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HomeMy WebLinkAbout118 Palmetto Ave (2)CITY OF SANFORD PERMIT APPLICATION Application #: 0 7— �QQJ 7 (G Submittal Date: Ott,t) [[,, . 0:1 Job Address: Value of Work: Parcel ID: Zoning: Historic District: Description of Work: .��tl;!/�.�y /0 6l% / Square Footage: ......................................................... ........................................ I...................... Permit Type: Building ❑ Electrical ❑ Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑ Electrical: New Service — # of AMPS Addition/Alteration ❑ Change of Service ❑ Temporary Pole ❑ Mechanical: Residential ❑ Non -Residential ❑ Replacement ❑ New ❑ (Duct Layout & Energy Calc. Required) Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines Plumbing/New Residential: # of Water Closets Occupancy Type: Residential ❑ Commercial Industrial ❑ Plumbing Repair —Residential ❑ Commercial ❑ Occupancy Use Group(s): Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required ) ................................,.//........................................................................................ Property Owner: �e �� A,,,e[- Contractor: Address: VA Address: Phone: E-mail: Bonding Company: Address: Arch itect/Engineer: Address: Plan Review Contact Person: Phone: State License Number: Mortgage Lender: Address: Phone: Fax: Phone: Fax: E-mail: 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 will notify the owner of the property of the requirements of Flori o� 1pn La> -_F -$,q13 A Signature of Owner/Agent Date Signature of Contractor/Agent Date Print Owner/Agent's Name Signature of Notary -State of Florida Date Owner/Agent is _ _ Produced ID Personally Known to Me or (P APPROVALS: ZONING: UTIL: Special Conditions: Rev 02/2007 Print Contractor/Agent's Nam \\A�� ® NN �%///.�(,� Sigr ureol'Notary-Sfate ,' \6, 2p� Date .�� O B n �� > c @ 2� C:) = L 0 j . Contractor/Agent is _ Pere.o�r . _ Produced ID // % G NN FD: ENG: BLDG: CITY OF SANFORD FIRE DEPARTMENT FEES FOR SERVICES PHONE # 407-302-2516 • FAX # 407-302-2526 DATE: Ob n &, 0-1- PERMIT #: BUSINESS NAME / PROJECT:-)b(A ) At EARS LA-nik"r [ P)U L ADDRESS:_, I A Imetto Aj E PHONE NO.: �Q7 ,`3, Z(- FAX NO.: CONST. INSP. [ J C / O INSP.:[ I REINSPECTION (] PLANS REVIEW [ j F. A. [ ] F. S. [ ] HOOD [ ] PAINT BOOTH [) BURN PERMIT [ j TENT PERMIT j TANK PERMIT [ ] OTHER [ j TOTAL FEES: $ -5©,r—> C2 (PER UNIT SEE BELOW) COMMENTS:_ U 12 rjn? ()(0, 07. © "1 10u),1 0 Address / Bldg. # / Unit # Square Footage Fees per Bldg. / Unit 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. Fees must be paid to Sanford Building Department, 300 N. Park Ave., Sanford, Fl. 32771 Phone # -407- 330-5656. Proof of Payment must be made to Fire Prevention division before any further services can take place. I certify that the above is true and correct and that will comply with all applicable codes and ordinances of the City of Sanford, Florida. Sanford Fire Prevention Division Applicant's Signature ISSUED B7 3` paw of �9anutacture APPUCATflEGISTEHION- ED.o ANCHOR- INDUSTRIES IN '�-,1 943682 4/14/92 NUMBER EVANsvaLe, INDIANA 47Tt t _ _' ` 8141300 , 8141200 r}� slkiloo iyC4Zr''W, FQ31. Q2 DAKACTtJRERS OF THE FMIS1tED , TENT PRODUCTS nESCRIBED HEREIN This is to certify that the materials described have been flame=retardant treated (or are inherentlyno�n�nte Spt�ta� vent Services ---plied to: NAME: PL oRLANno STATE CITY Certification is hereby made that: The articles described on this Certificate have been treated with a chemical and that the application of said chemical was done in co Fire Marshall Code, equal tour Nx ds NFPA 701, CPAI 84 20V82' Method of application dant approved with California Fnw 1 AB #6360 Tyrie, color and weight of canvaslvlrryl: 15 0z . VTMM LAN== 7 WHITS .; jr;.] F. - :r, , Daacrtptlon of Item certified, (1) 6a S � 4Q. CENTURY TENTr. Flame Retardant Process Used Will Not -6 Removed By Washing And is Effective For The L'f The Fabric { Duucm slgrto �v'�. NaBRM raa o/ Applicator of ame Raslataat n h iE ` D A � R. � RA9MA, on q 111 PON