HomeMy WebLinkAbout1204 S Palmetto AvePermit Type: Building Electrical
Electrical: New Service — # of AMPS
Mechanical: Residential Non -Residential
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential X Commercial
Mechanical Plumbing_ Fire Sprinkler/Alarm PoQI. .
-r
_ Addition/Alteration Change of Service Tempoe&y Pole
Replacement New (Duct Layout & energy Cali. Required)
# of Water & Sewer Lines # of Gas Lines
Plumbing Repair— Residential or Commercial `'
Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
(Attach Proof of Ownership & Legal Description)
Owners Name & Address: ! my Turne -
Contractor Name &"Address: (�%(
3136 Nmh C-�.
Phone & Fax. ?J D�a
Address:
Mortgage Lender:
Address:
Bonding Company:
Phone:
Arch itect/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 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, FURNACES, 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 I will notify the owner of the property of the requireme of Florida Lien Law, S /
449 _b/I h/o3
Signature of Owner/Agent Date Signature of Contractor/Agent Date
Pu n 1-Ibw o vd.
Print Owner/Agent's Name P n n t C e /
Signature of Notary -State of Florida Date No�ry- tate of Florida Date
os, ;P�aG Melissa Dunklin
Commission#DD 163723
�,. Expires: Dec 20, 2005
O%%ner/Agent is _ Personalh Known to Mc or C-0 0%w,/Ab�is _ �h@paliPh�iown to Me or
Produced ID ( ProNoe"I'D
30 _727470
PPLICA KION APPROVED BY: Bldg:
1Initial & Date)
Spccia! Conditions:
Zoning:
(Initial & Date)
U::: -_-S:
(Initial & Date)
FD:
(Irwial & Dat;
Date: 15-- /6--0.3
POWER OF ATTORNEY
do hereby authorize
INAA1
address
i3,4Fd_Y SKATES -WEARY ;
yauiurt,
=cgP�'pue
Commission # DD0134673
•
Expires 7/21/2006
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Bonded through
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(800 432 4254)
Florida Notary Assn.,
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1,=1 ti .fi Com_
Noy
Personally known to or dn'vreFs license #
ort a, Coi inty of Don 15 day of
IKA n 1 .2002.
May 19 03 11:20a POLIZ2I 3868601575 p.2
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3135 A`oah. ('d.
1)e.ITolm!' 11. 3-1,38
Phone (380) 800-17619
k
City of Sanford,
Attn: Joanne
This letter is regarding to permit #03-1869 which I pulled on Friday, .May
16, 2003. Under description I submitted it as a gas water heater
replacement, in error Asper our phone conversation, the actual work being
performed by us at 1204 S Palmetto is a gas fuel line to range and a line to
pool heater Please make this correction on the recorded permit. If there are
My questions regarding this matter, please call me at the office @ ph#
(386) 860-1709. Thank you in advance for your assistance.
-Ruthann Howard