg B LTO
Galvanized and, Black Lightwall Threadable Pipe
Me original "GalvanLzed" and "Black" Threadable Ughtwall pipes with exceptional hydraulics and economy.
XLSIBLTO's proven hydraulic
advantage and lighter weight adds value
to any system. When you need a proven
sprinkler pipe, specify XUBLT.
XUBLT pipe are an exceptionally
strong steel sprinkler pipe of the class
generally known as "lightwall
threadable pipe".. Its wall thickness is
less than that of Sch4O or Sch-10, but
the cold forming process undergone in
manufacturing gives XL/BLT pipe
mechanical strength characteristics
equivalent to those required for Sch-40.
It is designed for use in wet, dry,
preaction and deluge systems. XL/BLT
can be joined with threaded couplings
when in accordance with ANSI
B 1.20. 1), roll grooved or plain -end
couplings, or welded joints.
XU BLT products have metallurgical
properties which provide excellent
fabrication characteristics for end prep
finishes, welding and roll grooving. No
special process or equipment are needed
for fabrication and installation.
XL is manufactured with galvanized
coating.
BLT is black lacquer coated.
The internal surface of all black Allied
Tube & Conduit Fire Sprinkler pipe
products up to 4.5000" in diameter is
coated with our new Antibacterial
Formula, "AB17". In scientific laboratory
test, ABS proved to have superior
resistance to microbial colonization o
pipe walls, thereby delaying or possibly
preventing the onset of
Microbiologically Influenced. corrosion
NEC) when the First Sprinkler System
is first installed.
NPS Nominal I.D. Wt. Wt. (H20 Filled) Pcs/ WVLlft (21') WVUH (24') Mull (25')
In; MM In; mm LbslFt, Kalm LbslFt; Kg1m Lift Lbs; Kg Lbs, Kg Lbs; Kg
1 * 1.104 1.13 1.61 91 2,333 2,667 2,570
25 28,0 1.8 2.40 91 1,060 1,211 1,228
1 '/4* 1.452 1.46 2.25 61 2,019 2,307 2,226
32 36.9 2.3 3.35 61 917 1,048 1,058
1 1/2" 1.687 1.76 2 84 61 2,409 2,753 2,684
40 42.8 2.8 4.23 61 1,094 1,250 1,294
2' 2.154 2.35 4.06 37 1,959 2,239 2,173
50 54.7 3.7 6.04 37 890 1,017 1,041
21/2- 2.581 4.08 6.34 30 2,571 2,939 3,060
65 65.5 6.05 9.45 30 1,168 1,335 1,390
3" 3.200 5.01 8.49
80 81.2 7.43 12.7
XL only
XL/BLT pipe is manufactured to meet
ASTM A- 135, Grade A for fire
sprinkler applications up to 300 psi
working pressure.
Listed Approved Listed
It is LJL listed for wet, dry, preaction
and deluge systems, and FM approved
for wetsprinkler systems. XLJBLT is
ULC listed for wet, dry and preaction
systems. All threaded and welded
fittings are approved in accordance with
NFPA 13. ,
FM requires 12'maximum hanger
spacing for XUBLT. C-Factors for XL/
BLT are 120 for wet systems, and
C= 100 for dry systems. Refer to Hazen -
Williams charts for accurate flow
comparisons.
19 1,999 .2,285 2,380
19 908 1,038 1,081
XLJBLT pipe offers the maximum
hydraulic advantage of any available
threadable sprinkler pipe. Its inside
diameter is -up to 5% larger than Sch-40.
The use of XLJBLT in conjunction with
Dyna-Flow pipe, can dramatically
improve the flow.characteristics,
thereby increasing the potential for
downsizing" system components.
The clean surface quality of XL/BLT is
readily paintable. The lighter weight of
XLJBLT is a distinct advantage for
retro-fit installations and can also
reduce laborcosts.
Flow Control
6100 S. Lathrop - Harvey, IL 60426
ltqd:o/ P allied 11 1350 Norcom Rd. - Philadelphia, PA 19154
TUBE & CONDUIT 2525 N. 27 th Ave. - Phoenix, AZ 85009
Customer Service:
800) 882-5543
Fax 708-339-1806
S4-3
PHD Man
FULLYTHREADEP STUDS :'r
5/8'
3/8 Rod 1/2 Rod
Wt. wt. Wt.
Each List Price Each Regularly Furnished
Length List Price Each List Price
Each (in Lbs.)
Inches Each (in Lbs.) Each (in Lbs.) --
2.76 .14
2 $1.21 $1.69 .09 $ ain.
3 .
05
1.87 .14 3.29 .21
Finish: P1
1.34 .07
3.77 .28
Material: Low carbon steel.
4 1.51 .10 2.25 .18 - *
Bulk packaging.
5 1.80 .12 2.84 23 4.60 .35
3.29 .27 5.33 .42
6 2.08 .14 Tor lengths over 12
3.63 .32- 5.8.0 .48
P. 0. 7 2.18 .1 7
8 2.30 .19 4.11 .36 6.37 -55
9 2.53 .22 4.60 .41 6.80 .62
04 .45 7.41 .69
10 2.86 .24 5
8.15 .76
11 3.16 26 5.49 .60
6,02 .54, .83
12 3.33 .29
C e d leng-th. d ring: Specify rod size an
NGER;R ODMACHINETHR
j r LISCP
77 - arly Furn,isivid;
3
9
In
4!
5
4
WIN 7- U,
WkW%*C-
E- MiA41 20' Model 2,v -h d
91.3 01
Flfiish)Ialn
Ago by_ o. M Ddel
b6n'stee . I 38 1261
N
at 1: Low car
5,18
2
78 i
50i"" 488.234.75
4Z :`40
36!
10.87
24 15.94
77= 7777 77 N`z
Tn m
rnq:;S length and 0 r, size. ple
EN Sl
VN41 Fa'hStd.'
R V u n a41tioailFrI hed'- List Price
Package 0 PiEahzSIe,
I
Ir
2.76
3 29
50` FitW3' 4 48
bWir6nffjmea
6
Z 7LL-0
A2513.39
18.05 -25
7
n C-:1., -A C;70
7 Yt A N 19 P I I 1 1
01o'be
PIPE HANGER PRODUCTS, INC.
ALIQLmL 2001
D
A
THIO SIZE
C
SERIES
IRQN PIPE ;WIVEL RING
SME RANGE: il, through 8" plpe skze5.
MATIERIAL: Pr"alvanlzcd Cwbon Steel Alh a Zi EI—Jr.VW.
11.1 nut,
FMSH: Pre-Gnivantzed.
ORDERING: Specify rod aim: finlrh: and model number and plpe 6i4-e-
PPROVALS: UL Listing and FM Approved, Complk-s wIlth Federel
SpeefficatIon IAM-11-1471E (Type 10) and A-A-119?A
Type 10) and Manulaclurarr, 'Standartlitullon Society SF--
69 (Type 10) and MFPA standards 1w reduced rod slzoG.
FUNCTION- Dazign and recommended for (he susp6nalon of non-
Invulated viationary pipe Ones. The hanger staybe
installetil prfo( lo, tho erection of pl i. ng and also allows for
wartical =jjwAmew;4f1sr instEdlaWn.,
Model P4-
Photo FWerance MaAMUM
Recorrunended App3L WT. Carton
NIA11111M
A 8 C D E Load (lbsk) per 100 (Pos.) Qt-ndry.
300 204 1/2, 08, 2 - 112" 1 - it.—. 31 1-1/0' 100
300-206, X4' 318, 2 - 6/8' 1 - W41 3-1161 1 - 1/8' 400 9 100
300-2110 11. 3/8,
318'
2 - 2V4" I - WO' 3 - 3/8' 1-1/8'
1 - 1W
400
400
10 100
300-212 1 - 1/4' 2-7/8- 2 - 1/8' 3 - 311V' 11 100
300-214 1 - 1/2" Ysl 3- 2 - 1/4' 4' 1-118' 400 1:3 100
300-220 2.
2 - 112'
W
1/2'
3 - 3/8' 2 - jr* 4 -,5/8'
S - 1/21
1- 1/81
1 - 3/9'
400
coo
14
30
100
so3DO - 224 4- 3 - vir
300-230 3", 1/2, 4 - 5/8' 3 - -r.18" 6 - 318' 1-S/81 6w 32 so
3W - 234 3-1/2, 1/21
shr
6' 4' 7' 1 - 314'
1 - W,
600
1000
36 so
390-240 a. S-1/4' 4-1/8- 7-1/2- 25
300-250 5" sm. 6. 5' 8 - 3/4' 1 - 71W. 1000 58 20
300-200 6- 314' 7' 10-318, 2 - i/w 1250 116 20
300 - 21310 8' 1 3W a - 1/4' 7 - Ila- 2 - 3M" 1250 150 10, 1
Globe PlFw Hanger Products, Inc. 14601 Industrial Pailkway Cleveland Ohio 44135 - www.globopoehmver.com
Toll4ree: 1-8DO-338-3555 Local, 1-21rp.,362-6300,- Fax: 1-216-267-6884 - sales 0 globepipelianger.CoM
Page 14
Nk No I HUN I N P 1 "'6 (NOW Qi WIN
PIPE HANGER PRODUCTS, INC.
AugaLt 2oni
DD 14- G I-*--
C F
Foil" I recommended set screw
torque "Wi. per MSS-SP-09,
15
SERIES
SIM RANGE: 3m, through wal rod sizer.
MATERIAL- Ma6eabie iron casting vrith a hnrdened cup point 301
scrow and lock nut.
FINISH- Black.
ORDERING: SpecIly rod z1ae; finish,- and fnedel number.
APPROVALS! UL Listed for top or bottom of Deam. FM Approved for
NFPA 13, MaXIMUM rated Pipe Size. Complies vAlh
LjarwlaCturars Standardization Society SP-69 (Type
19 A 23).
FUNCTION: Recommended for artaching hanger rod to top or
bo" WuVe ol"a h6arn %w bar JoLst, wherc me
thlcknas* of a jolst or flarige does not exceed 314 inch -
The apen back design pormft rod adjustmonlL
INSTALL.AmON! Wsl i=LWI in an uprignt porAllon.
ALSO AVAILABLE IN: Elactro-Plated ZInc and 304 Stainle-- Steel
model
Nwnber
Photo Raierenco Appx VJT.
r 100 (PM) PL
Maximum
Recommended
toed oln.)
Carton
auanfityABCDEFr.
101 - 101 319, 1. 1 - U2" 1/2' 1. 4. 718, 33 400 100
104 - 10i 1J2' 1. 1-112, 112' 1. 314- 718" 33 500 100
105 - 10i 511131 1 V2" 1 -1 1 /2" 3/4' 1. 22 000 50
106 - 101 3/4' 1 7/8' 1 - 314' SW i - _V8- 1. 1 - 1/4' Be Boo 50
107-101 1 7191 2- 1 - 3/4' 6/8' 1-1/2' V 1 1 - 114" 79 1 1200 1 25 _j
Globe Pipe Hanger Products, Inc. - 14601 InduStrlal Parkway Ohio 44135 - WWW.globepipehanger.com
Tall -tree; 1 -800-3W-a555 - Local-. 1-216-362-6300 4 Fax; 1-21 &267-6864 - s ales 0globepipehanger.corn
Page 1
CORPORAMN
A UTOMA TIC SPRINKLERS
MODEL JN BULB SPRA-Y SERIES
UPRIGHTOPENDENT
VERTICAL SIDEWALL
HORIZONTAL - SNDE W,ALL
CONVENTIONAL (OLD STYLE)
DEscRiPTIONAND OPERATION
The Globe Model JN Sprinkler is a low profile yet durable design
which utilizes a frangible glass ampule as the thermosensitive
element While the sprinkler provides an aesthetically pie ' asing
appearance, it can be installed wherever standard spray sprinklers
are specified. This sprinkler series is, available in various styles,
orifices, temperature ratings and finishes..to meet.varying design
requirements.
I The heart of Globe's Model'JN sprinkler proven actuating
assembly is a hermetically sealed frangible glass ampule.that contains
a precisely measured amount of fluid.. When heat is absorbed, the
liquid, within the bulb expands increasing tne internal pressure. At
the prescribed te miperature the internal pressure within the ampule
exceeds the strength of the glass causing the glass to shatter. Thi's
results in water discharge which is. distributed in an approved'
pattern depending upon the, deflector style used.
TECHNICAL DA TA
U.S. Patent No. 5,494,114.
See revers side for Approvals and Specifications. e
Temperature Ratings - 1350F (57*C), 155*F,(68*C), 1750F (79'C),
200-F (93-C), 286-F (141-C), 360-F (182-C), 500-F (2600C).
Water'Working Pressure Rating - 175 psi (1207 kPa).
Factory tested hydrostatically to 500 psi.(3448 kPa).
Maximum low temperature glass bulb rating is -67OF (-550C).
Frame - bronze -.- Deflector - brass , Screw - brass
Bulb seat - engineered plastic - 0-ring - silicone elastomer
Bulb -glass with -glycerin solution, 5mm size. HORIZONTAL SIDEWALL
L,73 1rr7Af0VD A -rYTD17 DA'rTXTd"_1PT A CCTFTCAT1'f)7Vtr"d d"f)Tf)R Cl()1)17vr.
AVAILABLE BULB COLOR
KEPA. MAXI MU M
CLASSIFICATION SPRINKLER TEMPERATURES CEILING TEMPERATURE
ORDINARY ORANGEIRED
INTERMEDIATE YELLOWIGREEN
HIGH BLUE
EXTRA HIGH 1827 MAUVE 3W F 149 C"
ULTRA HIGH 260 BLAC K 47 F,,-" 5 .
4077 AIRPARK DRIVE, STANDISH, MICHIGAN 48658 5 17-846-4583 o FAX 517-846-9231
JANUARY 1998 A'- 12N BULLETIN JN- 1, REV. #3
4 A
ITY OF SANFORD FIRE DEPARTMENT
FEES FOR SERVICES
PHONE # 407-3024091 FAX #: 407-330-5677
PERMIT #:
DATE:
t
BUSINE
ADDRESS: I n
NO.: PHONE N
CONST. INSP. C 0 INSP.:j I REINSPECTION PLANS REVIEW
F.A. [ I * F.S. HOOD PAINT BOOTH I BURN PERMIT
TENT PERMIT TANK PERMIT OTHER
C:)( (PER UNIT SEE BELOW)
TOTAL FEES:
COMMENTS:
Address / Bldg. 9 / Unit #
I .
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Sguare Footan Fees ver Bld-F. -/Unit
Fees must be paid to Sanford Building Department, J)GO N. Park Ave., Sanford, Fl. 32771 Phone N -407-
330-5656. Proof of Payment must be made to Fire Prevention division before any further services can take
I certify, that the ab i true and correct and that I
place.
will comply all appli, ble d d ordinances
of the City7f Sanford orida
d <
Sanford Fii revention Division Appli nt"s SignaturV
ry