HomeMy WebLinkAbout3000 Mellonville Ave 03-1978 ElectricalCITY OF SANFORD PERMIT APPLICATION
I ermit # : Date:
Job Address: , /low
Description of Work: &0� %Q
Historic District:
Zoning: _
-43
Value of Work: S W 3�v '�Kv`o0
Permit Type: Building Electrical X MeQ ant' Ul Plumbing Fire Sprinkler/Alarm 1'ovl
Electrical: New Service — # of AMPS rr
�`/,,xC� _��,,_,7.�' TA !L�
dttlotm/Alteration _x— Change of Service '1'enmpoCary 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/Nero Residential: # of Water Closets Plumbing Repair— Residential or Commercial
Occupancy Type: Residential Commercial Industrial %C Total Square Footage: bVXr//Z4
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required tear other than X)
Parcel #:
Owners Name & Address: 7/Oi"0
S&AAP0rd �%r orT axe .2ed"6-7
Contractor Name & Address: e�171GT(>' e/PL /%"% C
Phone & Fax: Xid7-3ZZ /-�6Z
Bonding Company: __ 4✓A
k�o
(Attach Proof of Ownership & Le at Description)
Phone:
State License/umber:
Contact Pei -sou: 0)S;W Phone: — --- --
Address: J/ —
Mortgage Leader:�—
Address: �/
Architect/Engineer: _ /� 14 • Phone: ---- --
Address:
Fax:
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has corrrruenced prior to the
issuance of a permit and that all work will be perfornied to meet standards of all laws regulating construction in this jurisdiction. f understand that :t 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 r+gulating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE Oil COMMENCEMENT MAY RESULT I1,7 `/'OUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE Oh 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 1 will notify the owner of the property of the rcquiretm �� id I v, FS 7 "
Signature of Owner/Agent Date ignature r 'antra • -/Age Date
Print Owner/Agent's Name Print Contractor/Agent's Narne
Signature of Notary -State of Flo ida�---��1 0
Date Signaturo of Notary -Stale of Florida Date
Owner/Agent is _ Personally Known to Me or `/t s _ crs'onally Known to M r
_—Produced [D Contractor
�•� Produced ID
APPLICA-HON APPROVED BY: Bldg:�d"�
Coning: Utilities: FD:
(Initial t Date ) (Initial & Date) (Initial & Date) (Initial & Dare)
Special Conditions:
BARBARA HURLER
My Comm fxp: i/1705--- No. CC 990570
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