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CITY OF SANFORD ELECTRICAL PERMIT APPLICATION
Permit Number: Date: f-- aa`-d 2-
The undersigned hereby applies for a permit to install the following electrical:
Owner's Name: K C 7- VA/KP G-roo iNc
Address of Job: 31Z /AV- A c.- e--
Electrical Contractor: l Fe- c TY< <_
Residential: A Non -Residential:
Number Amount
Addition, Alteration, Repair (Residential & Non -Residential)
New Residential:
AMP Service
New Commercial:
AMP Service
Change of Service:
From G AMP Service to boa AMP Service
Manufactured Building
Other:
Description of Work:Q,til
Z
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
fXJly R rr> State
License Number
PONVER OF ATTOM Ey
Date:
I hereby name and appoint iV t ev
of
to be my lawful attorney
in fact to act for me and apply to the
Building Department for a l,:51/
lam?
Permit
for work to be performed at a location described as:
Section Township Range Lot _ Block
Subdivision
A r - K '4ve
Address of Job)
Owner of Property and Address)
and to sign my name and do all things necessary to this appointment.
l Ta/V K
Type or
c
Name of Certified CamtractW
Sigaaawe
The foregoing instrument was acknowledged before me this 2 a Z day of o0 2
by.
who is personally known to me/who produced
as identification and who did not take oath.
State of Florida
County,of
Notary Public, Orange C ty, Florida
C.\Plans Coordination ter Focmz\Powcr of Attorney. onePage1ofl
10/22/98
Seal
EE*- MARIq P. FRANCO
MY COMMISSION I DD 032822
q EXPIRES: June 11, 2oo5
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