HomeMy WebLinkAbout401 W Seminole Blvd (18)P.eceive ,Fax °_: c . Ser .15='20054:F?73AM'=' ': Fax°.Stational *Uerman,Grour)Mrc
Sep 15 05 09:09a
Permit # :
J*Addre=40 --
Description
Description of worlu
H i 1 i Di
Lexcor
CITY OF SANFORIa PERMIT APPLICATION
Date' —
3
P.2
s or c uricC Zoning. Value of Work. S_- 1.%® I
Permit Type'. Building —1/—"' Electrical McchanicaJ
--_.__ Plumbing Fire Sprinkltx/Alatm pal
Electrical: New Service —# of AMPS Addition/Alterntion
Change of Service Temporary Pole
Mechanttcal: Residential Non -Residential Replacernenl New
Plnter(„pL+/ Ne -Commercial: # of Fixtwes (Duct Layout & EneW.Calc_ Required)
H of Water & Sewer Lincs # of Gas Lines
Plumbing/New Residential.— 9 of WmvrClosms Plumbing Rcparir— Residential or Commercial
Occupancy Type: ResidetWol CommCrChd Industrial
Total Squwv Footage
Coostrtictioa Type: iF of Stories• !/ of ®trclline Units: Flood 7.onr.
(FEMA form required for other that, X)
Parrcltl: 5—/9-30-xD
300-0470 -Do
O+racrs Na & Addrtac 4 t /� ��tA ` . 1Attach Proof tttownersid do iAgal Description)
Contractor RomeAddress; Phone.
Phone & Fax: _
Bonding Company.
Address:
P16"09c Lender: -
Address:
.Arcbile"/FaI,(neer
Slate Lteenw Nuaaber
Contact Person: Phone
Address:rA
s ( _ Fitz: _ Q % f -T
Appikatida is hereby made to obtain a Pam ilia d o the wnrtc and installation as indicated. 1 eenily Ila/ cw work dr installation has cornmencAd
'0;5% me of a pem,it and that all work well be perfonnad to HIC4ti Standards of all laws regulatiag cones= ion in this j,xiulictitu,. I traderstartd 11tx tsepa[ate
AIRptsmiiC muu TI secumd tar ELECTRICAL WORK_ pLUM81NG, SIGNS. \V@Ll S, POOLS, FURNACES. BOILERS, BEATERS, TANKS,ond
AIR CONDITIONERS, ac.
nW PER'S AF610AY(T: 1 ecnify Ilett all of the
coastruNionopd Maine.AVE WARNING TO OWNER ypUR FAqLt n! URE tsaccamic2ndTO RECORD A at a1J wort; will be dooe in complianeewiih all applicable laws rcgulating
'r%VICE FOR IMPROVEMENTS To YOUR PROPCKTY. IF YOU INTEND TO OBTAN FINATICE NCING, CONCOMMSULT Wiry{ yO R ER OR AN
NCEMENAYING
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENTENDT.
NMIC An addition to the mquiremem-4 ofthis Permit. there tttay be additional mRriet ions applkablc to this
this cmrvy, and them rrary be additional permits rcpt" ran, nther Eorcr"mcfeal cath its such as water P^ tY that nwy W round in the public mnrds of
manageutenttriatriet9,sutcagencies,or�ederaln�etncice,
Acctptancco rt: cit is vcrificatiorVthat t wtlt",fot;t;er�
00;
ny orThe rcquircnt a1.7' Y� w• FS 713.
/�116f— 2su N202e
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465628MY ON466465628 O�EXPl EXPIRE :,September 11, 2009,
'PnxjucI
[APPLICATION APPROVED BY: 014:
finkial S. WIC)2ouirrg: Utilities:
(Initial & Datel (Initial & D atc)
Special Cont{Rias:
Olt,
Dote
cur
FD:
(Initial JL Dur)
Sep 15 05 o9:oea Lexeor-
P.3
AFFIDAVIT
REGARDING ,ROOF DRY -IN AND FLASMNG INSPECTIONS
:
Come an
P Y License #: C C -C -05,799F
I%%feZzo Project Information
Owner: D
C
Permit: � nernc
X15 )'yw �
adatcss .
/7'/'Subdivision:
Lot #: -
rhWC
I' , affiant, hereby affirm that I am the duly licensed
contractor o record fbr 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:
S
aur
� A)
printed pone
STATE OF FLORIDA /
COUNTY OF 519M //_r
This instrument wasacknowle ed befor his
above referenced individual, . day °f � ' 2() --by the
duly licensed contractor with who acknowledged that he/she is a
O/r'r actmowledged that
he/she was authorized to execute this document. He/she ' either ersoreat' own to me or
produced as valid identification.
WITNESS my hand and seal this / A
ay of
IA BAEZ
.� MY MM:,September
MN # DD 465y6y2�8
11, 2009
g�F aE Bonded Thru Notary Public UndetxaRers