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2404 S Mellonville Ave 04-287 Electrical upgrader Permit li 3 Description of Work: Historic District: CITY OF SANFORD PERMIT APPLICATION r Date: 2 \P._ Zoning: V Value of Work: $ . Permit Type: Building Electrical _LZMechanical JWPIumbing Fire Sprinkler/Alarm Pool Electrical: New Service — # of AMPS 6WO Addition/Alteration Change of Service t--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 Industrial Total Square Footage: Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X) Parcel #: Owners Name &Address: J 1 7 uk 0 Contractor Name & Address: C Attach Proof of Ownership & Legal Description) Phone: State jLicense Number: E-C— O0© M ),T Phone & Fax: 0-7— _L66 '' ,'25— Zl6 Contact Person: !'n t Lam_ Phone: _YQ I / 'Z ^ 5 L.J/ 0 Bonding Company: \\ Address: W.0 ( I l e 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. Acceptance of erm' is eri ca that I ti the owner of thepropertyfY of the requirements to ' Law, 3. :• 5 03 - : o Sign re of Owner/Agent Date Signakure of Contractor/Agent ate ",'„ 0 t OV Fy x Print Owner/Agent's Name Print on e = v.. ig " CD rn coCD to Q C7 Signature of Notary -State of Florida Date St tary-State o Flori D to J g a g b av Nod o z O O N Owner/Agent is _ Personally Known to Me or Contractor/Agent is Personall Known to Me or Produced ID g_Produced ID 56 —7.51 y/576 APPLICATION APPROVED BY: Bldg: Special Conditions: Initial & Date) Zoning: Initial & Date) Utilities: FD: Initial & Date) (Initial & Date)