HomeMy WebLinkAbout1116 Cypress Ave (2)CITY OF SANFORD PLUMBING PERMIT APPLICATION
Permit Number: . 0,3— iJ b r Date:
r'
The undersigned hereby applies for a permit to install the following plumbing:
Owner's Name:
�.. - ..■��II��Ii1IJ[M����`LIJI�►At�I.��li[�Ly
13M, MOVITIMU,�011. 'sW % ,
Residential: Non -Residential`.
Number Amount
Addition, Alteration, Repair Residential & Non -Residential S"
New Residential:
One Water Closet
Additional Water Closet
Commercial: Minimum Permit Fee $25.00
Fixtures, Floor Drain, Trap
Sewer Piping
Water Piping
Gas Piping
Manufactured Building
Description of Work: VC
A lication Fee:10.00
TOTAL DUE:
By Signing this application I am stating that I am in compliance with City of Sanford Plumbing Code.
Applicant's Signature
State License Number
• V•.
A110517848'. STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ���
CONSTRUCTION INDUSTRY LICENSING BOARD SEQ#LOZ080700843
OA/� 1,2 O'n n38'�74 CFc'd57t64 ''
The PLUMBING.CONTRACTOR •%
•Named. belowas; CERTIFIEDi;
Under the provisions of Chapter,.489,FS.
Expiration date3 AUG 31, 2004*-.'-- ;,�: ' • ..
RITNER DONALD EDWIN
FLORIDA PUBLIC UTILITIES COMPANY
401 S DIXIE HWY
WEST PALM BEACH FL 33401
JEB BUSiI
GOVERNOR —
RIM BINKLEY-SEYER
DISPLAY AS REQUIRED BY LAW SECRETARY
0