HomeMy WebLinkAbout3101 Orlando Dr 03-2262 New fixturesa
CITY OF SANFORD PERMIT APPLICATION
Permit # : 0 3 —' .Z .2 (PA Date: A3
Job Address: . i O.eeg/riDo Pie. S%rvsO.eo GL
Description of Work: ,E,liy/dO IX oG,O &AQ i%JiC12/R2 /y.3'1 l L A49W
Historic District: _--J —Zoning: Value of Work: $
Permit Type: Building Electrical _kMechanical 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 Occupancy
Type: Residential Commercial / Industrial Construction
Type: / # of Stories: # of Dwelling Units: Plumbing
Repair — Residential or Commercial Total
Square Footage: A11A Flood
Zone: (FEMA form required for outer than X) Parcel #: (
Attach Proof of Ownership & Legal Description) Owners
Name & Address: , '1441e6.e Q7 ODG T/L S /iisL llE9T0 fr/C a Phone:
Contractor
Name & Address: NE'TwQ iC C f.EGf_1ZZ Cr State
License Number: I Phone &
Fax: 322' Contact Person: [: Phone: D) _4 Bonding
Company: _ Address:
Mortgage
Lender: . Address:
Architect/
Engineer: Address:
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 agencies, or federal agencies. Acceptance
of permit is verification that I will notify the owner of the property of the requirej6,/nts 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 APPLICATION
APPROVED BY: Bldg: Zoning: Initial &
Date) Special
Conditions: Print
Contractor/ aw,
FS 713. a>
S.*.. Date
No
kent
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iQ
a
x 24LfD
ofFloridam
C7 lD Contractor/
Agent is Personall Known to Me o P o U o Produced
I r S. 1, s 2 a o w Vi W
Utilities: FD:
Initial & Date) (
Initial & Date) (Initial & Date)
r
POWER OF ATTORNEY
DATE: `'1 "q - O J
I HEREBY NAME AND APPOINT a u-z A-N 0 6 -k H A N
E i C c-72 c p L S S `
y'
OF l% TGyWDl2L O BE MY LAWFUL ATTORNEY IN
FACT TO ACT FOR ME AND APPLY TO THE 0,1114 DLE
BUILDING DEPARTMENT FOR A CV Ce-+K-t C- -j- PERMIT
FOR WORK TO BE PERFORMED AT A LOCATION DESCRIBES AS:
SECTION TOWNSHIP RANGE LOT BLOCK
SUBDIVISION .310( 0 12 L A," bo —J-Y. SA-+J Fmcx,D
ADDRESS OF JOB) ..
OWNER OF PROPERTY AND ADDRESS)
AND TO SIGN MY NAME AND DO ALL THINGS NECESSARY TO THIS
APPOINTMENT.
t 4-4
TYPE OR PRINT NAME OF CERTIF ED CONTRACTOR
SIGNATURE OF CERTIFIED
THE FOREGOING INSTRUMENT WAS ACKNOWLEDGE BEFORE ME THIS
BY
WHO IS PERSONALLY KNOWN TO ME/WHO PRODUCED -ti'` S A lJ 6 w
AS IDENTIFICATION AND WHO DID NOT TAKE OATH.
STATE OF FLORIDA COUNTY OF 4c--m /
COMMISSION
NOT weUC • STATE OF
411 a
ORMA
lSSION # DD170731
EXPIRES 12/10/2006
MY COMMISSION EXPIRES: eoNDED THRU 1-E88 tinTq--
1/92
SEMINOLE COUNTY OCCUPATIONAL LICENSE E>,p. Sept. 309 2003
STATE OFFY-16DA ACc unt 0 0693.'1
RAY VALDES, TAX COLLECTOR
LICENSE TO ENGAGE IN BUSINESS,
PROFESSION OR OCCUPATION SPECIFIED BELOW.
BUSINESS NETWORK ELECTRICAL SYSTEMS INC ELECTRICAL. CONTRACTOR (2,?
ADDRESS CR 1.. 835 State. L i c .0 - EC 000 138v5
SANFORD i FL 32747-
MICHAEL D MOYNIHAN (PRES)
MAILING NETWORK ELECTRICAL SYSTEMS INC
ADDRESS
Rp BOX 471314
LAKE PIONROE9 FL 32747-
l ii„!fl„f l 11„lf ff
Anw un t Paid: $ 20.00 OL.HS2002091109799
Ac# 0476219 STATt O04LORIDA
r
DEPARTMENTCTRICALSCONTRACTORSRLICENSING BREGULATION
SEQ#
L0207050162! DATE
IBATCH NUMBER 1111111
1 ar*141414 The
ELECTRICAL CONTRACTOR Named
below IS CERTIFIED Under
the provisions of Chapter 489 FS. Expiration
date: AUG 31, 2004 MOYNIHAN
MICHAEL D NETWORK
hLECTRICAL SYSTEMS INC. 5471 :
SANFORD
OAK
PLACE FL
32771 JEB
BUSH KIM BINKLEY-SEYER f
fTa T1TT/1f! ra ewr w v w n r+r nr rr-. '+i w ui QTi Afl 7 T 717]V