HomeMy WebLinkAbout401 W Seminole Blvd (19)t0 ®- a II®E
P•ecei,.4d Fix r-
_ Se 15x2005 8:13AM Fax_'Station Denmair-Grob Ino: 2
Sep 15 05 09:0Ba Lexcor p-2
i /� CITY OF SANFORD PERMIT APPI (CATION
Permit # : I V r 11 / "/,
d Date:
,1vbAddrcss: l- Jif. iC VS 3a 77
Description of Work '
Historic Districts Zoning; Value of Work;
Permit Type: Building _V� Electrical Mechanical Plumbi
n8 Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS AddWoWAlteration Change of Service Temporary Pole
Mechanical. Residential Non -Residential Rcplacemen[ New
(Duct Layout & Enagy.Calc- Required)
PluanbiW New Commercial: # ofFixtures K of Witter & Scwcr LRvcs # of Gas Lines
PlumbinglNew Residential: x of watcrClosets Plumbing Repair- Residential or Commercial
Occupancy Type: Residential Commercial Industrial
Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone
/� ^� (FEMA form requlrerl fur othtr than �[)
Parcel M: S"�9 `3D `306)-0070 -Vy0�
Owhm NO -- Auach Proal of Owocrshi d< t eaal Description)
rn� & Address - Ii�.i �F? G ly) ti.�(� el �. e �B �,�5 F
7nA a /.- - - - i i �D %�.Atiid /X�..ia.L .�_ n
Contraeter Narae Adde ; Pitt►ttm:
Phone a Fax: _
Sondiat Cottnpao):
Addres%:
Morl"te Lender:
Address:
ArchiretillUgincer:
Stale Urenw Nueamm..
Cmttaet Person: Phone
wadress: A! er5�� iN14e±AL >Fnz•
Application is ber6y etude a obtain a pennil to d a the worlt and installations ae indicated. 1 etatiCy that no work or iastaprtion has commenced issuanec 01`2 pemtit attd tfmt all work wt71 be perfannud to ttte�y uandaeds of all paws rL_gulatia€ cnnstnrct ion in this jtrristfiction I s coundq men that ar tsWar w
imijAIR C NDf^nunbe secured for ELECTRICAL WORK PLUMBING, SIGNS, W@LLS, POOLS, FURNACES. BOIias
LERS, IiE/ITn. TANKS, and
AIR CONDITIONERS nc.
OWNER'S AFFIDAVIT: I artily itut all or the fare9oin1t inroanatim isacettrmeand that all work will be done in compliance with all applicable laws r��
rwicu Fox
i Kov WARNINt3 TO OWNER YOUR FA ILURp 1 p RECORD A NICE OF CONIMENcEmENT MAY mULTIw YOUR PAYING
' ATTORNEY
BEFORE TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFDRE RECORDING YOUR NOTICE OF roMMENCEMENT.
L'+2T1CIe: In addition to The taquirctnetur ofthis pcnnk. Iheft may be avditional reariatonsappikuble tothis
this cmruy. and them may be additional permits rent ' . fmrn ser orcryrolcnfal Property that may be found in the public nerds of
E emit is sw h as ranter trtatugeutcnt rTrstrieLs, state agcna(cs, or federal agencies,
Acctpwne'OF retifigtion, 1 rll L he al'thcP n'artbcrcqui *n ti�so,,f�Fln law, FS713.0
d .4�
# DD 465628
W10umo M
APPLICATION APPROVED BY: Bldg; _T Zoning:
(Initial S. Date) (Iniriul & Datrl
Special Conditions:
dAgent
awry.
M'f SSION # D 465628
PI S: September 1, 2009
Utilities: Fp.
(Initial R patD.ti)
Received Pax SCO 15`2005 813AN' Fax`Sta.i n :' Cernnan-Grog Inc -3 -
Sep 15 05 09:08a Lexeor p.3
AFFIDAVIT
REGARDING ROOF DRY -IN AND FLASHING INSPECTIONS
Company: u � License #: C 'C
u± � Project Information
Owner: //91/_' iG ZA" s Permit #:
aamc
D U Subdivision:
address .
-7-3zZ /os/
I,OI
ant, herebY affirm that I am the duly licensed
contractor o record 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:
printed aatne
Lot N:
STATE OF FLORIDA k
COUNTY OF ��'hep
This instrument was acknowled before is day of
above referenced individual, ---f by the
duly licensed contractor withp who acknowledged that he/she is a
c who acknowledged that
he/she was authorized to execute this document. He/ is eitherpersonal known to me or
produced as v ten cation.
WITNESS my hand and seal this /S day of 20 b;T-
MrCO SS10N i D 465628
EXPIRES 11, 2009
BMW Thru rotary Puwic Underwriters