HomeMy WebLinkAbout1001 Rinehart Rd•4f .}, ,`!'•• `.` •9rr. h a. ♦� +Y•'* � e i .q,•'rT^'S+ •C fir.
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` r CITY OF SANFORD PERMIT APPLICATION �N /�����
Permit # . O� 'S u Date: 1 �•� Ar' 6t4Y Z•�J'"``
Job Address: 1 �� n+z e. a•- o �� f/fes /
Description of Work: IF �-c'-t- –k --c r%Ir 'aC�� d = + cc.- .� c Off/
Historic District:
Zoning: Value of Work: $ q\5L> –
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alann Pool en
Electrical: New Service – # of AMPS Addition/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 –14 Industrial Total Square Footage: Cgbc>
Construction Type: # of Stories: _� # of Dwelling Units: _–I— Flood Zone: (FEMA form required for other than X)
Parcel #: 31;1-- l " 3 O - 3 o O VD -TPr ^ 010 0 d (Attach Proof of Ownership & Legal Description)
Owners Name & Address:
N
V% KJ%ft 4- —59%) 9=�Ryp 3 ',I6–Z Z 1 Phone: Yo -7 •- SF �' 37 C o
Contractor Name & Address: t \ t,,T �
State License Number:
Phone & Fax: % b—i %k ;LZ - L 001 `E•32-047$ontact Person: Bit o Phone:
Bonding Company:
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, FURNA ^ES, 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 1 will notify the owner of the property of the requirements of Florida Lien Law, FS 713.
le
Ii,��
� • , • o , ignatureof Owner/Agent
Special Conditions:
ally_ISnown to Me or Personally Known to Me or
(Initial & Date)
Zoning:
Produced I D
FD:
(Initial & Date) (Initial & Date) (Initial & Date)
.9=
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��
Print e
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Ty. � f�D✓
Signa re of Nota -tate of 1
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CL d �
:it
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Owner/Agent is Perso
c 2 e 0
• N O�
�wduced lD
O w _
�4'"RCATION APPROVED BY: Bldg:
Special Conditions:
ally_ISnown to Me or Personally Known to Me or
(Initial & Date)
Zoning:
Produced I D
FD:
(Initial & Date) (Initial & Date) (Initial & Date)
CCITY OF SANFORD PERMIT CHECKLIST
INvo1cE # 3
NAME: ' C�
LOCATION:_
DATE(S) TENT UP: 7 // IN USE: TENT DOWN:.
SEND INFORMATION TO THE CITY IN THE FOLLOWING ORDER:
COVER SHEET
POWER OF ATTORNEY
APPLICATION
COPY OF INVOICE
DIAGRAM
FLAME CERTIFICATE
Special Power of Attorney
Date:.
I hereby name and appoint N& -eat. -
Of Kirby Rental Service to be my lawful attorney in fact to act forme and apply to the
Building Department
for a Tent Permit for work to be performed at a location described as:
v •
(Owner of Property)
and to sign my name and do all things necessary to this appointment.
A0 LL "(Ort)ci" c7oc)-7S
Print name of Certified Contractor & License Number
Signature of Certified
The foregoing instrument was acknowledge before me this-�- k ` tti-GZ�3
Jr\ / \ . I -I--
by
State of Florida
County of. r�
�2! �• -
. /
(Seal) ,.���Shandra Ya Mur
` 0000"W831011# CC 85392
I 1
: J c P.apiree Aug. 30, 2003
Atlantic Th,,
tic sanding Co" Inc.
who is personally known to me:
r
R 10. 1. 5
* * * * * * KIRBY RENTAL SERVICE R SALES INC. * * * * * * *
* * * * * Phone 407-422-1001 Fax 403-422-0028 * * * * *
WAREHS/DELIVERY DRIVER: DATE:
WAREHS/ PICK—UP DRIVER: DATE:
PAID: DATE:
Billing Address —***** DELIVERY ADDRESS *****
Customer ID===== ------- Number
4075853900 RESERVATION/RENTAL CONTRACT 01-037354-03
07/11/03 COURTESY ACCURA
COURTESY ACCURA 1001 RINEHART ROAD
1001 RINEHART ROAD SANFORD, FL 32771
SANFORD, FL 3771
407-585--3900
--------------------------------------------------------------------------------
REP: JEANETTE ORD'D BY? TOMMY COD? Y REV? N Rsrvd: WED 07/09/03 15:00
DELIV CONT:TOMMY OR WALTER EXT.3904 PH:407-585-3900 Delivr: FRI 07/11/03
WAREHS/DEL- DRIVER: DEL DT: / / Out: FRI 07/11/03 17:00
WAREHS/PU DRIVER: PU DT: / / Pickup: MON 07/14/03
Due: MON 07/14/03 17:00
FAX: 407-351-1565
--------------------------7-------------------------------------------------------
=Item No.====Qty=Description=====---------- =Rate Info=====------==Unit==Extended
1110-0505 1 Tent 20x40 Frm WHT AA j
SET ON ASPHALT
1620-0165
19100-0105
19100-0045
'9100-0040
9100-0035
1 Fire Safety Package
1 PERMIT + COURIER FEE
CITY OF SANFORD
1 EVENT TYPE_ & FAX #:
TENT SALE
FAX: 407-585-3960
1 ENVIRONMENTAL FEE
1 DELIVERY CHARGE
P Sales Agent: Date: Customer: Contract:
CL _P_T_gSY_�f'L�1P_ __ ____ 1711_-171��3�b
==2002"* EXPIRES
ORANGE COUNTY OCCUPATIONAL LICENSE 3100-013986
iRI GINAL 09/30/2003
Earl. K. Wood, TAX COLLECTOR
ORANGE COUNTY, FLORIDA
Z,-- ANY L'7_c L E �.cQ RED .Y -'T' = .. :i=:,_ r.i� iK_ =� _� __
'ii15 LIC:'cLIcU = _ C= JI
D 3E Z. Y 0-ri _kWFJi -64OR.1?Y. :T' VAL: _ - ;A01! JCT05 `A t 'SRCUvf S °T= .S=am 3:,• _. ° _` Yc�-. 7_LIN?U_NT PEKRLT:' • .4�?=� OCTOE�R 1.
SVC -RENTALS
30.001 WORKER
.00
-00 DETAIL
30.00 1 WORKER
TOTAL TAX 60.00
�? KIRBiREN AL'•. SERVICE F. SALES
t;Q;,
TOTAL PAID 60.00-
�SIt E RICHARD 6 BONNIE L
/! ;:
TOTAL DUE 000
1i'
'WANOOEFL'A32805-1512
L1 NAMES AV
`
- ORLANDO
BROWNE RICHARD 6 BONNIE L
PAID: 60.00
99-305680 8la''12002
TS;;S F0R!:". BECOMES '"'IF 1'. .'r' `: S_'_. _ . " �.in cc,.!
W,
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JLL 11 2003 10' 45
r FX
t LUt4c � �Cr.�.c . • • ••
uriaa�t�+u� VO•J:J
DATE:
To At am it May Concern.
"U, tz� 4366 TO 4074224943
Mlmz � hz,:I I NL �GIw 11.G
Please be advised firs
Gives. KIRBY RENTAL SERVICE. vermission t treat a tent all Our eroeern+ lecared at
Be advised that reszoorns are Provided.
Please note chat this letter is good for one year from the above date and will be kept on file
T. 11 1. 1Awv .,% • . -
P.01/02
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ticer#ificate of fftamt �e�i�#anrE
ISSUED t3Y
KIRBY TENT RENTAL �Go$ T/,�9�
Division of Kirby Rental Service & Sales ��� 0 a
411 Hames Avenue 8711 Phillips Highway U)
Orlando, FL 32805 Jacksonville, FL 32256
r
MANUFACTURERS OF THE FINISHED TENT PRODUCT DESCRIBED HEREIN4 9�QREMN�� Q'
�FRETP"e`O
DATE:
This is to certify that the materials used in the construction of the
ao x (4C)
have been/flame retardant treated (or are inherently non-flammable)
*by the __ Snyder Manufacturing Company
Their registered application concern number F-140-01 __ is approved and registered by the State Fire Marshal
and the application of said chemicals was done in conformance with the laws of the State of California and the rules and
regulations of the State Fire Marshal.
Flame Retardancy Cannot Be Removed By Washing And
Is Good For The Life Of The Material.
*THEIR Fabric Meets The Requirements Of Specifications
Listed As NFPA-701 (Large Scale)
F-140-01 �
4 „L.
I r'h.91
REGISTERED
— _
APPLICATION Signed. -
TENT DEPARTMENT
CONCERN NO.
CITY OF SANFORD FIRE DEPARTMENT
FEES FOR SERVICES
PHONE # 407-302-1091 * FAX #: 407-330-5677
DATE: I O PERMIT #: be�` , 35g
BUSINESS NAME / PROJECT: Ci411 r +<s V Ac V r'&--
ADDRESS: 100 1 1-1. I
PHONE NO.:
FAX NO.:
CONST. INSP. [ ] C / O INSP.:[ ] REINSPECTION [ ] PLANS REVIEW [ ]
F. A. [ ] F. S. [ ] HOOD [ 1 PAINT BOOTH [ j BURN PERMIT [ J
TENT PERMIT JK TANK PERMIT [ ] OTHER [ ]
TOTAL FEES: $ 2,6:0
z) (PER UNIT SEE BELOW)
COMMENTS:
Address / Bldg. # / Unit #
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14,
15.
16.
17.
18.
19,
20.
Square Footage Fees per Bldg. / Unit
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 Prevention Division 1`` Applicant's Signature