HomeMy WebLinkAbout3425 Whippoorwill Ct (2)CITY OF SANFORD PERMIT APPLICATION
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lPermit # al_r(Pc Date:
JobAddresshipbi�� ile
Description of Work: I Jo 6167 L 041d
nn )
Historic District: Zoning:
� 1
Value of Work: $�{ .
Permit Type: Building Electrical
Mechanical umbing V Fire Sprinkler/Alarm Pool
Electrical New Service — # of AMPS
Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential
Replacement New (Duct Layout & Energy Cale. 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 V Commercial
Industrial Total Square Footage:
Construc(tii"o'n� Type:# of Stories:
# of Dwelling Units: Flood Zone: (FEMA form required for other than X)
�J 1 /�� " 31 "" 6r+'^2- 0 0
Parcel #:
(Attach Ownership & I egal Description)
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Owners Name & Address: - It lam/ QJ O
I0— C[CIO yProof
foof
L/" -� 1' I J � ZT W tt � V oc��"` U C1-,
Name & Ad
Phone & Fax: v 0
Bonding Company:
Address:
Mortgage Lender: .
Address:
Architect/Engineer
Address
State License
�Number: V-41 /
"7 Contact Person: S1teIli% /f-L^I
/— Phone:
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.
?2,S 4
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 r is Florida Lien Law, 713.
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Signature of Owner/Agent Date Signature ontractor/Ag' t Date
qau_�b�s jq ol
Print Owner/Agents Name Print Contractor/Agent's Name I
Signature of Notary -State of Florida Date Signature of Notary -State of Florida
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg: Zoning:
(Initial k, Date)
Special Conditions:
V
Date
Contractor/Agent is,__ Personally I�Voown,to Mer
Produced ID M 1 j.� �, s /IV— ®--VN--- 6
Utilities: FD:
(initial & Date) (Initial & Date) (initial & Date)
% AS o0
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546 South Shell Road
DeBary, Florida 32773
(407) 644-1432
(407) 330-7196
Fax (407) 668-8577
POWER OF ATTORNEY
Date l' 19] 0-7
I hereby name and appoint h! , Q.L� b(-& Discount Propane, Inc.
to be my lawful Attorney in fact to act for me and apply to the CL4�fr
sem`+)' /d Building Department for a C Q.�
permit for work to be performed and to sign My name and do all things
necessary to this appointment.
104-n 0. Al LA
Name of Certified Contractor.
Signature of Certified Contractor
The foregoing instrument was acknowledged before me this
By��l� HOLM Lu-) who ipersonallly�kn to me/who propduced
as identification and who did not take an oath.
STATE OF FLORIDA, COUNTY OF VOLUSIA
7'7
and Suzsbed befo e me this
Notary Pu ice -11$a
• e o •
Commissi n�e,�ssioN� . �..��j
® • G� 'tom ° • 7
�
•° �� •
® + e April 1, 2008 N , ®
® ° a '0
®U�;A �• #DD289022 �o •pq
ed TtrN £h ° OQ
I�yp e ence
day of 20 V� .
TANK IS NOT IN EASEMENT, AND 20
FT FROM SPA HEATER
20 FT 1/2" COPPER
RICHARD BURNS
3425 WHIPPOORWHILL CT.
SANFORD, FL 32773
DISCOUNT PROPANE, INC
546 S. SHELL RD
DEBARY, FL 32713
(386) 668-0111
LICENSE #04172
120 AG
PROPANE
TANK
REG
SPA HEATER
400,000 BTU
400,000 BTU SPA HEATER
120 AG PROPANE TANK
DELIVERY PRESSURE- 11 INCHES
10# GOES TO 11"
3/4 Hard pipe � ��
2 foot
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Y•SURVEY- FOR: Waterford Quality Homes
_OT 10, WHIPPOORWILL. ACCORDING TO THE PLAT THEREOF AS RECORDED IN PLAT BOOK 40,
SAGE 60 OF THE PUBLIC RECORDS OF SEMINOLE COUNTY, FLORIDA.
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,tfEETS OC EX CEE�s T.yE.eE4v/.eE.�E,vTs
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DATE OF:
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BOUNDARY: /1.11 -
FOUND.: Z-17-
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FINAL: 6-28-
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FOiE'M BOATED SU,eYEY
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