HomeMy WebLinkAbout1002 S French AvePermit #: L?(p - 3 S
Job Address: \c) O a. S • t— 4eT
Description of Work: 6 w4iqe 6J
Historic District: 00 Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date:
Value of Work:
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06- OeSce4 W
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Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool _
Electrical: New Service — # of AMPS ca Addition/Alteration Change of Service Temporary Pole _
Mechanical: Residential on-Residen-tia,
n
e lacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures NI # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets N (A_ Plumbing Repair — Residential or Commercial _
Occupancy Type: Residential ommercial Industrial
Construction Type: —A-- # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
Address:
Mortgage Lender: N
Address:
Architect/Engineer: Phone:
Address: 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.
Acceptance of permit is verification that I not the owner of the property of the requirements of Florid ien La1 .
Signature of Owner/Agent Da a !/!! Signature of Contractor/Agent Date
Tko„nots T N Xa 7-o s T. ` xo
P int Owner/Agent',i Name Prin Contrac or/Agent's Name
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i arSignareofNotary -Star Flori a Date Si re of Notary -State o ru a, ley ('.0 ,MISSft DD &10
Nr, or EXRRES: March 23, 2006FnfF Opp Bonded Thru Budget Notary sar ft,
Owner/Agent is lc Personally Known to•vle ol,,, ST'LP: IANIE JOYCE Contractor/Agent is _ Peronally ovtn t e Produced
ID , "rAr a,''•,, Comm# DD0478928 Produced ID Y J /' U " ( b LJ Expires
10/5/2009 Fore-.
P' Bonded thru (800)432.4254: APPROVALS:
ZONING: UTILy " ^ 1 Flon DNota...... Ine ENG: BLDG: Special
Conditions:
LIMITED POWER OF ATTORNEY
I, Thomas T. Nixon, holding the certified Class A Air Conditioning
Contractor license # CACO29393 do hereby grant Limited Power of Attorney
to to pull permits within the municipality of
Thomas T. Nixon. Presi nt
DATE: \—a
STATE OF FLORIDA
COUNTY OF ORANGE
SIGNED, SEALED AND DELIVERED IN THE PRESENCE OF:
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My Commission Expires:
VIE JOYC
C :.::r.# OD0478926
s 10/5/2009
L.,r, ^_d ;'ru (800)432-4254:
3................. F-:urids Notary Assn., Inc '
C:\Documents and Settings\kathryn.bumworth\Local Settings\TemporaryIntemet Fi1es\0LK5\jmpowerofattomey.doc