HomeMy WebLinkAbout601 Elm Ave 03-2822 Light poles for Toughy ParkRim
njZ
CITY OF SANFORD PERMIT APPLICATION
Permit # : —
L" "
Date: _03
Job Address: C WlWGA5
Description of Work: l
Historic District: Zoning: Value of Work: SS 39 Squ —
Permit Type: Building Electrical 6- 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 # 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 #: / -
Sc(
Attach Proof of Ownership & Legal Description)
Owners Name & Address: CA l l/ t7TSA-Cc L
j Phone: ' \
Contractor
Name & Address: 0.kM1` E [CcA l L - v S \ C CL1i1 A U C tW/ 1 n'11)-)
E 91 // / Q
y /Shale
License Number: L c /kS Phone &
Fax: (0L-1 k> ) 1p"E l S Contact Person: C hC' (,S PItone: .C'J Bonding
Address:
Mortgage
Address:
Architect/
Address:
r I N Fax: Application
is hereby made to obtain a permit to do the work and installations•a"sindicat . t VtE
tallation }
ias commenced prior to the issuance
of a permit and that all work will be performed to meet standards of alt laws re t ons US,
diction'.
understand that a separate permit
must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, PO F N CEEATERS. TANKS, and AIR
CONDITIONERS, etc. OWNER'
S AFFIDAVIT: I certify that all of the foregoi rmation is accurate and that all work will be done in compliance with all applicable laws rep_ulaf ng construction
and zoning. WARNING TO OWNER: Y ALLURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE
FOR IMPROVEMENTS TO YOUR PROPER cwN*INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY
BEFORE RECORDING YOUR NOTICE OF'COMMLNCEMENT. 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 requirements o F nd yen Law, FS 713. Q -
iro3 Signature
of Owner/Agent Date S16,
re
of Contractor/Agent Date Park."
Print
Owner/Agent's Name Print o tractor/ ent s Na e p
Signature
of Notary -State of Florida Date Signat#Fe of Notary -State of Floridd Date Oydna
M Alexander Owner/
Agent is— Personally Known to Me or Contractor/Agent is ersonall own to •• My COMMISS1011 00139525 Produced
ID _ Produced ID ' „dF ,
Expired August O5, 2006 APPLICATION
APPROVED BY: Bldg: Initial &
Date) Special
Conditions: Zoning:
Utilities: FD: initial &
Date) (Initial & Date) (Initial & Date)
CITYOFSANFORD
IHSTORICPRESBRVATIONBOARD
APPLICATION FOR A
CERTIFICATE OF APPR OPRU TENESS
P_O. Box 1788, Sanford, FL 32772-17887
F RVOL i8'' % Phone: 407 330-5672 Fir: 407 330-5679
PORA 90
Property Owner: Property Address -:1(2pK.R.,.
Mailing Address. Phone Number:
Fax Number.
Agent: IRC ACC (ADL*X Phone Number: _ G Address: "?
a,aa-, t Fax Number. Downtown
Commercial Historic District: Residential Historic District: Describe
all changes in material, color or location to the exterior of the building and property: I
Applicant'
s Signature a
Owners'
Signature OFFICIAL
USE ONLY Historic
Preservation Board Me ting Date: Date:
11
Date:
C) — Staff
Review Date: Application
is Approved Approved with Conditions Conditions:
Signed: --
Date: Denied
CITY OF SANFORD ELECTRICAL PERMIT APPLICATION
Permit Number: Date: _
The undersigned hereby applies for a permit to install the following electrical:
Owner's Name:C1-11l p t ctv ror
Address of Job: U k k-- ') 1 Vt kuU '"-
Electrical Contractor: PcA mcc C lcc l i s
Residential: Non-Residential:y—
Number Amount
Addition, Alteration, Repair (Residential & Non -Residential)
New Residential:
AMP Service
New Commercial:
OC7 AMP Service
Change of Service:
From AMP Service to AMP Service
Manufactured Building
Other:
Description of Work:
16
6 ec
Application Fee: 10.00
TOTAL DUE:
By Signing this application I am stating that I am in compliance with City of Sanford Electrical Code.
Applicant's Signature
E7(' JKP0
State License Number
f — .
3-3/v c
o
t' _t,C s
kk Ll bc,(,- w
p
A E C- a
Go{1 GT
1('
rJ
v S10Z,) 4 u
Rst: tccc.i i ti„ s
Fc
a
O 76 7l 69O :.9 87 O O
O O N140,
n
Y2'
n 65
O
40 y
PALMER ELECTRIC COMPANY
875 Jackson Avenue
Winter Park, Fl. 32789
POWER OF ATTORNEY
I hereby name and appointM&y-P1 D
of 875 Jackson Avenue, Winter Park, Florida to be my lawful attorneys in fact to act for
me and apply to the
for an ELECTRICAL permit and to sign my name and all things
necessary to this appointment.
PALMER ELECTRIC COMPANY
Robert N. Parker, III
Signature of Certified Contractor, EC 0001858
875 Jackson Avenue Winter Park, Fl. 32789
State of Florida, County of ORANGE
Sworn to and subscribed to before me this 9 day of
ow n„` SignatpyanaMAlexanderSignature of Notary
MY Commission OD139525
a a `
Expires August 05, 2006
Personally known:
2003 .
P.O. Box 421731 (407) 84 ;-7007
Kissimmee, FL 34742-1731 (407) 84 )-0570
CUSTOMER r DEPT
A DDR FQS
PICK UP TIME:
AM PM
TYPE OF ITEMS PICKED UP / DELIVERED
CITY ZIP PHONE: (407)
PICKED UP AT
ADDRESS
CONTACT
RECEIVED BY: TIME DELIVERED:
N AM ,PM'
CITY ZIP PHONE: (407)
DELIVERED TO
ADDRESS
f `"}" ,,
i J ! /!/+P
CJ e+ t'
i JY F%
CONTACT
PRINT NAME
DELIVERY RECEIVED IN GOOD CONDITION
CITY c ,... .ram s ZIP PHONE: (ao7) MISC. CHARGES
COMMENTS: TAL GkTARGES
CHARGE CASH CHECK Thank You For Choosing The Kangaroo Couriers, Inc. For Your Delivery"
7-
KWAIW HORSE, CLERK OF CIRCUIT COURT
NOTIGE,OF COMMENCEMEi IW COUNTY
l3K 05004 PG 1690
Permit No. _ ' of 2003 160447
State of Florida 1
County of Seminole RECORDING FEES 6.0S
RECOIW BY M Nolden
The undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
1. Description of property: (legal description of the property and street address if available) 1 DcJ14 Y PAP- h-
0 ( ct-m 41 i S4:11Z FaAZD [66- 4cc. 81-i- 53 M 6 7-OL41,41 OF 1-
6 15- / F a — 5.4G — 0806 oo-,0 2.
General description of improvement: sc:ouiGC ,4-7-8 Z.7i,;,o-7-ixjb in P rwc 3.
Owner information a.
Name and address C 4V o F S14A/F62p U, %
p-K- A(IF F/ -3Z77Z ->78Q b.
Interest in property c.
Name and address of fee simple titleholder (if other than Owner) 4.
Contractor a.
Name and address fl 1MCyL EL T2I c 07S
s,cs s i l c r v ,.+ , F• '5 27 0 ?400 b.
Phone number qo-7 b yb 87ao Fax number 5.
Surety a.
Name and address b.
Phone number Fax number c.
Amount of bond 6.
Lender a.
Name and address b.
Phone number Fax number 7.
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 713.13(1)(a)7., Florida Statutes: a.
Name and address b.
Phone number Fax number 8.
In addition to himself or herself, Owner designates of 713.
13(1)(b), Florida Statutes. to
receive a copy of the Lienor's Notice as provided in Section a.
Phone number Fax number 9.
Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different date
is specified) / C
Signature
of Owner Sworn
to (or affirmed and subscribed before me this day of J-,ey r , 20 03 by CERTIFIED
COPY Personally
Known OR Produced Identification MARYANNE MORSE Type
of Identification Produced CLERK OF CIRCUIT COURT, SEMINOLE
COUNTY, FLORIDA YP
Melissa
Dunklin f -- ot '
uB` ;Commission ADD 163723 DU-11Ty oi. Signature
of Notary Public, State F a =* •; Expires: Dee 20, 2005 PSEP
1 2 BondedNEPAREDB0 'Atlantic BondinnggCo.,CInc. NAMEv& ADDR100 ®
li.