HomeMy WebLinkAbout114 W 1 St (2)CITY OF SAI14ORD PERMIT, APPLICATION
O (v- I o • Permit #': Date i " t7 b
Job Address: t % 4 W. 0Y IT.
Description of Work: AD toIMELMATC Fll?.E SR12INV-4ARLS
Historic District: Zoning: Value of Work: S 2, 500.0L
Permit Type: Building Electrical Mechanical Plumbing Fire Sprin arm v Pool _
Electrical: New Service - # of AMPS Addition/Alteration Change o 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 Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: 7-5 ^ - 1!0 , SAA — 01,0* —MR) (Attach Proof of Ownership & Legal Description)
Owners Name & Address:
Phone: 401 871 - OZ09 /
D. c. i'siUX Cj tOt2l.I tdD ti'-Z,`+jZ>354 State License Number: -&7-J 5000017,001?
Phone & Fax: Z1 0147 -45C3 4M Contact Person: AAA" 5T7M 1A k1 Phone: 2a I s7 qdi 4 G3
Bonding Company: 57-Z' 539 1
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Phone:
Fax:
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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: 1 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 I will notify the owner of the property of the require nts of lorida ien Law, FS 713,
i
Signature of Owner/Agent Date Signature of Contractor/Agent Date
MAev_'gr Mtti.
Print Owner/Agent's Name Pn Contractor/Agent's Name
6
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date
r, 0,z&
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg: Zoning:
Initial & Date)
Special Conditions:
Contractor/Agent is Aele—nally Known to Me or
Produced ID
Utilities: FD: r !\
Initial & Date) (Initial & Date)
1 9 9
010
f
QUICK"SPONSE
AUTOMATIC,,SPIUMaERSFIRESPINNLER
CORMODEL g ULB SPRAY SERIES PORANUPRIGHT•
PENDENT ppro
VERTICAL SIDEWALL HORIZONTAL
SIDEWALL DESCRIPTIONAND
ON'ARUA CONVENTIONAL OLD STYLE) The
Globe Quick Respoi IION ise
Model JN Sprinkler is a low profile
yet durable design which ut lizes a 3mm frangible glass ampule asthethermosensitiveelementhisprovidessprinklerapproximately
six times faster th Quick
Response Sprinkler operation
ordinary
sprinklers. While the provid
ance,
it can be installed wherev an aesthetically pleasing appear_ r
standard spray sprinklers are specified
when allowed by the additional
feature of greatly increased pl!
cable standards. It offers the in
various styles, orifices, tempe safety to life and is available ture
ratings and finishes to meet s many
varying desl8n, requiremen should
be used advisedlyand Response
Sprinklers QUICK
RESPONSE underthtlrckedirectionofapprovingaPpgauthoritieshavingjurisdiction. I UPRIGHT CONVENTIONAL The
heart of Globe's Model JN spnnkler proven actuating assemblyisahermeticallysealedfngibleglassampulethatcontainsa
precisely measured amount of fl id. When heat is absorbed, the liquidwithinthebulbexpandsincringtheinternalpressure. At the
prescribed temperature the int Mal pressure within the ampule exceeds
the strength of the glass c using the glass to shatter. This results
in water discharge which is disfr•ibuted, in an approved pattern
depending upon the deflector style used. TECHNICAL
DATA QUICK RESPONSE U.
S. Patent No. 5,494,114. PENDENT VERTICAL See
reverse side for. Approvals d Specifications. SIDEWALL Temperature
Ratings - 135°F (57 C), 155°F (68`C), 175°F (79°C), 200°
F (93°C), 286•F (14I Water
Working Pressure Rating C).
I
175 (1207 kPa). Factory
tested hydrostatically totulb isi
00
psi (3448 kPa). Nor Maximumlowtemperatureglassratingis -67°F (-55°C). Frame - bronze Deflector - b s Screw - brass Bulb
seat - engineered plastic ring - silicone elastomer QUICK RESPONSE Bulb -
glass with glycerin solution 3mm HORIZONTAL SIDEWALL SPRINI(
LER TEMPER,4T size. AVAILABLE
1,
4TING/CLASSIFICATION SPRINKLER
and
COLOR CODING CLASSIFICATION
TEMP
BULB
RATURES
N.KR& MAXIMUM ORDINARY
1356F/ISS°F COLOR
5TGb8°
C ORANGE/RED CEILING
TEMPERATURE IOp•
F INTERMEDIATE175°FR00°F HIGH
79°
C/93°C YELLOW/GREEN 150°F 38°
C C
186•F 4077
AIRPARK DRIVE, STANDISH. MICHIGAN 141 °
C BLUE 225°F 107°C ArRIl.
I996 I8658 517-846-4583 • FAX 517-846-9231 A-
6N BULLETIN )N-QUICK RESPONSE, REV. ##3
QUICK RESPONSE .
A UTOMA TIC SPRINK I
MODEL JIV BULB S R
UPRIGHT • PENDEN •
HORIZONTAL SIDEW
i
f
lY SERIES
ICAL SIDEWALL
CONVENTIONAL (OLD STYLE)
FICATIONS
ORIFICE SIZE I NOMI K"FACTOR THREAD SIZE LENGTH FINISHES
3/8" (10 mm) 2.8 39 metric) I /2" NPT 2 1 /4" (S.7 an) Factory Bronze
7/ 16" (12.5 mm) 4.2 S9 metric) 112" NPT 2 1 /4" (5.7 an) Satin Chrome
1/2" (15 mm) 5.6 80 metric) 1/2" NPT 2 1/4" (S.7 an)
Bright Chrome
White Pol
17/32" (20 mm) 7.9 111 metric) I /2" NPT 4*2 I /4" (5.7 an) Black Polyester+
17/32" (20 mm)
wnrc. urrw. r u.rwnw.u. .
8.1 116 metric) 3/4" NPT 2 7/16" (6.2 an) 001"d Coated
w. ..w..w. w..cnrvry e.nc vr..vn rv.. c.
I • HORIZONTAL SIDEWALL IS 2 9/16`.
EXCLUDING PINTLE.
FINISHES AVAILABLE ON SPECIAL ORDER.
AVAILABLE AS V.L AND C-U.L LISTED CORROSION
APPROVALS RESISTANT WHEN SPECN9M ON ORDER
STYLE ORIFICE 13VF 1 S F 17S•F 2WF 286'F V'I" CANADIAN
F.M. L.P.C. N-Y.C. - DOA
SIZE sm 68 C 79'C 93"C 141°C U.L- MEA 101-92-E
3/8"I X X X X X X X
7/ 16" X X X X X X X
UPRIGHT 1/r I X X X X X X X X X
17/32'j X X X X X X X X
17132" X X X X X X X X X
3/8" X X X X X X X
7/16" X X X X X X X
PENDENT J/2"I X X X X X X X X
17/32I X X X X X X X X
17132" X X,, X X X X X X X
VERTICAL
3I"
i
X i X X X X X
SIDEWALL t 7116" X x X X X X X X
U2"I X xx X X X X X X
3/8" I X X X X X X XHORIZONTAL
SIDEWALL 1 7/161 X Xi X X X X X
I/2"l X x X X X X I X X
CONVENTIONAL. 1 /2" I X X X X X X X X X
OLD STYLE) 17/32F X X XI X X X X X X
ORDERING INF
SPECIFY
Quantity Model Nur
Orifice Thread Sizes
Finishes desired
Quantity - Model JN V
PIN 3123" (l.O.)
HORIZONTAL SIDEWALL U.L. AND C-U.L LISTED FOR DEFLECTOR 4" TO 12" BELOW THE CEILING.
TION I t VERTICAL SIDEWALL SPRINKLER U.L AND C-U.L LISTED FOR LIGHT HAZARD ONLY.
t 3/B' VERTICAL SIDEWALL U.L AND GALL LISTED FOR UPRIGHT INSTALLATION ONLY.
17/32" X IQ' NPT.
Style
P/N 32$390 (112");
ANN zasE®
VF11NESPIRINKIERCORPORATION
APRIL 1998
GLOBE® PRODUCT WARRANTY
Globe agrees to repair or replace any of its own manufac-
tured products found to be defective in material or workman-
ship for a period of one year from date of shipment.
For specific details of our warranty please refer to Price
List Terms and Conditions of Sale (Our Price List).
4077 AIRPARK DRIVE, STANDISH, MICHIGAN 48658
517-846-4583 FAX 517-846-9231
1-800-248-0278 www.globesprinkler.com
PRINTED U.S A. BULLETIN JN-QUICK RESPONSE, REV. ##3
AUG- IM3 0e:41 Fllol TQIMleao•..
S hedule 1
Fully Listed and fM
roes oteoe • ----•-- -T: -p:ool ooi -F:o:,;::...... .
I*/Schedu#eIW*II-4W-
pproved Sprinkler Pipe. _
When you specify Schedule-ID/Schedule- 0 sprinl kr pipe you get UL fisted and FM approved prodtut. Although drewproductsdonotrequireSeparateapprovals. SChedufz-10ISchedule 40 gives you the extra gaWary assurpwe you datsartd.
Our Sch-10 (I- (!4"- 6") Pipe and Sdr-Q f 1 "- 2-1 _") pipe have paced the same tborough lab testing as our odw listed
pips products, and receive periodic mill in. pcc:ienrrotn both UL and FM t:gents to ensure consistent quality Sch-
40 5pectficat ions F'
nduct qW"I WVPt WVFt Pay ltifrM Won WVIA Schedule-
10/Scbadule-40 product can
be ''hot -dip" galvanised to NPs
I.D. 1,
049 1.6el) • 20laaad
2_
05 Lire
70 •
a.
2470
21V
2822
a'
2940
meet
Fi<1 requirzments fa dry x :1 25
26.6 2.5 3.05 TO 1120 1280 1334 systems in
accordance with the 1 014"
1.380 2.270 2.93 51 2431 27-M 2894 zinc coating
specifications of 32 35.1 4.36 4.36 51 1103 SZ60 1313 ASTIM A-
123. 11l/2-
1.610 2.720 3.61 44 2513 2872 2992 4a 40.
9 4.0 5.37 44 1140 13M 135T Ing Superior
Coat'A 7 60 2330 2025 2738 50 52.
5 5.4 7.63 30 1043 1192 1242 Our advanced
fOt nttla'111 c oadFIF 2I1/2- 2.469 5.790 7.86 9 2310 2640 2760 offers a
cltan, durable surface. It is 65 62.7 8.6 11.73 19 1048 13.9T 124T also paint -
ready for custom color applications without
special preparation. American ,-
F'
rodott
Pioininel W,/F1 vlrM Pies,/ own Won WVlA Meets "Buy
American" 6quiramrnt NPS I.D. k2oAlled Llft S' 24' 2W and is
available throughidistribtttota in 1K V 1.097 1.400 1.81 91 2675 30S3 3185 the USA.
Canada and Mexico. 2S 27.9 2.1 2.70 91 2213 1395 1a45 1 1/
0- 2.442 1.810 2.52 61 2319 2664 2760 32 36.
6 2.7 3.76 61 1052 1208 1262 1 V2-
1.682 2.080 3.04 61 2604 3045 3172 Schedule-105chedule-
40 pipe are in w 4C 42,7 3.1 4.52 61 1206 1381 1439 compliance with
the following: x 2 - 2.15T 2.640 4.22 37 2051 2W 2442 ASTM A.
135, and NFPA 13. 50 5k8 3.9 6.28 37 930 2-063 nos a u2.
2.635 3.530 5.88 30 22:14 2542 2648 Both pipe
products have working pressu rating of
300 psi maxitauyn and also 65 66.
9 5.3 8.77 30 L009 1728 1153
1973
1201
2087
meet
the
stringent requirement for the 3 4.330 7.r?4 19 784 96
933 following tests:
80 a2.
8 a a'
4.260 8.4
5.610
11.62
11.T8
19 19
2238
2538 2eaS Welded Outlets
90 106.2 a 17.53 i8 10:3 1180 1.-'09 Hydrostatic Pressure
6- 6,357 9.290 23.03 10 1951 2230 2322 Side Wall
Rupture 150 261.E 13.8 34.2T 10 805 1012 3053 Vibrbtlon Test
g` 8.249 16.490 40.15 7 2424 Z770 2585 200 209.
5 24.5 59.73 7 1, 00 125e 1309 fed I
CuPft"
W
se"low sloo.s. thrOp' 1_350 Nanzm Rd. 2525 N. 271h Me. tiarno, IL
26 : P headelphla. PA 19184 Phoenix. AZ 54-009 140"97 MM W
Mp.w- i .. I
Fax
70833941l08 W$PrWWOUGAI1PI18NiM14"
M 60 i
1
AUG-18, ES SOPLY
ribn
4..,,, : ,.,.L C690 " Threaded Mings
04s IS: 125, [Standard)
A
Weight Obs) uo EUMW ske 0 M(M)--
901, Mbcm sts,*Vt Sim B (
Hpa) I A
RGUIV 359A (in) (in) -790-k7 gwv. F 351 (mpg) black gale19mv
141
A
tA, il, .25 .16 .80 •
Apj Yj 114s y I 1,'& .4 C .41
1% h Im, 1.40 •
4/404o 11','* .80 .61
VA .92 .95_
ir , 7'
1.44 1.46
I 'It's 1 3.5 2.00 L
2 s/. 2.30
2 11fis V; an 3.21 air,
I Ili 04 6.11rig Omer 510CM
4_11 _ I
45* EMOW film A 044ta2.0, Figure366 (NPS) (in) 5% ji 31.33 1 33.33
1 1 mjm* j INV.
908 Elbbw Site 'A 9 Weight (lba) .36
Funged and Threaded We) n) (in) black .56
2-Va 11 1 As 12 As I 10.22 1.33 j 11.36
1.79 1.03
3 13.25 N
4 21.58
2 1 1.69 2.95
21A 1,,4f ilVis 4.29 4.35
3 11its a 6.44 6.65
31-1; 11% V1, 5.4? 5 3'vf CA 26.13II1ii4
1V,4 2% 10.84 1112 I
Vt 40:50 1 Va 131,4 116.96 17.38 j -
26 I
aps Ste IP a
4"m 3 g6.0,00 .19 L
A v", 6%. a0.06 i "
Pse pengr-9w I Av'r. 27A11017 $2.00 JDMlnrl
Pipe SIZ44 ol 4' and 100F have two hom t%fold I
to r. Stud of tp. 0or3.1 49'
Elbow Stm A 8 WOW pbs) FMpqsdendThreadedNPR
on) In)Mack Figure
372 4
I VIPs 21% 19.68 r'
I
2'
A CA 64-41 NO-.$:
ms pace 31143-tr AIM
AU'U. I 2VULJ-;A3AM.'—
fro' Tirvvaiiii
Class 195,
90, Flodudno
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VIA# 1.44 1.
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I Size A Figure
M i ("PS on) on) l —
178 1 2A
IV,
11 !aA 3
A 5
13Y.9 VA
12171.
t 071 - I - 3M
VA
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yes mpmlqf A
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FIG. 7400 - RIG IDLITV -COUPLING - The Fig. TQOD RlgiOlRe coupling frorn QrU It le specially designed ro rollprovldeai19idoftlied-ln pipe oonneedon 'to meet the specific demandi GrueOftidddeignSteelpipeandcopperWbe .6MMS. Past and easy oval0INofthe ugged IiptrlwSiQht ho+ Q afldrrces a Copstcure, t1d pipe )olrrt.
i The fig. 7400 Rlpidllte COupSng la L, I j
1 pcl f20.7 bet) fire prDEeCltOn service In both wet end' ry sy rrp 300 catJ
Mon:. Site a Its 111110L Wk. Aft. NoFpps IN I NeO
1 1,J1d 3 7 10'1 i ? 4A .. ra .. --
1
I or out grooved steel pipe PMPOMI in Pcudapce WMowrijTvnenCouplingah"Grr4deEEIntendedforusewtheGrbktod. 0RlQldlne
COuPling is Wended for use M Several aopli- Pegs 81forgasketgraftindexandrei: mrnendadons aft 1
1
iy --.
7 ;.
I LY<R14R
r is
iv
fro s.w •
i i,yZe O it 1 .'.1' L' s
YOi Ply
0•$2 D 3 4 01r x a4
t 3d !'
o addr0oner rlveln aee FjG. 7003 -
HINCELO COUPLING eaemanseerosp eas.
Thei,fiig.
7003 Ffingelok Couplbp is apecM de 1 lgrkd fob 8 egUltlnQ squickoonneetlons>rld/or dWconnee rr , Ij cL The to g' use a "g bon too sf ach the cam lction handle *" housing$. 1wo;ouAlinghalvesafthingedforeaseofhead a tripe
JokrL The A kxidng pl tA upf the handle a eslb9.-
aoflon herrdJe. Silas f'/:' to 4' use toggle! 0 leftand IM :fired coupling. Drevent11-11Wderrfal pperhrg of »re MinQerok Coapnngisaf1exiolecoupaieand0gIplates
and slze8 5' Mows woAJi aura ratings up to Spo pw (W7 berg- data olip'"
note peps 9. - — --- ---r• r ca,pllnq
Will eo.r NO I x
Dbaeedoae
I
NtpMe
OL s.1
201 sod
in so- 'jj 0
AUG.•a8...i0G _.9•42AM .
HUGntaClabipF09:2
Size Range: 1 •
a : - ;-" ^
1/ Sl ge 'A
MMbrlal:fe
I
k'oa. hardarlld eleei cup polm set strew and toelanRFIRM: Plain or 8alwnmed I ; 3fJndes; Recommended for use War root iroteJla km sohar obtbpe amchmem 10 the top or bottom 3frv0aurll ARM where the Co.yerO
or to
MQuired to be effsat from the edge i Me Serge and Whom fir tMeb'se d '
ga rOd !e
1
no: mued vo : Jdbt Sange does
AAPtov ft,; rttpiee tee, Fides
caw-f 171-E irype fsj end MMOP49 ft4n a-IM 192a (q pe 19 a 23)i
UL, FAI and L•LC Approved, (
tYPe
if0W 10 VIM MR of clamp is dstenmk" by size at tag 10 be used,
inafafht(at: klow nOmmendedlsrxtw torque vuues per M3S-gp4SeetablecnMtgePH312) _
Fealms:
e
boW my h x acha
ban po*on ed
to hodion Or" of st; uctural members in ei•i mp beam or 5ecu
ed in prep by &CuP-POkftdSet t;h; qg dsn!ecec against theft AJamNutJr. prmvlded for Nylfte ril•0 the set Seneca against the Body body
a ' i
Thru
tapping of t he . eatkq pe r liis ex,endeo fldjusttnent of the tMg db;. arxibeI:sed `dthf!g Box ramrinp dip l seismic aoptlattoNs, Ordering: SpeetJy
rod arze, figuro m"ber, rami of damp Ind finish. e i
At T1 qE ' i7D&JUST,
1 i
y mv
awy
I
Ii 97—
I` I
NLT 6F
WAmEw
r Rw$tm
A R91ft
Load (
in) . vWelght Obe) • Bet t3eswee !
Mart Lopds i Ttspl ; .l .
E F
G 600 230
0.34 f t iei5e
f%:t 'tl,t 950 760Iroof
430•:F• : i9ti t''`t t f'As A& ei•5t PH 48
fix: i,
y[ ... . .. '
11
m
AUU.-I 8. -.2-00-3- -9, 44AM RMIES.-SUPPLY NO— 50 P.
Sta HongRange: ikiro gh r,
Materiel: Carbon tell
F1111118h; eWvWM
Service; RewmMorWad for MAPOWon of'noft-irtUlaM *Notary Pw)1fw
Maximum Temp@Mm: OW, F
Approvab: 0amplilsomilth Fedwil Spedft6on A,6,llX4,Type 10)
I?f.E(rAm
UL and RA Approved (VM ON - 6',1
Throods ere cmMmnt so ft May ;ipnot became burred or dVm,qed
Knurled swivel cW. provide: vertim! adf6j"t am Ploy is to plate'
C&pmmd swivel mt. in the lfz, through T shm.
Ordering: 69miyare, Igum nufriworo irdmir.
GEE
I V IF
Fig. es: Loads Obs) • Weight (U). • DimetWons (in)
Pipe Otte Max L4Nw Weight i4
1,41 0.08 21/4
0.09 25/14 ITA
0,10
300 g I $A
J
11/3 0.10 rW
2 1 31/4 VAG
4112
0.20 i i4%
4 4"As FIV,
4%
coo coo - I
1.0D
G.'A
ra
5%
PH - 26
CITY, OF SANFORD PERMIT -APPLICATION
v.lv Ioal l-q-oePermit # . Date:
Job Address: , •
4"` e7T-
Description of Work: A.DV/Mo-OCATC— (1l.) Fu7.E 5P21Nl"1:27-`s' Ilistoric
District: Zoning: Value of Work: S Permit
Type: Building Electrical Mechanical Plumbing Fire Sprin arm ' Pool Electrical:
New Service - # of AMPS Addition/AlterationChange o 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 Commercia Industrial Total Square Footage: Construction
Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel
N: '14 - 19 -'1,O - SACa — 01,04: —=30 (Attach Proof of Ownership & Legal Description) Owners
Name & address: gl _ l CAIt'bL Q400EM 4l 0?Q Contractor Name &
Address: 0- 13y
Phone & Fax:_/
Bonding Company:
Address: Mortgage
Lender:
Address: A,
rchitectiEngincer:
Phone: 4,
C { 677,— OL09 E[- I-
L %%4 rState License Number: _ 1-2545000017,60-5 Contact Person: It/
I A (M 5 T7 M /A Q— Phone: _91$3 4-9 -S Zi 51 Phone: Address:
Fax: Application
is
hereby made
to obtain a permit to do the work and installations as indicated. 1 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. Acceptance of permit is
verification that I will notify the owner of the property of the require nts of lorida ien Law, FS 713. Signature of Owner/Agent
Date Signature of Contractor/Agent Date KAU- 'g11M&ntz. Print
Owner/Agent's
Name P, i Contractor/Agent's Name i a'f iLl
urn/ t/Yt .1•. //!/U 7 Signature of
Notary -State
of Florida Date Signature of Notary -State of Florida Date Owner/Agent is _ Personally
Known to Me or Produced ID APPLICATION APPROVED
BY: Bldg:
Zoning: Initial & Date) Special Conditions:
Contractor/Agent
is Personally
Known to Me or Produced ID Utilities: FD:
Initial & Date) (
Initial & Date)
601 i Initial & Diie)'
1j!
fI1/
C'
CITY OF SANFORD FIRE DEPARTMENT
4
FEES FOR SERVICES
PHONE # 407-302-1091 * FAX #: 407-330-5677 /
DATE:
RMIUST01
B INESS NAME / P OJECT: AJZ t
ADDRESS: 1,J
PHONE NoC FAX NO.:
CONST. INSP. [ ] C / O INSP.:[ J REINSPECTION [ ] PLANS REVIEW
F. A. [ ] F.S. HOOD [ ] PAINT BOOT BURN PER IT [
TENT PERMIT ] ANK PERMIT [ ] OTHER ['
STOTALFEES: S O (PER UNIT SEE BELOW) ,
COMMENTS:
Address / Bldg. # / Unit # Square Footne Fees Der Bldg. / Unit
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Fees must be paid to Sanford Building Department, 300 N. Park Ave., Sanford, Fl. 32771 Phone # -407-
330-5656. Proof of Payment must be made to Fire Prevention division before any further services can take
place. I certify that the above is true and correct and that I
will comply with all applicable codes and ordinances
of the City of Sanford, Florida.
Sanford i revention Applicant's Signature