HomeMy WebLinkAbout401 W Seminole Blvd (16)C10 ®- e
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Sep 15 05 09;09a
Permit N:
,1obAddress: o l
Description of Wort:_
Historic Di
Lexcor
P-2
CITY OF SANFORD PERMIT APPLICATION
��Date,
- t c vd Sa- t nle.d r. 3.;t7-7/
atNcC Zoning: Value of Work:
Permit Type. Building —A—/*� Electrical Mecttanica! plumbing Fire SptinklalAlarm Paul
Electrical: New Serviec — # of AMPS Addition/Alrertttion
Change Of$ervicc Temporary Pole
Mechanical: Residential Non -Residential Replacerttcn, New
Plnwtbi (DuctI�tyovt & Enagy.Calc, Requited)
AW New Commercial: # of Fixtures 4 of Water & Scwcr Lincs # of Gas Lines
I'lumbing/New Residential: # of water Closets
Occupancy Type;Plumbing Repair— Rcsidcntial or Commercial
Residctwo) Comrntrcidl Industrial
Total Square Footage;
Cottstrt(q(oa Type- R of Stories: p of Dwelling Units` Flood Z*nc:
L_ Q ( FEMA form required for other than K)
Atlaeh Proof titow al Description)
O.raers Nam4 & Addressz �6�f L //Yl use. w. 1 I _: L� 'f''_ ,� _ A/_ F )
Coate -Mw Name i Address:
Phone & Fas' _
Sonding Compaa}':
Address:
Mortgage Lender:
Address:
Plume:
State License Number.
Contact PCMS.- Picone
Addrts::/A eL hl a Phone: Q b t) — 3J
Application is hereby made to obtain a petmil to d o the wcrtit and instillations as indicated. 1 certify that now** er instaUation has eommenrad
issutttce of a permit and that alt work will be peevnmd to mco stand trds oral, laws rcgulatiap conwuct ion in this jurisdiction. I andetstattd Ihat W t
�rste
P13AIR C must NDITI N RS fot ELECTRICAL WORK, PLUMBING, SIGNS, WCLLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS. and
AIR CONDITIONERS, at,
()V/NER'5 AFFIDAVfT: 1 ceniry shat all otthe kWvgQinLe inflarmaiiott is acemateaod that all taunt will be done in oomplianeewith all applicable laws; rcgtchting
canstructionond coAing. WARNING TO OWNER YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULTIN YOUR PAYING
f tvICE FOR IMPROVEMENTS TO YOUR PROP M- TY. IF YOU INTEND To OBTAIN FINANCING, CONSULT WITH YOUR
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. LENDER OR AN
NOT'CE: In addition to the tequimate m -A of this permit. t herr array be Minna, merits tons appikable to this property that may bo found in the public monis of
thisetwnly, and epees rrwy be additit>ft rl prnrei ngtri(sy1 fmm atltcr overpAtcntal
E entities such as water nt*WSC nest dia Cis, stateagene(es, Or federalagcncirc,
Acctptenecoriw*t is verification t twill i1, it rete art ox:
ny of the ' n
tl
to
UDIA BAEZ
iSION 465828
19bRrW-aW9 M l
____ Pnxiuced ID
Is�pps-
D�tte
APPLICATION APPROVED BY: BlJ S":
Utilities: FD:
flnitial &pale) Oni(iul & Datel
(Initial & pate) (lnitu-rl &- (Tek)
Spotiol Coad'uiau:
e 1 - _ s
Recei�ri Fax ., SC , 15 20x5 8:73AId IFaxsSta.i'anrc- Cemnan Grou InC. 3,� ,
Sep 15 05 09:08a Lexcor^
AFFIDAVxT
,,REGARDING ROOF DRY -IN AND FLASMNG INSPECTIONS
Company:`. ncl A'f�►tV( f ,4rl pG
License #: CC ' C Q� _ O ff .
13 �radki.-J `4ve. —zvtk
a 536en
Project Informatio>u
Owner:
ae� Cv. Permit M
-�`/1�Y/ A/ Subdivision:
addmss.
Lot it:
r, A �� a ant
hereby affirm that I am the duly licensed
contractor o ecord for the above referenced permit, that all the foregoing information is 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:4
4L,--
printed mrm
STATE OF FLORIDA
COUNTY OF L:YU1 (A 0 `e
This instrument was acknowled befVs �S da of
above referenced individual, y 57 by the
duly licensed contractor with Who acla�o ledged that he/she is a
he/she was authorized to execute this document. He/she is eithersand who acknowledged that
produced _ R__c° - own to me or
as vah�entification.
WITNESS my hand and seal this _ day of -,20
U 1A BAEZ
' OMMIS ON # DD 465628
E) eptember 11, 2009
pp
.0 nded Thru Notuy Public Underwriters
P.3