HomeMy WebLinkAbout1503 Travertine TerPermit #
Job Address:
Description a
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Date: / I /Vol,
Permit Type: Building Electricalx Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Additio' n/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 Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: 33 11{30 52-0
Owners Name & Address: Y V V 1f712
Address:
Attach Proof of Ownership & Legal Description)
State License Number: Ec- coo 1' E 5 2
Mortgage Lender: L1 I
Address: , +
Architect/Engineer: K1 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 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 r quw4maFAs•Gf F.-lariclg,,,Lieenn Law, FS 713.
Signature of Owner/Agent Date Siignatureo for/Agent ate
Print Owner/Agent's Name Print Co for/Agent's Name
Signature of Notary -State of Florida Date Si ature of N tary-StateofFlorida w ,c„ Date
gAMONR`A RAMOS
l -k
MY C0MI1.41SS10N 4 Du 461113
F- 27 v y EXPIRES: September 23, 2009
Owner/Agent is _ Personally Known t Contractor/Agent is _ Personally l A fo,'Me okided 7hru Budget Notary ServicesProducedIDProducedID °F Fk
APPLICATION APPROVED BY: Bldg: Zoning:
itial &Date)
Special Conditions:
Initial & Date)
Utilities: FD:
Initial & Date) (Initial & Date)
LIMITED POWER OF ATTORNEY
I Richard J. Deese hereby name and appoint Bill Paolello to sign his name on my
behalf in order to apply for electrical permits and/or to pay reinspection fees in Orange,
Osceola, Seminole, and Lake County in the state of Florida.
1
Richard J. Deese
EC0001882
STATE OF FLORIDA
COUNTY OF ORANGE
The foregoing instrument was acknowledged before me on 19th day of January
2006 by Richard J Deese who is pgsonally known to me and who did not take an oath.
Ramonita Rai
DD059303
Seal
RAMONITA RAMOS
COi:;bilgSiON r D 461113
EXPIRES ScPI ber 2009
rFOF Fo Banded hra B;:ogel Notary Service, Commercial -
Residential Service P.
O. Box 530103* Orlando, Florida 32853* Ph: (407) 895-7075*Fax (407) 895-7054