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Home My WebLink About1201 12 StCITY OF SANFORD PERMIT APPLICATION Application # : lI /� Job Address: l a 1-11 Parcel ID: Zoning: Submittal Date: Value of Work: $_ -fes Historic District: Description of Work: �im 0,0 t L �Z�Z7,Ur-4 1Z C— j 2 F Square Footage: ........................................................................................................................ Permit Type: Building ❑ Electrical LY..Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑ Electrical: New Service - # of AMPS -00 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 BY"' Commercial ❑ Industrial ❑ Plumbing Repair -Residential ❑ Commercial ❑ Occupancy Use Group(s): Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required ) ......................................................................................................................... Property Owner: () 1ApLiq Q t2 L4ty D 0 Contractor: M 2 L &tC72(C eF 5'Ey)l d0uA/Ty Address: Address: 6/02— CWCO-O CZ -7 DfZ -1 ' / Ao2'T ep_ y r�GE , r" -"L 32_1Z 7 Phone:3g6 _SS / -3067 E-mail: Phone: 0949 tZState License Number: CC(3 00Z q� Bonding Company: Address: Architect/Engineer: Address: Plan Review Contact Person: 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. 1 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. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN AT-FORNEY 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 grope oft equi em nts of Florida Lien Law, FS 713. Signature of Owner/Agent Date S pd ture of Contractor/Agent Date jot n/ Pe4R Si)AJ Print Owner/Agent's Name Pri ontractor/Agent's me ..,. 1 Signature of Notary -State of Florida Date Signature of Notary -State o lore\ i ' 21uary 16 Owner/Agent is Personally Known to Me or Contractor/Agent is Per, 1Kbown t'ak le or Produced ID Produced ID G'% �!} ,s APPROVALS: ZONING: UTIL: FD: ENG: /wjiilw0 Special Conditions: Rev 07.07 0 Your Query Results: 1 VOLUS IA COUNTY F L O R I D A ABOUT VOLUSIA BEACHES BUSINESS COUNTY SERVICES COUNTY COUNCIL PARKS PERSONNEL TOURISM WEATHER Page 1 of 1 VOILISia county goner nr ient Occupational License Codes Occ. Lic. Number City License $18.00 Number: 2005090134 #: 05-14119 VOL Number: 0 City Number: 9 Home Occupancy 902 CHICKADEE DR Port Orange Owner Name: PEARSONS MAINTENANCE INC Mailing 902 CHICKADEE Address: DR Owner Phone: (386) 756-2460 PORT ORANGE,FL Business MR ELECTRIC OF SEMINOLE Name: COUNTY Business (407) 898-2500 32127 Phone: Sections of Law 1 Fees Prior Year Number Total $18.00 Total State Date 301E1. ELECTRICAL CONTRACTOR of 1 Fee: $18.00 Number: EC13002977 Paid: Items Fees Prior Year $0.00 Total $18.00 Total $18.00 Date 8/18/2006 Delinquent: Due: Paid: Paid: Parcel Information I Roll Type: I 1 I Parcel Number: 1 6317 05 00 0450 I Occ. Lic. Area Code:' 3 Cell us what #v tKo Comments or questions? E-mail the web administrator Copyright © 2001 Volusia County, Florida. http://www.vcservices.vegov.org/buildzone/ContractorLicensing/OLDisp. asp 6/26/2007