HomeMy WebLinkAbout411 W 14 St (7)Permit # : G $— ?a S-/
Job Address:
Description of Work:
CITY OF SANFORD PERMIT APPLICATION
II ,' 1 I q4 c— Date:
b A c,K t�10 fA,0-41 6t1\-1• rO S,,Z-A vier
Historic District: Zoning: Value of Work: 5—UG
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 Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair —Residential or Commercial
Occupancy Type: Residential Commercial 1/ Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Name & Address:
(Attach Proof of Ownership & Legal Description)
U Phone
contractor Name & Address: Il/�T/d/�� trC C( ;rg /�L c^V
J'C 1 -7,11t --1-,C21 Si It 119 G -4,,v i Gr�,— M✓J State License Number: C• C
Phone &Fax:,rO6 SS -77 7-Z✓Zx Contact. Person:1,3 f/AZz--v Phone: S^U* .?5es—suou
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer: Phone:
Address: Fax:
Application is hereby made to obtain a permit to do the work and installations as indicated. I 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 M 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 pen -nit, 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 wat manag ent districts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the requirements olkorid ien Law,,/FS 713.
Signature of Owner/Agent
Print Owner/Agent's Name
Signature of Notary -State of Florida
Date S
Ax -
Date
PrkVontractor/Agent's IIS
g, 2 p5
Date lure of Notary -State o//f�� orida 1nu���n�� Date
,U ANN M. JOHNSON
# MY COMMISSION # DD 285622
Owner/Agent is _ PersonallyKnown to M or Contract EXRm e r
Prodced ID ^ / _Prod"uG,,,. °�r�eetlThr
APPLICATION APPROVED BY: Bldg: 1' ' ' Zoning:
(Initial & D t
Special Conditions:
(Initial & Date)
Utilities:
FD:
(Initial & Date) (Initial & Date)
NATIONAL ELECTRIC CONTRACTING, INC.
P.O. Box 511957
Punta Gorda, FL 33951
Phone (239) 243-4406 - Fax (941) 575-6734
September 7, 2005
Sanford Building Department
Contractor Licensing
300 North Park Ave
Sanford, FL 32771
RE: Qualification and Permitting
To Whom It May Concern:
Please be advised that I, Christopher D. Piazza (Florida License #EC13001862) give my power of attorney to
John S. Ryan and Walter F. Linfield as my agent to set up a qualification file for registering and applying for
company permitting. Please consider his request for qualification and permitting as my request.
Sincerely,
Christopher D. Piazza
President
National Electric Contracting, Inc.
Signature
-("
On this '% 1 day ofSi54� 20 oS , before me, the
Undersigned notary public, personally appeared
i R15,0PHF",119zZR , proved to me though satisfactory
evidence of identification, which were 6K -'Oa t--� , to be the
person whose name is signed on the preceding or attached document
in my presence.
Notary Signature
My Commission Expires�i
Corporate Office -
56 Manley Street West Bridgewater, Massachusetts 02379 Tel (508) 587-7224 Fax (508) 587-8044