HomeMy WebLinkAbout1200 Wp Ball Blvd (2)Per.w"it #:
Job Address: o%l
Description of Work:
CITY OF SANFORD PERMIT APPLICATION
Date:
7 `U
141,10Historic District: Zoning: Value of Work: $ 13 coo, 666 IC2( ,
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential _1 Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures �t� # of Water & Sewer Lines # of Gas Lines qe1V1/Vs
Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential CommercialIndustrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than x)
Parcel #:
Owners Name & Address:
Contractor Name & Address:
(Attach Proof of Ownership & Legal Description)
Phone: P
State License Number.
Phone & Fax: q0`? d.1 300 ZKOg),--X)3-�03 0 Contact Person: �"6&A a U@ Phone: qb() -q Ll1 —41 ll
Bonding Company: R ( r-, '
Address: R
Mortgage Lender:
Address: w `^
Architect/Engineer: Phone:
Address: Fax: 14
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. 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
Signature of Owner/Agent
Print Owner/Agent's Name
Signature of Notary -State of Florida
Owner/Agent is _
Produced ID
Personally Known to Me or
APPLICATION APPROVED BY: Bldg:
(Initial & Date)
Special Conditions:
Date Signature o�
Print Contras
Date Sianature of
Zoning:
FS 7 �.
ay��o 5
Date
Date
Contractor/Agent is ✓Personally Known to Me or
_
Produced ID
(Initial & Date)
Utilities:
9`/—V5
FD:
(Initial & Date) (Initial & Date)
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OFFICIAL NOTARY SEAL
BARBARA A SCHAEFFER
COMMISSION NUMBER
*
DD108588
Nom, CQ
9rF
MY COMMISSION
OF f,O�`
OE6XPIRES
P. O. Box 678521
Orlando, FL 32867
407-273-8300 fax 407-273-6030
e-mail acatapano@bellsouth.net
Date: q -0(-0_S
LETTER OF AUTHORIZATION
To Whom It May Concern:
This letter is to authorizep
to pull the plumbing and/or gas permit for the following project and this project only:
PROJECT NAME: `aln �� I
PROJECT ADDRESS: � acro Ro,'O 'N d
BUILDING PERMIT #: (� —
GOVERNING MUNICIPALITY: ' �}
This authorization is given by ANTHONY F CATAPANO, for
A. Catapano Plumbing Inc.
Thank you,
Anthony F. Catap
President
CFC040020
Sworn to and subscribed before me this Cday of 2005.
Known to me personally or produced ID
*Py P& OFFICIAL NOTARY SEAL
Notary Public 26V —� � !ten BARBARA A SCHAEFFER
* * COMMISSION NUMBER
20 f
NP DD108588
My coinmission expires: OF FVpQ`� MY COMMISSION EXPIRES
APR. 30, 2006
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