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HomeMy WebLinkAbout300 W Lake Mary Blvd (4)Permit #: ® J— n7 3 3 b Job Address: CITY OF SANFORD PERMIT APPLICATION Date: J / V— Description of Work: Historic District: ; Permit Type: Building Electrical Electrical: New Service – # of AMPS Mechanical: Residential Non -Residential Plumbing/ New Commercial: # of Fixtures Plumbing/New Residential: # of Water Closets _ Occupancy Type: Residential Commercial Mechanical Plumbing Fire Sprinkler/Alarm Pool. – Addition/Alteration Change of Service Temporary Pole _ _ Replacement New (Duct Layout & Energy Calc. Required) # of Water & Sewer Lines # of Gas Lines Plumbing Repair – Residential or Commercial Ad IndustrialTotal Square Footage: ec4lroC Construction Type: _� # of Stories: —I— # of Dwelling Units: �_ Flood Zone: (FEMA form required for other than X) Parcel #: / 10 O -5- VS ji0 D O d S 0 (Attach Proof of Ownership & Legal Description) Owners Name & Address: _hj L&CC-t so ✓L ig 6VN'wM -c Phone: ?Olt a3 7 = 33Sb Contractor Name & Address: �y State License Number: �<:�o Phone & Fax: t(>-7 1 d 3-�� oo i Contact Person: " ,N:� �� Phone: Bonding Company: Address: Mortgage Lender: V>4vly e/ ) 1 1 /�' Qom_ Address: Architect/Engineer: Address: Phone: Fax: 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 appir.cab'.F [a -,k's 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 F a Lien aw, FS 713. Ills c.... Signature of Owner/Agent bare Si re of Contractor/Agent Date cis Tint Owner/Age is Name P t C acm/At's Name Signature of Notary -State of Florida ,, a '',. D;a1ev' liA i�ay'tore of Notary -State of Florida Vate omlaieaion # GG 853921 Expires Aug. 30, 2003 r Bonded Thr Owne A e Personally Known [o+eyiS�°°i Atlantic Bonding oCdi#fractor/A znt is Personally Known to Me or Produced ID ro uced ID APPLICATION APPROVED BY: Bide: (Initial & Date) Special Conditions: Zoning: (Initial & Date) Utilities: FD: (Initial & Date) (Initial & Date) r vL 0 DATE: �� /©—p' To Whom It May Concern: Please be advised ` � P') c. yvice�-- (Client) gives, KIRBY RENTAL SERVICE, permission to erect a tent on our property located at 3 Do (Address Please be advised, restrooms are provided. Sincerely, LS �uLtc' (Signature) 624-e a-- rf-N'9,f - Owner / Title (rela,(jonship to owner) ) ��Jj �=::7 1M�W 7fkp] r, ir ISSUED BY KIRBY TENT RENTAL Division of Kirby Rental Service & Sales 411 Hames Avenue 8711 Phillips Highway Orlando, FL 32805 Jacksonville, FL 32256 MANUFACTURERS OF THE FINISHED TENT PRODUCT DESCRIBED HEREIN DATE: 5-- !! - o7 This is to certify that the materials used in the construction of the ii-cc.f 30XYT, /Cnf- �d � � lN.ad` • C u. n �(�O PYlO , have been flame retardant treated (or are inherently non-flammable) *by the Snyder Manufacturing Company Their registered application concern number F-140-01 is approved and registered by the State Fire Marshal and the application of said chemicals was done in conformance with the laws of the State of California and the rules and regulations of the State Fire Marshal. Flame Retardancy Cannot Be Removed By Washing And Is Good For The Life Of The Material. *THEIR Fabric Meets The Requirements Of Specifications F-140-01 Listed As NFPA-701 (Large Scale) REGISTERED Signed: e APPLICATION TENT DEPARTMENT CONCERN NO.