HomeMy WebLinkAbout1251 Forrest DrCITY OF SANFORD PERMIT APPLICATION
Permit # : ) O Date: iZ
Job Address: :i.i1 E)r rT e_st x- Description
of Work:yu W _i C 1 J Historic
District: Zoning: Value of Work S-ta,(ti Permit
Type: Building Electrical X_ Mechanical Plumbing Fire Sprinkler/Alarm Pool Electrical:
New Service - # of AMPS 1 _ Addition/Aheration Change of Service Temporary Pole Mechanical:
Residential Non -Residential Plumbing/
New Commercial: # of Fixtures _ Replacement
New (Duct Layout & Energy Calc. Required) of
Water & Sewer Lines # of Gras Lines Plumbing/
New Residential: # of Water Closets Plumbing Repair - Residential or Commercial Occupancy
Type: Residential Commercial Industrial Total Square Footage:raG139 _ Construction
Type: _11L # of Stories: _1__ # of Dwelling Units: ,1_ FloodZone- (FEMA form required for other than X) Pared 0:
a Owners
Name & Address: Bonding Company:
Address: Mortgage
Lender:
Address: Architect/
Engineer:
Address: Attach
Proof
of Ownership & Legal Description) Phone: Fa::
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 s 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 infuriation 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 govermuental entities such as water management districts, state agencies, or federal agencies. Acceptance of
permit is verl5cation that I will notify t4-e kwntAofthe property of the requirements of Florida Lien Law, FS 713. Signature of
Owner/Agent Date Signsam of Contractor/Agent Date Print Oxmer/
A;,3's N ry , Of Fbrlda P Contractor/Agent's Name Ka' mvpi,
Sign
of
Ntary to Fl w Fe3 1K1 Signature of Notary -State of Florida Owner/Agent
is Peaamaiiti.Ymnm rn, Me Produced ID
Date Contractor/
Agent
is _ Personally Known to Me or Produced ID
APPLICATION APPROVED
BY: BloaefEi Zoning: Utilities: Initial & Date (
Initial & Date) Special Conditions:
FD: Initial &
Date) (
Initial & Date)
i
ELECTRICAL SERVICES INC.
2153 PREMIER ROW ORLANDO, FL 32809
407) 812-1822 -FAX (407) 812-7171
February 2, 2006
City of Sanford
P.O. BOX 1788
Sanford, FL 32772-1788
407-330-5656
Subject: Temporary Power of Attorney
I, Steve Miller authorize Karen Zozula to apply for electrical permit for Miller Electrical Services Inc.
in Orange County for the following house:
Lot: 9
Subdivision: Winwood
Address: 1251 Forrest Dr.
Permit #: 05-4162
We would like to pull the money from our escrow account to pay for this permit.
Thank you
Li n c
Steve Miller
President
Signed before me this day of January 2006, in Orange County Florida by Steve Miller who is personally
kno to me
NO Nfotary Public State of Fbrida
Kam da zuta
O 14 Gw m;moipi DD3MW
n a expires 01102/2009
Notary Pub
State of Florida Certified Electrical Contractor EC 0000594