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HomeMy WebLinkAbout1601 Rinehart Rd 03-00002875 PlumbingPermit # : . 0 ©-O <) a q -j' Job Address: r V, ,; Description of Work: Historic District: Zoning: CITY OF SANFORD PERMIT APPLICATION I Date: 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 Cale. Required) Plumbing/ New Commercial: # of Fixtures ---L_ # 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 otlecr titian X) Parcel #: Owners Name & Address: Contractor Name & Address: Phone & Fax: 14 i53 Bonding Company: Address: Mortgage Lender: Address: Architect/Engineer Address: Attach Proof of Ownership & Legal Description) Phone: State License Number: - ©( o (3 C'j R(, Vontact Person: L , 1h . Y 1 17 S Phone: Ll q- %ZZ O 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 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 ag ies, or federal agencies. Acceptance of permit is verification that I will notify the owner of the property of the requiremen lorida Lien FS 3N Signature of Owner/Agent Date S atu f Contractnr/Avenr Date ,,, N0 M N s OU t0 _C c o F 0 ID E ice. UWztsQ Print Owner/Agent's Name Signature of Notary -State of Florida Date Owner/Agent is _ Personally Known to Me or Produced ID APPLICATION APPROVED BY: Bldg: Zoning: Initial & Date) Special Conditions: Signature of Notary -State of Contractor/Agent is Personally Kno n to Me or Produced ID l 10% Initial & Date) Utilities: FD: Initial & Date) (Initial & Date) y Power of Attorney Date: December, 3,-2003 I hereby name and appoint Carol Robbins of Robbins Mechanical Inc., to be my lawful attorney in fact to act for me and apply to the City of Sanford Building Department for a plumbing permit for work to be performed at a location described as: Section Township Range Lot Block Subdivision: Address of the Job: Bldg Permit # 03-00002875 1.601 Reihart Road Sanford, FL 32771 Owner of Property and Address: wand to sign my name and do all things necessary to this appointment. U D Wayne R bin CF-0040009 The foregoing instrument was acknowledged before me this day of 2003, by UJG _ qMjZbj r)D who is personally known to me/ev e produced Q C1t- d who did not take oath. State of Florida County of Orange Seal hu,-) A. Not Public, Orange ounty, orida Karen A. Yaeger N F MY Commission DD050356 OW Fxpires October 16. 2005