HomeMy WebLinkAbout1501 E Airport BlvdSep 11 05 12:21p MORRN ENVIRONMENTAL 904-241-4732 p.1
08/30/2005 17:05 4078330012 t�59 lbiJ rwnr- Ui
CITY OP.SANPORD PEP -M" APPLiCATiOPi
Permit # LA \S Date:
Job Addreu: JhA
r It
Description of Work:
Historic District: ?.ening: Value of Work: S
Permit Type: Building Electrical _ Mcclunicai Plumbing Fire Sprinkler/Alarm Pool
Electrical; Now. Service - f/ of AMPS Addition/Alteration Cbaoge of 3rrvice Temporary Polo �a—
Meduniml: Residontial Non -Residential Replacement Now (Duct Layout & Energy Cale. Required)
Plumbing/ New Commerdal; If of Fixtures a of Water & Sewer Litief. 0 of Gus Linea
Plumbing/Ncw Residential: if of Water Closets Plumbing Repair - Residential or Cortnnercial
Ortorpancy Type: Residential Commercial Indusuial Total Square Footage:
Constynetiou 'Type: k of Stork&, q of Dwelling Units: Flood Zone:' (FEMA form required for other thea X)
p,cet a:11�
Owners Name & Addreu:
_(AltachProornrOvrneraMp&Legal Dererlplloci)
Phone:
Contractor Name & Address
State Licepee taxi er: _ F-C-n,X'
Contoci vennn: Phone:
Boadlag Company:
Addrew:
Mortgage Leoder:
Address:
ArchltecUEaglseer: `
Address:
7
Phone:
Fax:
Applicalion is hetebynudo ro obtain s pert To do the work and installations as indicated. I certify that no work or installation has commerwed prior to The
issumice ora permit and that all wock will be perfonned to meet standards ofall laws regulariog cons(ruction in this jurisdictloa. I understand that a separate
permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS; TANKS, add
AIR CONDITIONERS, etc.
OWNER'S AFFIDAVIT: I certify that 411 of the foregoing inronrtation is ■ curate and that all work will be done In compliance with all applicable laws ngulalittg
umstruction and zoning, WARNINGTO OWNER: YOUR FAILURE TO RWORD A NOTICE OF CMIMENCEMENT MAY RESULT IN YOUR PAYNG
TW1C£ FOR IMPROVFWNTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINAIiCENG, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NQTICE: In additlon lothe re:quiremarla oft his petmil, thm maybe additlenal reatrietions applicable to this property 11151 may be found in 1h public records of
this eeunty, and there may be additlonol permits required from other govemmental entifies such as wsler management districts, stale agencies, or fedenliapenaica.
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eprance of permit is verification that t will notify the owner of the property of the roquiremwts o orlda L" n L , FS 7
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o Signature ofOwner/Agent Date Si stye o ontr t Data
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Print Owner/Agent's Na Print Con ctor/Agen 's N e
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vo Signature of eery a of F r Dole Sipxnhuc ofNataryStalo of Flori ale
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s OwncrfAgent is Personally Kn7to ContrneroifA6ent ia� Personally Known b Me or
£ _ ProducedID _ Produced
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APPLICATION APPROVED BY: B1dv Zoning Ulilitira FD
(Irulul &Daae) (Initial k. Dale) (Initial & Date) (burial e& Dale)
Special Conditions �tLtt�_—Nolaty o„hl� -,-,p n1 FIRMA
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