HomeMy WebLinkAbout144 Kelly DrCITY OF:SANFORD PLUMBING PERMIT APPLICATION
Permit Number. lam/ L'—_7Z7 Date: -4eaztb,OZ,
The undersigned hereby applies for a permit to install the following plumbing:
Owner's Name: GKflQ.I.t.lE Qw c.sT
oNRAE B;1a oW Sv:3 .
Address of Job: tan- V_4ELLy Q lC R SA p3'Z'1 3
Plumbing Contractor MtC.ba:-qff1.5
Residential: Non -Residential:
Number Amount
Addition, Alteration Repair residential & Non -Residential
New Residential:
One Water Closet
Additional Water Closet
Commercial: Minimum Permit Fee $25.00
Fixtures, Floor Drain, Trap
Sewer Piping
Water Piping
Gas Piping
Manufactured Building
Description of Work:
To %_W_S Ne w
Application Fee: 10.00
TOTAL DUE:
By Signing this application 1 am stating that I am in compliance with City of Sanford P. mbing Code.
Applicant's Signature
Rq ont 142"Z .
State License Number