HomeMy WebLinkAbout1701 W 13 St 05-395 Tent1<ermit # : I
Job Address: % C
n
CITY OF SANFOR.D PERMIT APPLICATION
I r t r Da e:
Description of Work: 1-0 t
Historic District: Zoning:
Permit Type: BuildiigElectrical Electrical:
New Service of AMPS Mechanical:
Residential Non -Residential Plumbing/
New Commercial: # of Fixtures Plumbing/
New Residential: # of Water Closets Occupancy
Type: Residential Commercial Value
of Work: Mechanical
Plumbing _ Fire Sprinkler/Alarm Pool Addition/
Alteration Change of Service Temporary Pole Replacement
New (Duct Layout & Energy Calc. Required) of
Water & Sewer Lines # of Gas Lines Plumbing
Repair— Residential or Commercial _ Industrial
Total Square Footage: Construction
Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required. for other than X) Parcel #-.
Owners
Name & ,Address: TI Y1 O 4o-
S'A 11,i 1 Attach
Proof of Ownership & Legal Description) Phone:
40-2 - 3 2Z , Contractor
Name & Address: State
License Number: Phone &
Fax: Contact Person: Bonding
Company: Address:
Mortgage
Lender: Address:
Architect/
Engineer: Phone: Address:
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 ail applicable laws rep ula.tsng 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. r\
Acceptance
of permit is ficaion I wi n ify t owner of the property of the requirements of Florida Lien Law, FS 713. Si
at e of Owner/ADate Signature of Contractor/Agent Date Pn'n;
Owner/A ent's Name / ZK Print
Contractor/
Agent's Name ignature of
Notary -State of Florida ate Signature of Notary -State of Florida Date Owner/Agent
is _ Personally Known to Me or Contractor/Agent is _ Personally Known to Me or Produced ID /
Produced ID APPLICATION APPROVED
BY: Bldg: Zoning: Utilities: Initial ate) (
Initial & Date) Special Conditions:
FD: Initial &
Date) (
Initial & Date) EVELINE E.
BENNETI MY COMMISSION #
DD 053453 EXPIRES: August
28, 2005 Bonded Thru
Notary Public Underwriters
a........,......_......._.. -- hvelyntsenneu
Presidett/CEo.. City of Sanford ti
Richard'Burke Recreation Supervisor Y
Admuiiatrative Direz!or P.O. Box 1788
SyIviaD: izquierdo` Sanford, FL 32772-1788 j
Chairman' .
Melvin Plulpot it
vieerreatae,, Dear Ms. EvelynBennett: Qui
iton'Faison`: secretary
The Rescue Mission,' :Inc. 'in Sanford has given, Bristol
c: con}1in p 1otny 'James to., hold an ermissronto7:rr: Evange listic Tent t
Treasurer .. Revival on „Nov :nber.• 16th 21 ` at 6:3 0 pm.' The Revisal will be i "."
scottNelson,
held at 170.1 ,j; 13`h Street, Sariford;Florida. ni
tor Scott
Flakon Sincerely, Steve
Harriett 9Julia
Starling w Kip
Beachman,. k James
G. Viol:aryous. J f s
y via Izq C o. M1 Haromry
Bo rti Merhers Program Director EMiohael
J. "Good Stephen
Strang 3
yr Open
Door Shelter ® 1 t 25, W. 131` Street, Sanford, FL 32771."
3
CITY OF SANFORD FIRE DEPARTMENT
FEES FOR SERVICES
PHONE # 407-302-1091 * FAX #: 407-330-567((7
DATE: \\ O PERMIT #: V —
BUSINESS NAME /PROJECT: F-/cY. C iv c,-v C . { —v . tJc`
ADDRESS:
PHONE NO.: 0-1 — FAX NO.:
CONST. INSP. [ ] C / O INSP.:[ ] REINSPECTION [ ] PLANS REVIEW [ ]
F. A. [ ] F.S. [ ] HOOD [ ] PAINT BOOTH [ ] BURN PERMIT [ ]
TENT PERMIT} TANK PERMIT [ ] OTHER [ ]
TOTAL FEES: $ Q (PER UNIT SEE BELOW)
COMMENTS: t' /` l\ d / 4 1
Address / Bldg. # / Unit #
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Square Footage Fees per Bldg. / Unit
6-ay I
V"-/- \OE
Fees must be paid to Sanford Building Department, 300 N. Park Ave., Sanford, FI. 32771 Phone # -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 I
will comply with all applicable codes and ordinances
of
San ord Fire Prevention Division