HomeMy WebLinkAbout3050 Carrier Ave (2)' p CITY OF SANFORD PERMIT APPLICATION - '�i. �,; :� •'
Permit # - �lD -[ (P Date• SJ !.14 Z Co, ZAO co a r,
Job Address: 3 O S p (2�-r rf PT ArE 3X,-, f!�r C( FL
Description of Work: guoxck rAccr t - E lec-fri cco Ccnomt_ c-�%
Historic District: Zoning: Value of Work: S C D
Permit Type: Building Electrical X Mechanical Plumbing Fire Sprinlder/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration e of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair -Residential or Commercial
Occupancy Type: Residential Commercial --_ Industrial Total Square'Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA torm required for other than X)
Parcel #: (Attach Proof of Ownership & Legal Description)
Owners Name & Address: t- 4" ej4r (5 r Por&:h crv\-- ?.ZS* f3rexe Dot! I,e-yaAA
P, r m Rzd.5 e- , /tJ 3 0 -4 C. SG _ Phone: e+
Contractor Name & Address: Hra4w F (I S- C. J.✓ �- • too *.as k Nr) (oR'v J tT 1 iv- 100
Lo -,V— 44, F E. 3 Z } ` 5P State License Number. 're dOC
Phone &Fax �}- �3 �$a - w. �- 8 •9S�-? Contact Person: CLA n -% F4?JL" f' /Z. Phone: 3 3 -S? ,Z
Bonding Company:
Address:
Mortgage Lender:
Address: �1
Arcbitect/Engineer: re e.j b,.^ a r-rat.j Ar .L .,f ec7f u re Phone:
Address: Z4 S -DOi cUd--% A;rL 0 �orK Cr3� r., 229, 08 fa } 3 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: 1 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 ma t districts, state agencies, or federal agencies.
Acceptance of permit is verification that 1 will notify the owner of the property of the requirements o Lien
Signature of Owner/Agent Date Si ature ofconKtplkAgWt J Date
Print Owner/Agent's Name Print Contradtod �Nmme
? Z -d G
Signature of Notary -State of Florida Date Signature of N tate of Florida tea+ Date
+I_ � Mary Vondermarwitz
Owner/Agent is _ Personally Known to Me or Contractor/Agent is V Personally ntto7vr June 03' 2000
Produced ID _ Produced ID
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Special Conditions:
Zoning:
(Initial & Date)
Utilities:
FD:
(Initial & Date) (Initial & Date)
POWER OF ATTORNEY
Date:
-Ot-� )aPj(-
I hereby name and appoint
of 'VA c% -t–M EAa4-f'rc, to be my lawful attorney
in fact to act for me and apply to the
Building Department for aAi 2�n'Ca-1 (Gua.J'd permit
for work to be performed at a location described as:
Section Township Range Lot Block
Subdivision
30 Sa C&rr
(Address of Job
'L
C�rr,�ra l?�A- - =s Br-fe
(Owner of Property and Address)
and to sign my name and do all things necessary to this appointment.
I
r
-PlN
The foregoing instrument was acknowledged before me this —�7 day 6 20 0 6
by W, -Is" /-
who is personally known to me/who produced
as identification and who did not take oath.
State of Florida
County of le
Notary Public, r ge ounty, Flori
fty VaioKMV is
V Expkm JUM 00.2000
Seal