HomeMy WebLinkAbout1185 Upsala RdPermit#: 06-00002638
Job Address: 1185 Upsala Road
CITY OF SANFORD PERMIT APPLICATION
Date: 3-6-07
Description of Work:
Meter and service
panel for entry signs
Total Square Footage:
Historic District:
Zoning:
Value of Work: $
4,400.00
Permit Type: Building Electrical X Mechanical Plumbing Fire Sprinkler/Alarm Pool _
Electrical: New Service — # of AMPS 100 Addition/Alteration Change 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 form required for other than X)
Parcel #: 28.19.30.506-0000-0290 (Attach Proof of Ownership & Legal Description)
Owners Name & Address: Roberti. Maksimowicz
Phone: _
Contractor Name & Address: Quality Plus Electric, Inc. 1511 Seminola Blvd. Suite 1093
Casselberry, FL 32707 State License Number: EC0002697
Phone&Fax: 407 699-6991 699-4599 fax Contact Person: Dave Morris Phone: 407 699-6991
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Phone:
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: I 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 management districts, state agencies, or federal agencies.
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Acceptance of permit is verification that I will notify the owner of the property of the requirement F F l3.
3-6-07
Signature of Owner/Agent Date Sign re of C Agent Date
George E. Tiffany
Print Owner/Agent's Name Prt Contractor/Agent's Name
-6-07
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date
SUSAN M. HUNTER
Notary Public, Stacie of Floorrind�at
Owner/Agent is _ Personally Known to Me or Contractor/Agent is ✓ �i
Personallympoore"p• J811. 28,2M9
_ Produced ID _ Produced ID n__M 1Mn. DD 3593
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Special Conditions:
Zoning:
(Initial & Date)
Utilities:
FD:
(Initial & Date) (Initial & Date)