HomeMy WebLinkAbout1308 W 8 St (3)r,
CITY OF SANFORD PERMIT APPLICATION
Submittal Date: li /72_/0-7
Value of Work: $ 0.C) , 0 0
Application #: J !1
Job Address: 3 0 ti W • i S -t Ell,
Parcel ID:
Zoning:
Historic District:
Description of Work: n e- 4, a (d hx.! Square Footage:
........................................................................................................................
Permit Type: Building Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑
Electrical: New Service — # of AMPS Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑
Mechanical: Residential ❑ Non -Residential O 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 ❑ Commercial ❑
Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑ Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
.........................................................................................•..............................
Property Owner: e5 a FL bat ft 4 k -j klicv Contractor: _J. {'bl
Address: ( d ? (� t 5 C f C. t 1M P4o . EL. Address: 2.o. 1),5x-L.Zr
Phone: 1 K �~ �2 �' S�9 fC E-mail: Phone: "�" 3 30-7101 State License Number: G[3C 1251 &8
Bonding Company:
Address:
Architect/Engineer:
Address:
Plan Review Contact Person:
Mortgage Lender
Address:
Phone: Fax:
Phone:
Fax:
E-mail:
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.
Acceptance of permit is verification that I will notify the owner of the property of the requirements of Floridan Lien Law, FS 713.
Signature of Owner/Agent Date Signature of Contractor/Agent Date
i ! TI � ' G . 1. �`I �s AA
Print Owner/Agent's Name 4Princontractor/Agent's azne\\
C / i
Signature of Notary -State of Florida Date re of o -State of Florida a
C3 T hr
Owner/Agent is _ Personally Known to Me or Contractor/Agen is _Personally Known\\\\\\\
Produced ID _Producedl �/ i«1►i�+'t`�\\�
APPROVALS: ZONING:
Special Conditions:
Rev 02/2007
UTI L: FD:
ENG: BLDG:
TAIWO MANAGEMENT SERVICES, LLC
General Contractor (CGC 1508489)
253 Hayden Road, #112
Tallahassee, FL 32304
Tel: (904) 200-2582
Fax: (813) 243-3232
February 20, 2007
Planning & Development Director
Bldg. Permit Division
300 N. Park Avenue
Sanford, FL 32771
Attn: Mr. Russel Gibson
Dear Sir:
I wish to assign Permit # 06 — 2654, for a generator project located at 700 W. 13th Street, Sanford, FL, to
SOUTHERN ELECTRIC OF TAMPA, INC., whose Qualifier Is Richard Jones.
The project entails installing a back-up diesel powered generator at a T -Mobile cell phone tower.
Thank you.
Sincerely,
Derrick Sm'
Manager / Owner
STATE OF PM*_
COUNTY OF m1y
I HEREBY CERTIFY that the foregoing instrument was acknowledged before me this day of�
200x, by DO gLfl G1 L SNS ( who is personally known to me or who has produced
111 S S3D — T-7 3 - S;l — 1-711 - D as .identification.
Public
_Dca s T. `/D>A'rJ c_
Print, type or Stamp Name of Notary
DORIS T YOUNG
MY COMMISSION # DD639508
•",fit,a�; EXPIRES February 12, 2011
(40�)388.Ot53 Flondallota Service.com