HomeMy WebLinkAbout500 Central Park Dr12-17-203 11.30AH FROM / P.1
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Dacriptioa of. Work.,
CITY OF SANFORD tLRMIT APPLICATION
Date:
Historic District; /yy_ Zoning; VatnO Of Wor11: S 1 Lad Permit
7ypa Building Elccaical Mechlatiea; Plumbing ire Sprintlu la"n Pool Electrical:
Now Servioe - # of AMPS AddidodAltapidon Change of Se rviu Temporary Pole Mecbaatcai:
Residential Non-Resitimlial RsPltcemm New- (Duct Layout & Eatngy Cal,-- Requiroo Plumbing/
New Cannmsrcial: # of pixures M of Water & Sewer Lines` # of ()et Lines PlumblaWNew
Re iofentbu: # of Water CYocets _ Plumbing Repair - Residential or Comm&vdal OCCUPRUCY
Type; Residential Comrtterdal ,induttrial TOW! Square Footage: 7 1 Coustruedoa
Type: `^, # of 5toriear L 0 of DweWut Uaits Flood 7,o40-' FEMA fetrta rtpnlrW for vtbtr than In Parocl
0: Owners
l Address: Contracror
iYrala 6: Addre "; U VfNTe:
A44 Gee. L Pboae &
Fax: A0—VC7- 3 372 47-o Bonding
Company: Aderess:
MOrtgagi
Leader: Aedreas: •
Attach
Prw of Owamitip & tagsl Description) Pewtw;
State
Lirsase Number. & f S7 24"wt 17 8 S 40) ^
G) 5-33?2 A-
Altoct/Eagiaaer. "' °' - ..• ULU I V LUUJ Addrt
s: Fas:
Application
is btteby made to obtain a peaait to do they wort and t' i c t no work or installation hat Commenced isttwttceofapermitanda.at all wort will be p^o. to the perK,
PLUMBING, to
meet edl 1 in this jatisdiction, I under taod that a Separate permitttwsttt0tiosurodforELECTRICALWORK, PLUINBING, 1 CES, BOILERS. RBATERS. TANKS. and AIRCONDITIONERS, etc. " OWNF_
ER'S AFFIDAVIT: I ccstify than all of dw foregoing iafouNdOn iS at MMC and tbU all work will be done in COMPlianoe with all applicable laws regulating constructionandmainPAYING
MAYRESULTINYOURPj. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE Of COMMENC]MET M TWICEFORIMPROVEMENTSTOYOURPROPERTY. IF YOU INTEND TO OBTAIN F[NANC[NtS. CONSULT NT YOUR LENDER OR ATTORNEYBEFORERECORDINGYOURNOTICEOFCOMMENCEMENT. AN TICE:
111 addition to dw tt:Q"cme m Of this Pemtit, tare, may be, additional restrictions apPlicable to this prtrpertY Wet may be 110 din the pttblie records of thiscouary, and Were maybe additional perarits re qulred from other govexruatntal entities sunk as water musegenteat districts, etm agencies, or federal agencies. ACeepfance
of permit is verification that I will notify the owner of the property of the regta f Florida Lt o Law. Pg 713. Stttttattt:
aof0wser/Agmu Srg lL
11 Desk
rotttre of C000attor/AStatAretn Date off —
PrierOwner/Agt at's Name Print Contmota/Aaenex Nama signature
of -State ofPiorids D 07- -
O ? NotaryseeSigosturcOf >` prY6, y [A1t'!)gr NYPtrbfic-
5tateofFiorida 7
MYCortr n,EW-:j nZ2tm5 Owner/
Agedt[ a Pcrsonaily Known to Me or CtxrtyeWdAgrnt is erito'nill Known ye on # CC983p68 Produced [
D Produoed
ID r
APPLICATION
APPROVED BY: Bldg: _ [ Z -b (' Zoning; Utilities: FD: 4 Iv Initial & Date) (initial & Gate) (Initial & Date) t ilnitiai& Dsu) " f Spacial
Conditbtu•
CITY OF SANFORD FIRE DEPARTMENT
FEES FOR SERVICES
PHONE # 407-302-1091 * FAX #: 407-330-5677
DATE: C ' PERMIT #: d`I
i ,\
BUSINESS NAME / PROJECT: Np A
ADDRESS:
19.3
PHONE NO.t-i0 G 3 3--t-FAX NO.:CL-l07 r1 `Y - 17 &3
CONST. INSP. [ ] C / O INSP. j J REINSPECTION [ ] PLANS REVIEW
F. A. [ ] F.S. [ J HOOD [ J PAINT
5BOQTH [ BURN PERMIT L ]
TENT PERMIT TANK PERMIT [ J OTHER 11 tf_ Se t,,
TOTAL FEES: S -
o (
PER UNIT SEE BELOW)
f
QS
g.bCATP-J
Address / Bldg. # / Unit # Square Footage Fees per Bldg. / Unit
1.
2.
3.
4.
5. I
6.
7.
8.
9.
10,
H.
12.
13.
14.
15.
16.
17,
18.
19.
20.
Fees must be paid to Sanford Building Department, 300 N. Park Ave., Sanford, FI. 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 Fire Pre ntion Division
0 q (? /
Appl' ant s Signature