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HomeMy WebLinkAbout2411 S Oak AveCITY OF SANFORD PERMIT APPLICATION Appikation # : l10 `0� k3 Submittal Date: �..l�Y �.. Job Address: C X41 6 1 n r, Value of Work: $ CA Parcel ID: i Zoning: Historic District: i �U De crip� o WorAk:fiz.�yC- (� � "IZ'� r1G � �J �1 l4 •��' • U d•C©=S Square Footage: ...................................................................................................................... Permit Type: Building ❑ Electrical Mechanical ❑ Plumbing ❑ Fire Sprinkler/Alarm ❑ Pool ❑ Sign ❑ Electrical: New Service - # of AMPS 'w,- 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 Plumbing Repair -Residential ❑ Commercial ❑ Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑ Occupancy Use Group(s): Construction Type: # of,Stories: # of Dwelling Units: Flood Zone: (FEMA form required) .................. ........... ....................... ................. Property Owner: ` V Contracto'0 0LILb 06 dress: ST:ai PNo e: t)9S'l1095 E-mail: PhoV 8 S"'IM53tate License Number: 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. 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. 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. p ance of permit is verification that I will notify the owner of the propert , of the ie uirements of Florida Lien Law, FS 713. C) Sipaatre of Ownerer/Agent n Date SigrpNe of. Contractor/Agent �-� Date Agent' Owner/Agent is ✓ Personally Known t� oMe or Produced ID APPROVALS: ZONING: Special Conditions: Rev 07.07 Name .-) •(o-07-7 . ANGELA VERMILLION MY COMMISSION # DD 660881 EXPIRES: April 9, 2011 Bonded Thru Notary Public Und" ita" Contractor/Agent is V/ Produced ID UTIL: FD: ENG: IFUJ 71•(D•v-1 Florida at - a ,,...� "` ` • " ems iJ'rt ANGELA VERMILLION MY COMMISSION # DD 660881 BondedXfiruRNotary Public Underwriters sonalty nown• to Me or BLDG: r— ACk 2 6 9 9'5 9 4 STATE OF FLORJDA DEPARTMENT OF•;',BUSINESSD PRQFESSIONAL REGULATION ELECTRICAL 'CONTRACTORS LICENSING'BOARD SEQ#Lo6o6osoo6i3;6 LICENSE.NBR 08 05 2'006 0.50812334 ;EC0001882: The :EL.ECTRICAL CONTRACTOR Named 'b-elow IS CERTIFIED Under the provisions of Chapter 489 FS. Expiration .date: AUG 31, 2008 DEESE, RICHARD JASON - SOUTHEAST ELECTRIC OF CENTRAL FLORIDA, INC. 2012 CURRY FORD RD ORLANDO FL 32806 JEB BUSH SIMONE MARSTILLER GOVERNOR _... .... SECRETARY AC# 269959'1 4 STATE OF FLORIDA ➢DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION EC0001882 08/05/06 050812334 CERTIFIED ELECTRICAL CONTRACTOR DEESE, RICHARD JASON SOUTHEAST ELECTRIC OF CENTRAL FLO IS CERTIFIED under the provioiono of ch.489 FS. Sxpiratioa date. AUG 31, 2008 L06080500686 Earl K. Wood, Tax Collector Occupational License Orange County, Florida lawful This license is inaddition to and not in lieu of any other license required by law or municipal ordinance. It is subject to regulation of zoning, health and any other authority. It is valid from October 1 through September 30 of license year. Delinquent penalty is added October 1. "'ORIGINAL"' 2006 EXPIRES 9/30/2007 1802.0962260 1802 CERT ELECTRICAL CONTR $30.00 1 EMPLOYEE. 1 5000 BUSINESS OFFICE $50.00 60 EMPLOYEES! SOUTFIGA5T ELECTRIC OF CENTRAL TOTAL TAX $80.00 FUVINC• PREVIOUSLY PAID $80.00 DEESE,,RICHARDJ QUALIFIER TOTAL DUE $0.00 p 08 0X 530103 , .,ORLANDO FLi3?853-0103 2012 CURRY FORD RD :.:"QEESE RICHARD J QUALIFIER U - ORLANDO, 32806 PAID: $80.00 99.306125 8/8/2006 This form becomes a receipt when validated by the Tax Collector. POWER OF ATTORNEY Date: I hereby name and appointW Of ��� �LJ to be my lawful attorney In fact to act for me and apply to the WO)dJ 1 Building Department for a ol) For work to be performed at a location described as-- Sect-Ion s=Section Township Range Lot Subdivision c) 1 1 0(Q X) J XJj permit (Owner of Property and Address) and to sign my name and do all things necessary to this appointment_ Type or Print Name of Register or ctor and Eontractor's License Number. Signature ofRegister or CettiGed Contactor f , The foregoing instrument was acknowledged before me this g day of of 20 Byi�/ Who is personally latown-.to mc/who, produced As identification and who did not take oath. State of Florida C04ty of&0x:r'e' Orange(�unty, rida ANGELA VERMIWON € MY t,OMMISSION # DD 660681 EXPIRES: April 9, 2011 ionded i'hru Notary Public Underwriters Seal