HomeMy WebLinkAbout712 W Lake Mary BlvdV
4• _
CITY OF SANFORD ELECTRICAL PERMIT APPLICATION
Permit Number: 3 4-7 Date:
The undersigned hereby appliesJfor a permit to install the following electrical:
Owners Name: TGC v' CaV
Address of Job: La)62--, KV A::, lJC3
Electrical Contractor.
Residential: Non -Residential: _ W
By Signing this application I am stating that I am in compliance with City of Sanford Electrical Code.
App icant's Signature
State License Number
I hurby name and appomt K.I &h /0/ -v 9 0"On
Of N In e le o ,, —7pC . to be my hrwN Womey in tact to act
for me and apply to be pmfozmed at a location descrUnd as: Section Township
Range Lot. Block
ADMUS OF JOB)
OWNER OF PROPERTY AMID ADDRESS)
and to sign my name and do all things necessary to this appvia t
Aclmowledl
Sworn wand subscnbed before me this Day of Iga A.D. 200
N?
Notary Pub ' of Florida
SEA - Minerva Soto
MYCOMMISSIONI CC93021 EXPI&INMEX
May 15, 2004
BONDED TNRUTROY INN INSURANCE INC My
Commission Expires: o
it es