HomeMy WebLinkAbout110 W 1 StCITY OF SANFORD MECHANICAL PERMIT APPLICATION
Permit Number.Qa, — �`��o� Date:
The undersigned hereby applies for a permit to install the following equipment:
Owners Name: H od/ond
Address of Job:
Mechanical Contractor/awC.
Residential
N C
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Non -Residential
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29 "If WNW IZWA
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'Job Valuation:
Application
TOTAL DUE:
r 0� _'
By signing this application, I am stating that I am in co�fipli qle with ity,6f Sanford
Mechanical Code. // /
A licant Signature
State License Number
[,mW19L4L9um1\LPIAIL4a
State of Florida
County of
The undersigned hereby informs all concerned that improvements will be made to certain real property, and in
accordance with Section 713.13 of the Florida Statutes, the following information is stated in this NOTICE OF
COMMENCEMENT.
Legal desq&tiort ofpropgrty(include street addressiif
General description of im rovements.e`
. �\�\\. ` t,, Nom•. �:�1
Owner
Surety(if any).............................................................................................................................................................................
Address................................................................................Amount of Bond $ ......................................... _.............................
Any person making a loan for the construction of the improvements:
Name.....................................................................................Address .......................................................................................
Per on with Sate of Florida designated by owner upon whom noti es oro er docu�ne �s mabe served:
.... f��l.: �'S...�.....f ah.itl...........................................Address•.[. . :. c�/cacti l�r.fT..::l.. .l... ..........
In addition to owner, owner designates the following person to receive a copy of the Lienor's Notice as provided
in Section 713.13 (1) (h). Florida Statutes. (Fill in below at owner's option)
Name.....................................................................................Address........................................................................................
This space for recorder's use only ...s...�x�z,
61q-z.
q� Owner's sign tune
fMIS INST MEN( VRE ABED ell C G�-� /
NAME ' \ e.�S V\- .. d.
ADR. 1s p r ; Swor to and subscribed before me this 3 day
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NOTARY PUBM