HomeMy WebLinkAbout1401 W Seminole Blvd (7)(;_C PFRMTT# 041657 '
CITY OF SANFORD PERM I.1' APPLICATION
Permit # : Date: 6/3/04
Job Address: 1401 W Seminole Blvd Sa'n Ford, Florida
Description of Work: add/relocate fire sprinkler heads as per plan
Historic District: 'Zoning: Value of Work: S 1 , 268. 00
Permit Type: Building Electrical Mechanical _ Plumbing Fire Sprinkler/Alarm XX Pool
Electrical: New Service — It 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 X X Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood 'Lone: (FEMA form required for other than X)
Parcel #: 25-19-30-5AG-0117-0000 (Attach Proof of Ownership & Legal Description)
Owners Nante&Address:CENTRAL FL. REG.. HOSPITAL INC C/O TAX DEPT PO BOX 30953. NASHVILLE TN
37202;
Phone:
Contractor Name & Address: SOUTHER
SANFORD, FL 32771
Phone & Fax: ' —
Bonding Company:
Address: T""''—> n 1Al n --) onnA
Mortgage Lender:
Address:.
74072300011990
Phone: 407-323-4200
ArchitecUEngineer: 0 11 i I— 1 ! 1 �f "� Phone:
Address: 1, A Fax:
Application is hereby made to obtain a permit to do &.-Mork and installations as indicated. I certify that no;ivork 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 IN 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 permit, 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 water management districts, state agencies, or federal agencies,
Acceptance of permit is verification that 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
� e 6/3/04
Signature of Owner/Agent Date tgnature of t tmctor/A rt Date
Robert _Hs Caldwell, Jr.
Print Owner/Agent's Name 11crinit-Ce tractorlA 61 s
6/3/04
Signature of Notary -State of Florida Date; Signature of Notary -State of Florida Date
ROBIN M.`DUNAKIN
Notary Public, State of Florida
Owner/Agent is _.: Personally Known to Me or Contractor/Agent is XX Personally Known to Mydiomm, 00. Jan., 25, 2008
_ Produced ID _ Produced IDQjrl " NO D,D 842 4
APPLICATION APPROVED BY: Bldg:. �, ('40 7 Zoning: Utilities: FD.
(Initial & Date) (initial & Date) (Initial & Date) (Initial &'Date)
Special Conditions:
. cn