HomeMy WebLinkAbout308 N Entrance Rdsex o ; 0 x o
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Permit#: 01. 31
Job Address: 30' 8— Al fiVT,
Description of Work;
CITY OF SANFORD PERMIT APPLICATION
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Historic District: Zoning: Value of Work: S
S4A,-'
Date: / / .2 - o- G
SA4i TS
Permit Type: Building Electrical Mechanical Plumbing Fire Spdnldcr/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechaniak Residential Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbbag/New Residential: # of Water Closets Plumbing Repair— Residential or Commercial
Occupancy Type: Residential Commercial Industrial Total Square Footage:
Construction Type: # of Stories. # of DwdUng Units: Flood Zone: (FEMA Corm required for other than X)
Pared #; (Attach Proof of Ownership & Legal Description)
Owners Name & Address: 0'4FW 1A t 0,. < TO Nc C'ciyTw. /"hO /3 70 3 3
AAO/,4 ^I A "?"Ai S 1 N y6 Phone: _ice/ 7 3 '$ o 'i'4
contractor Name & Address: 44c .4 s ave TF.0T- 4- X vravTs / /.gr3 OCOC a
State Lien= Number.
Phone & Fa= Contact Person: Phone:
Bondhig Cosapany:
Address:
Mortgage Leads:
ArcbiteeHEogiocer: Phone:
Address: For
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify tint 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 ju isdjction. 1 understand that a separate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WEDS, POOLS, FURNACES, BOHIMS, HEATERS, TANKS, and
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: I certify that all of the foregoing information is accurate and that all won adll be done in compliance with all applicable laws regulating
construction and toning. WARNING TO OWNER YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR 1I4PROVEMENTS 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 permik 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 rich as water management districts, state agencies, or federal agencies.
Acceptance of permit is verifiatica that I will notify the owner of the property of the requ' eats o londa Lien Law, FS 13.
Signature of OwnedApau Date Sigrcadae of " CopfiactodAgent, Date
lelAv
01
Print OwnedAgeaes Name tractod Ps Name
Signature of Notary Swe of Florida Date Signature of Notary -State of Florida Date
Owne dAgent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg:
Initial & Date)
Special Conditions:
D -B I E BLA1 p&
551 # DD 1aWj
00.31.6MXARy FL Nowt' DisaourM A sm Co. Utilities:
Initial &
Date) (Initial & Date) (Initial & Date)
11/01/2006 18:34 4072081365 CENTRA CARE PAGE 02/03
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3977 November 1,
2006 To Whom
It May Concern: Nelson's
Tents and Events lus the permission of Florida Hospital Centre Care toerectatentonthepropertylocatedat308N. Entrance Road, Sanford, FL32711. Restroom facilities are provided on. site. This tent
approval is granted for the following date: Thursday. November 9, 2006.
For any
questions or concerns, please contact Scott C. Brady, MD at 401)3404246.
Best Regards,
Scott C.
Brady, MD Adminisu-mor
and Sr. Medical
Director wwv My
Commission
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