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HomeMy WebLinkAbout1151 Rinehart Rd 05-2554 Fire Alarmc APR 2 Q Z00 CITY OF SANFORD PERMIT APPLICATION Permit # y - P Date: Job Address: Description of Work: ti t r`Mi - a tct g 1 cel `lZ t Historic District: Zoning: Value of Work: $ 1 @' Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm k. 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 Line Plumbing/New Residential: # of Water Closets Lines Occupancy Type: Residential Commercial Industrial Construction Type: # of Stories: # of Dwelling Units: of Gas Lines Plumbing Repair — Residential or Commercial Total Square Footage: Flood Zone: (FEMA form required for other than X) Parcel #: " 1'1 - 5 0 Q0C'C) • CX'ZC_) Attach Proof of Ownership & Legal Description) Owners Name & Address: U LQ • k el 1 —7 Z Lc i =C c. 1 J Phone Contractor Name&Address: State License Number: Phone & Fax: 4- , 7`) slq 02 1i 1 ` i ; M l Contact Person: 1=[ ,' _[`4t_t t's aPhone:1 71 /y 02T 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 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 require its of Flo ' a Lie , FS 713. cU Z/r L 6nf Signature of Owner/Agent Date A a& Con etor/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: C/ r Zoning: Initial & Date) Special Conditions: Print Contractor/Agent's Name - Signature of Contractor/Agent is _ Personally Known to Me or Produced ID Utilities: FD. 5 Initial & Date) (Initial & Date) (Initial & Date) J WIRING LEGEND SYMBOL WIRE TYPE USED ON A i PAIR #14 THHN STRANDED 1 YELLOW DATA CIRCUIT 1 BLUE 2 COND, #12 AWG SOLID THHN 120 VAC CIRCUIT 7T GROUND WIRE) PM: REF - CD R 00 m csS LO CC) e6 H