HomeMy WebLinkAbout711 E Airport Blvd (2)Permit # :
Job Address:*i / / Ead -.7 % A,J,
t
Description of Work: e Q ✓ w
Historic District:
Zoning:
CITY OF SANFORD PERMIT APPLICATION
Date:—d"oZ–'�3
C 4 i'gedmt� ce 5 C (iC. (J G 1-6 trt /, t -
Value of Work: S o 1300, a Qo
Permit Type: Building Electrical ` Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS / S D Addition/Alteration A--- Change of Service Temporary Poley
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 Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Name & Address:
(Attach Proof of Ownership & Legal Description)
T /� Phone:
Contractor Name & Address: �i (e G l eN f n n �f? C r
State License Number: Dl 11 C
Phone & Fax: �n % �3 �i�� ! 0 Contact Person: cST�ern sky _Phone:,/O 7 "
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/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.
fpermit is yerificai
Signature wnerh
Print Owner/Agent's
I will notify the owner of the property of the requirements of Florida Lien Law 713.
Date Signature of Contractor/Agent Date
a CS7�-rJr-c',
Signature of Notary -State of Florida
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg
(Initial & Date)
Special Conditions:
Print C ��nt'sName ' kp�
Date � XX ' CommlSSion �D163723 Date
Expires: Dec 20, 2005
a. doe; Bonded Thru�
Coracfhu,igdrlt rs Qjljil�_1�111`� o J Me (mor
''CC
Produced ID (�(p ZIn
Zoning:
Utilities:
FD:
(Initial & Date) (Initial & Date) (Initial & Date)
AC# 0 4 7 0 7 6 4 STATE OF FLORIDA
DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION
ELECTRICAL CONTRACTORS LICENSING BOARD SEQ#L02062702163
DATE IBATCH NUMBER
I OW I Q --- I
The ELECTRICAL CONTRACTOR
Named below HAS REGISTERED
Under the provisions of Chapter 489 FS.
Expiration date: AUG 31, 2004
(INDIVIDUAL MUST MEET ALL LOCAL LICENSING
REQUIREMENTS PRIOR TO CONTRACTING IN ANY AREA)
PERRY, STEVEN H-
ELECTRICOOL INC CpDwr
5703 RED BUG LAKE ROAD SUITE 322
WINTER SPRINGS FL 32708
JEB BUSH
GOVERNOR
KIM BINKLEY-SEYER
DISPLAY AS REQUIRED BY LAW SECRETARY
SEMINOLE COUNTY OCCUPATIONAL LICENSE
STATE OF FLORIDA Accc-uiit it. 0653'10
RAY VALDES, TAX COLLECTOR
BUSINESS ELECTRICOOL INC
ADDRESS F,703 RED BUG LAKE Rb I'MR #:.1222
W:CNTL.F; SPRING -Si
: ^'r0 :
STEVEN H I'E:RRY ',OWNER)
MAILING ELECTRICOOL INC
ADDRESS 703 Fll.:D BUG LAKL RD PMN #-12'.''
WINTER SPtRINGS, EL
{Ill;lllilillfl{1{III{Ilillilll!
Arii1:1unt F'aitl: $
LICENSE TO ENGAGE IN BUSINESS.
PROFESSION OR OCCUPATION SPECIFIED BELOW.
I ONTRACTOR--ELECTRICAL
ER0011941
A, i; CuN i'RACTi7R (1 i
'State L i c .4 RAO06-0 'v
LIC .# - RAO() 6-702`6
40.00 OLHS2002090607761
1