HomeMy WebLinkAbout361 Golf Cove CtPermit # : C J
Job Address:
Description of Work:
Historic District: Zoning:
CITY OF SANFORD PERMIT APPLICATION
eove c7Date:— —
Value
of Work: $ 1—
5'067 Permit
Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Electrical:
New Serv' — of A S Addition/Alteration Change of Service Temporary Pole Mechan'
al: Residentia 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 79 Parcel#: /
r/Vr7 Y 0 Y"' a7"rum (Attach Proof ofOwnersh/i& Owners
Name & Address:+ Ms A
n
eso V7 IT G 5
C !
1 —& a"% Phone: Contractor
Name & Address dVl .O 4_k—01n F 00 AAA it .::LA L -141 00dSe /'
i') I rl /- P/- %{ State License Number. V C}
Phone &
Fax _ Contact PersonO l7 —at;S Phone: ee e7/ Bonding
Company. Address:
Mortgage
Lender. Address:
Architect/
Engineer. 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 standardaf all laws regulating construction in this jurisdiction. 1 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 appdable 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 isverification that 1 will notify the owner of the property of the re it men aen r F 713. Signature of
Owner/Agent Date of Contractor/Agent Print Owner/
Agent's Name Print ont ctor/Agent's Na Signature of
Notary -State of Florida Date Signature of NotaryState of Florida YY Owner/
Agent
is _ Personally Known to Me or Contractor/Agent is —Personally Known try Produced ID _
Produced ID r APPLICATION APPROVED
BY: Bldg: 1 Zoning: Initial & Dat (
Initial & Date) Special Conditions:
Utilities: dtth
Alleq
r WD511154 :
O FD: "r/
Initial & Date) (
Initial 11
Melton Electric, Inc
14000 Starboard Drive
Seminole, Florida 33776
727-542-6454
June 29, 2005
To Whom it may concern:
This letter is to verify that Denise A. Mers, Florida Drivers license #M620-161-
67-640-1, is authorized to register and pull permits under License #EC13001330.
Sincerely,
Jerry Melton
Melton Electric, VC
STATE OF A\
COUNTY
Sworn to (or affirmed) and subscribed before me this 28th day of Tune, 2005, by lerry Melton.
Signature Of Notary public - State of Florida.....
Renee AAelbn
d
My Car+mbsgn p004o959
Personally Known....... ... Or Produced Identification......... av' '*
25' 20W
en icafion Produced ............................................
Electrical Panel
Box
Added
2 amp,
Square-D
Breaker
Existing Conditions:
Henderson
361 Golf Cove Court
Sanford, FI 32773 Electrical Plan
Wheelchair Lift
Drawings by:
Home Safe, LLC
5914 Jet Port Industrial Blvd.
Tampa, Florida 33634