HomeMy WebLinkAboutCelery Estatesi "
1
t' CITY OF SANFORD PERMIT APPLICATION
Permit#: 0—T- 5 _ /' , Daft: /I - a.I-06
Job Address
Description of Work eV Cfy' r&.P l irv, eiah A ' OK,attic,Ce 44P Square Footage
Historic District: nr2 Zoning: Value of Work: S OhO
Permit Type: Building Electrical Mechanical Plumbing Fite Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS a 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/Now Residential: # of Water Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial Industrial
Construction Type: 0 of Stories: # of Dwelling Unite Flood Zone TEMA form required)
Beading Compaur
Addrew..
Mortgage Lender.
Address:
Pbone:
Address Fax:
Application is baeby 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
bwai ce of a permit and that all work will be pe fo med to meet standards of all laws regulating construction in this jurisdiction. I understand di t a separate
permit must be setaaal for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, and
AIR CONDITIONERS, eta
OWNER'S AFFIDAVff l catify drat all of the foregoing information is acc uate and dud all work will be done in compliance with all applicable laws regulating
l , Ilion sod mning. WARNING TO OWNER YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR SeROVEMENTS 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 require. kits of this permit, there may additional astricuorts applicable to this property that may be found in the public records of
this count), and Thee may be additional permits required from other governmental entities such as water numaganent districtr, slate agnmes, or federal agencies
Aeoeptamoe of permit is verification that I Will aotify the owner of the property of the of;FlorLidaUen Law, FS 713.
7
Stuatrae ofOwnedAgent Date Sigrmadrre o/Agent Date
I V'1 Gfit .'lyw-c 4'
Print Owns/Agent's Name Print ContraetodAgent' Name
Skndm of Notay-State of Florida Date Signahue W111614YOUM of Florida Date
Owna/Agent is _ personally Known to Me or
Produced ID
ContractodAgent is i Personally Known to Me or
Produced ID
APPROVALS: TONING: UTIL FD ENO: BLDG.-
Special Conditions:
Rev 03/2M
eyN Carolyn J Merritt
My COMnlission DD370586
Goo Expires,ianuaryW 2009
j o•
r• 1 O TLMAr, POWER
OF ATTORNEY Date:
November 28.2006 I
hereby name an appoint Kimberly Kmett Of
Optimal Elec to be my lawful attorney In
fact to act for me and apply to the City of Sanford Bldg Dept for an electrical permit For
work to be performed at a location described as: Section
Township Range Lot _ Block Subdivision
Celery Estates irrigation and front entrance 1o5 6auAe-& Celery
Land LLC 101 Southhall Lane Ste. 200 Maitland FL Owner
of Property and Address) And
sign my name and do all things necessary to this appointment. Floyd
D Smothers EC0002772 Type
or Print name of Register of Certified Contractor and Contractor's Lice_gse Number or
Certified Contractor The
foregoing instrument was acknowledged before me this day of Ato U of 20 0 6 By
Who
is personally known to me/who produced As
identification and who did not take oath. State
of Florida County
of 5e til,, ; h„f Notary
PtAfic Carolyn
Merri 6'+
Carolyn
J Merrifl My
Commission DD370586 No.
w0+4
Expires
January 07 2009 4_
2499
OLD LAKE MARY ROAD, STE. 1 16, SANFORD FL 32771 PH: (
407) 323,0377 FAX: (407) 323-3766 EMAIL: optimalhtgandair@bellsouth.net EC0002772
CAC043970
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