HomeMy WebLinkAbout1481 WP Ball Blvde CITY OF SANFORD PERMIT APPLICATION
Application #: ^ ` YryAI �/� / Submittal Date: _
Job Address: 1 "I fin% , P. 12A LL Sbkx to �`'1. 3a 77 ( Value of Work: $
Parcel ID:
Zoning:
-), 7 -v 7
15-,000
Historic District:
Description of Work: r%e J f cc\ /<��tvl tri Square Footage: I/, oo a1 .
•Permit Type: Building ❑ • • • • • Electrical •C�' 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
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential ❑ Commercial &'� Industrial ❑
# of Gas Lines
Plumbing Repair — Residential ❑ Commercial ❑
Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
•P ...................................................... �Yyr?ar /A/�Q-�� C- ��Ei )C.•
roperty OwnerContractor:+' i Zt-.1r.
Address: (-IR 13 A L -L Address:
S�P�P rl X27?�
Phone:
Bonding Company:
Address:
Architect/Engineer:
Address: P C',
E-mail:
Plan Review Contact Person:
Phone: State License Number:
Mortgage Lender:
Address:
d 11 e�./ l✓LG//Q
377
Phone: Fax:
Phone: 72 7- W - 93.7
Fax: 7.27 -726 - 2070
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. 1 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 taws 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 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 requir ents of Flon ien Law, FS 713.
?-207
Signature of Owner/Agent Date Signature of(`ontractor/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _
_ Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 07.07
Personally Known to Me or
UTIL
Print ntractor/Agent's N °// /
Signature of Notary- ,F1q?id�y
2°. o#OC)507298 0 ZZ
Contractor/Agent is j 'ITy Rntrif to
Produced ID
FD: ENG: BLDG:
r3,C0.&0
MASTER ELECTRIC, INC
300 RYDER LANE, SUITE 1024
CASSELBERRY, FL. 32707
Phone (407) 788-3222
Fax (407) 788-9577
To: City of Sanford — Building Dept.
Re: Permitting Authorization
We hereby authorize Steve Pardo to pickup the electrical permit on our
behalf, upon notarized copy of this letter, for the construction project at 1481 WP Ball
Blvd. for the following licensed contractor Master Electric, Inc.
License # EC -13002131.
State of Florida
County of .
The foregoing instrument was acknowledged before me this day
of , 2007 by U 8EfL7--_ LJ Ar'ZilmfyJ , who is personally known to
me or has produced 'D2y s t- r- &N5 E , as identification and who did/did
not take an oath.
(Notary Public Signature)
My Commission Expires: O 02l � �/:
iiiffl
ic State of Floridarbert McIntoshsion D063985611312011