HomeMy WebLinkAbout391 W Seminole Blvd (3)SI
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Sep 15 05 09: ii L``excor P.2
4"'t,tI) C171Y(OF SANFORD PERMIT APPLICATION
Permit it : � �jIN U tt' QL�S �'
C�(�' �/ Date:
,lob Address: �'�`+_. t .5 J'VI ► tJO Ohs 81 Vl� 5� 3 a -7
Description of Work: 0 - --
Historic District Zoning. Value of Wolk: ° v�
Permit Type: Building Eleetrimi Mechanical_ Plumbing Fire Sprinkler/Alarm Poot
Electrical: New Service - # of AMPS Additior✓Alteration Change of Service Temporary Pole
Mechanival: Residential Non-Residemiai Replacement New(Duct
Plnwrt„tlgJ Herr Commercial: # of Fixtures Layout & EneW.Cak- Required)
11 of Water & Scwcr Lines # of Gas Lines
Plumbing/New Residenni 4 of WatcrClo%ml; Plumbing Repaif- Residential or Commercial
OccuPancy TyPw. ResiderWal Cotnrnercial Industrial Total Square Footage:
Coastructivn Type: iF of Stories: # of Dweiliws Units: Flood Zone-
form
/� (FEMA form re"Ired for othrr than X)
Parrc1 5"� / — t7-3oD-Dp?p 7-7-C X0
Attach Proof of Ownerslri do 1.eEaI Dewe iFrtion)
O% -*v” Not" � Address 14C i �i e_ i'N,.°tc ° . 1 I : L.. 'f' .� _ n r _ i
�. mar ler n Pltatte:
COntra~ Name Address; 111
• Slate Liecrrse Number:
PhOut Fax _
89ndiug Company:
Addresx:
411 Lender: _
Address:
ArebiiwAii rtfineer.
Cawtuet Person- Plane•
F� l�r� � � %
Application is li made to obtain a para it to d o the work and insmllatitms x indicated. I ccriily ural no work irtsra
ale
issuance o! a prnnit wed that all ri oric rn11 be peAanned to men taieedard$ of all laws rLZtulatiaP construct ion in tteis jurarlictiort 1 notlpstand That p a� trepasate
prnnil must besccurtd for ELECTRICAL WORK PLUMBING, WELLS, POOLS, FURNACES, in
AIR TANKS, and
AIR CONDITIONERS, etc,
tcQrst1vc1id004dwA69. WAR14ING TO OWNER- -W ER'S AFFIDAVfT; 1 artily Ihat all orthc fi inl�maatim isacertrmeand thu all wort will bCE C e dune in oompliancewitb all rppGca6lc Lswi rccclatin#
TYVICEFOR
MPROVE1rtENTS TO YOUR PROPli ":YOU NTENYOUR FAILURE TO DCTOOOBTAIN ORD A FIN FINANCINGOF , CONSULT WITMAY MULTINYOUR H YOUR LENDER OR SAYING
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMCMCEMENT.
L'14T1C�: ht addition to the tegtun°menct ufthis pcttnit, t herr may be �tionol raciritTions applicahlc ro this property Thai may be found in the public iceards of
this "Olay, and them may ba additional penrdts requinarl fmm ether Eorerummntal calil it$ surr:h as weer rnanagearcnt d stricla, W fou ere in t e pul rat agr sof
or
Acceptanec oP i � vcrificotia� that ( 1 tr y rl^.rwncr of the pn penv of rhe requirenrctm ar Ftna�, r d..! r t7 r.
3AEZ Date
# DD 465628
ber 11, 2009
ll X tJlnl *9 M or
Caetrrcwr/A ffenl ispammlly
— Produced 1D
APPLICATION APPROVED BY: Bldg: zmrirt
fleshiest S. Dutc) E Utilities:
(Initial & Datel
SPorial C-nditions:
FD
(Initial & Date) fleshiest A D.itc)
..
s
a 1 - _ s • ® 9
Received fax —" Sc 15 20a�18:73At4_.:.: faxRSta:ibm'c _ °Cernnan Gr,"oi. inc'"°: °--- •°_i. 3�-�� .::.a° -W=
Sep 15 05 09: oea Lekcor P.3
AFFIDAVIT
REGARDING ,ROOF DRY -IN AND FLASKING INSPECTIONS
Company:/ (/r �i4-rT� License #:
a`11 8�-(C2c�G(, Vel <,�[_
J Project Information
Owner: '12 �4,& l s��• Permit M
�e� aamc
�/U/ w
Uo Subdivision:
address.
Lot
c �, affiant, hereby afl-irrn that I am the dulylicensed
contactoor r of ecord for'the above referenced permit, that all the foregoing infomatiois true
and accurate, and that the dry -in, flashings at the above referenced address or lot has been
installed in accordance with the applicable codes and standards.
Contractor:_
IV-1urc
Eb F ,aAJ
prfnuC name
STATE OF FLZP11,
A
COUNTY OF
This instrument was acknowledgeefore m
above referenced individual, day of , by the
duly licensed contractor with who acknowledged that he/she is a
he/she was authorized to execute this document. He/s ho acknowledged that
produced i[y known tome or
as valid identification.
WETNESS my hand and seal this � qday of .2005,
MY COM DD 485628
EXPI :Sep ber11,2009
e«�aea PP a uraenniters