HomeMy WebLinkAbout3101 1 StCITY OF SANFORD PERMIT APPLICATION`"
Permit No.: 03-1,50(0 0Date: APRIL 2, 2003
Job Address: 3101 FIRST STREET, W SANFORD, FL 32771
Parcel No.: 26-29-30-5AE-33OA-0000 (Attach Proof of Ownership & Legal Description)
Description of Work: ADD ONE HEAD IN RECEPTIONIST AREA
Type of Construction: FIRE SPRINKLER SYSTEM
Valuation of Work: $ 300.00 Occupancy Type:
Number of Stories: Number of Dwelling Units:
Flood Zone:
Residential X Commercial
Zoning: Total Square Footage:
Owner: CENTRAL BAPTIST CHURCH OF SANFORD
Address: 3101 FIRST STREET, W SANFORD, FL 32771
City: SANFORD State: FL Zip: 32771
Phone No.: Fax No.:
Contractor: WAYNE AUTOMATIC FIRE SPRINKLERS, INC
Industrial
Address: 222 CAPITOL COURT
City: OCOEE State: FL Zip: 34761 State License No.: 90293400022002
PhoneNo.: 407-877-5588 FaxNo.: 407-656-8026
Contact Person: BECKY ROMEA / CHRIS MOSS PhoneNo.: 407-877-5588
Title Holder (If other than Owner):
Address:
Bonding Company:
Address:
Mortgage Lender:_
Address:
Architect:
Address:
Phone No.:
Fax No.:
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 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.
Signature of Owner/Agent Date Si nature of Contractor/Ag nt Date
PETE SCHt'AB
Acceptance of permit is verification that I will notify the owner 7mt=4i
, F
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: I
Fire Dept
Special Conditions:----R.�.
rmai insp.,
Date
Print Contractor/Agent's Name
4-2-03
Signature of Notary -State of Florida Date
REBECCA S. ROFIr EANotary Public, State of Florida
My comm. expire sJoulyy 85320
Bonded thru Ashton Agency, Inc.
Contractor/Agent is XX Personally Known to Me or
Produced ID