HomeMy WebLinkAbout1301 E Seminole Blvd (6)No
f1
rmil N : f It /
b Address
ascription of Work:
istoric District:
CITY OFSANFORD PERMITAPPLICATION f11
a- IJIDY Uu rrt: Zoning:
Date:
1 —a 0— 0 6. P
7 -1 1 Total
Square Footage Value
of Work: S ag0o' 0 V rmit
Type: Building -_- Electrical Mechanical Plumbing 4 Fire Sprinkicr/Aland Pool ectrical:
New Service - N of AMPS Addilion/Alteration Change of Service 'Temporary Pole echauical:
Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required) umbing/
New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines umbing/
New Residential: N of Water Closets Plumbing Repair - Residential or Commercial cupancy
Type: Residential X Commercial Industrial mstruction
Type: N of Stories: # of Dwelling Units: Flood Zone: (FEMA form required) voers
Name &Address: 1MV 1 k Q S 0 rCe 30 •
Se ran atraclor
Name & Address: 3q
3(e S . Tel rnorc one&
Fax: 401-2gq- ading
Company: dress:
rrtgage
Lender: dress:
chileN/
F.ngiueer: dress:
For
3 1, I Phone. O-? - Y-
L 3.20*A : Slate License Nu I r: 8a3-
g191 Contact Person: Gedccaz MMr Phone:
Fax:
7?
q 6a
7a - ie
uo7-ay4 plication
is hereby made to obtain a permit to do the work and installations as indicated. I certify that no wort: or installation has commenced prior to the ranee
of a permit and that all work will be performed to meet standards of all laws regulating construction in this jurisdiction. 1 understand that a separate mit
must be seared for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS. HEATERS, TANKS, and t
CONDITIONERS, ctc. NUR'
S AFFIDAVIT: I certify drat all of the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating nstruction
and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING 1ICE
FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN TORNEY
BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. 1110E:
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 county,
and Urge may be additional permits required from other governmental entities such as water management districts, state agencies, or federal agencies. eptance
of v ion Ih 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713. f
11 5 0 fo Si
a/Agent Date Signature of C ntraclor/Agent Dat 6,
ue I ' of l to adlo o
Si
ahue f Not -:p of Fl ida JACQUELINE HAZWe Notary
Public, State of Florida Commission#
DD540104 My
COMM. expires June 18, 2010 Ownpr/
Agent is. ally Knowrn t Me or oduccd
ID —I ` t vein 1 ROVALS:
ZONING: UTTI.: FD: A
iCont
ctor/Agcnine a
o06alure ofNotary -Stale of Florida Date ANN
MARIE MORAN Notary
Public, State of Florida My
comm. expires Norc 26, 2007 82
Contractor/Agent is Personally %MM Alrhton Agency, Inc. (800)451-4854 Produced
ID ENG:
BLDG: cial
Conditions: 03/
2006 O
POWER OF ATTORNEY
Date: ): - Iq -0 6.
I hereby name and appoint
Of
In fact to act for me and apply to the
Building Department for a
Ch- rI
For work to be performed at a location described as:
SectionTownship(Cj _Range 3 I Subdivision
A -
a % to
be my lawful attorney Lot
Block, G-
1- r C 12 CCk,- .. Owner
of Property and Address) and
to sign my name d do all things necessary to this appointment. L .
fbeAec CSC 1406D-7c Type or
Print Name of Register or C fied Contractor and Contractor's License Number or Certified
Contractor The foregoing
instrument was acknowledged before me this 'Z O day of Decew.)c)
pr of 20 O By '"Je e 6.4 v dsz f knownto
me o proG Who is personallyk/ who ZMArii y atI)/1
As
identification and
who did not take oath. State of Florida
County of 9rae),
R LA Votary Public,
Ora}
OvCounty, Pforida e Ko 1
Qk—S tb(los (ZO 1 O Seal M"` • Notary
PM;
06 Of PIO da P Todd JLabuzienskiaoMyCommission
DD602514 Expires 10/05/
2010