HomeMy WebLinkAbout4477 W. 1st St 04-428 electrical control panelsCITY OF SANFORD PERMIT APPLICATION
Permit #: _ Date:It - 2,0 -a 3
Job Address:14 7 4-f-11-A . is S 3 7-7
Description of Work: man+ C; kta.- i4.1E 1 i YYr e ql Fi W e Go,..t. 61+,Vi ' ,"g -Tc4v%tc a, L" „ Historic
District: Zoning: Value of Work: S 5c Permit
Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Electrical:
New Service - # of AMPS <Meplacement
Iteration Change of Service Temporary Pole Mechanical:
Residential Non -Residential 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 #:
X) i.Y` — (Attach Proof of Ownership & Legal Description) Owners
Name & Address: I'L, G'-'7- M M
Phone: Contractor
tName &
Address: _ (
1 T -i r{ f; [ T t L 2 '] ((9y 1 Y, r C , Sahfcr ;
FL ' 3 7 A State License Number: 90DO 14 JC Phone &
Fax: HUT3 - C 3Co Contact Person: C ` ett, Phone: Bonding
Company: k .I A Address:
Mortgage
Lender: Address:
Architect/
Engineer: J I 1A 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 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 thiscounty, 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 require trt s of Flori Lien Law, FS 713. Signature
of Owner/Agent Date V4,
Owner/
Agent's Name Print Signature
of Notary -State of Florida Owner/
Agent is _ Produced
ID Personally
Known to Me or APPLICATION
APPROVED BY: Special
Conditions: Date
Signature of,Notarv-State of ao &&
Date
Con
ractor/Agent is P rsonally Known to Me or roducedID
Bldg: _-
Q Zoning: Utilities: Initial &
Date) (Initial & Date) FD:
Initial &
Date) (Initial & Date) A.'
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Expires Sept. 30,2004 SEMINOLE, COUNTY OCCUPATIONAL LICENSEAccount:'0990?1
i RAY V6i QES, TAX COLLECTOR
I 7 '
r4 'f ::". r _^fi W_[LICJ?NSE TO ENGAGE IN BUSINESS,
PRQFES'SION OR OCCUPATION SPECIFIED BELOW, ausu+ess
ADDRESS
K K ELECTRIC INC r
25V COUNTRY CLUBRD REGULATED SANFORDi
FL32771— State LEC'r'# EC' 0001650 Qua;l,
i f i er— CHRISTOPHER-N" FERRAR CHRISTOPHER N
FERRARA tvP) 4 MAILES 1
anDR[ir Es ' S K & K ELECTRIC INC 2517 COUNTRY
CLUB RD r SANFtOlR!D,
i FL :
32771-
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SY•'" . Amount Paid:
i 45.00 OLHS2003091508837