234 N Scott Ave - 08-001747 (2008) DETACHED GARAGE - ELECTRICALCITY OF SANFORD PERMIT APPLICATION
Application #: rya 1
f/— /7" /
Job Address:
Parcel ID: &/ / 7 3l `J Do? 0/06 CV -5 C) Zoning:
Submittal Date:
Value of Work: $ 5_'0B010C) Historic
District: Description
of Work: ll/(b / ///'-i jL lIQ T .21 l1)Gf quare Footage: 2 Permit
Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Sign Electrical:
New Service - # of AMPS Addition/.Alteration/Q Change of Service 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 Commercial Occupancy
Type: Residential Commercial Industrial Occupancy Use Group(s): Construction
Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required ) Property
Owner: lqj'1!hlle 1V1_W,C! n?iLc _ Contractor: Az ele, Address: ,
3`/t// /G 2. Address: ? _ IQ yi Phone: -
8-3:9 E-mail: Phone:M-35?1%tate License Number: Ae:OX PW Bonding
Company: A/A Mortgage Lender: Address:
Address: Architect/
Engineer: Address:
Plan
Review Contact Person: Phone: Fax: Phone:
Fax:
E-
mail: 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. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE 10B SITE BEFORE THE FIRST
INSPECTION. 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 foun to th public records of this
county, and there may be additional permits required from other governmental entities such as water management districts, state a ncies or federal agencies. Acceptance
of permit is verification that I will notify the owner of e p pem of tIt requi tnents of 46
72 Florida
Li n L FS
3 /
Signature
of Owner/Agent Date Signature of Contractor/Agent Date n
a)
I ( f-3D ra t'r/c C Print
Owner/Agent's Name Print Contractor/Agent's Name Signature
of Notary -State of Florida Date Signat e f Notary -State Florida Dale AaY
P c CAROLYN MORGAN MY
COMMISSION # DD 611907 j
P,41 EXPIRES: December 13, 2010 APrForFLO?
Bonded Thru Budget Notary Services Owner/Agent
is _ Personally Known to Me or Contractor/Agent is Personally Known to Me or Produced ID _
Produced ID APPROVALS: ZONING:
Special Conditions:
Rev 07.
07 UTIL: FD:
ENG: BLDG: L30
f
t r1r100i
Elect i I Contractors, Inc. 430 West Drive • Altamonte Springs, Florida 32714 P: (407) 788-3500 F: (407) 788-2007
L-IMITEDr POWER OF ATTORNEY
Date. October 6, 2008
I hereby name and appoint: Richard Rogers
an agent of:Tri-City Electrical Contractors, Inc
to by my lawful attorney -in -fact to act for me to apply for, receipt for, sign for and do all
things necessary to this appointment for the specific permit and application for work
located at:234 N. Scott Ave, Sanford, FI
Expiration date for this Limited Power, of Attorney:l0/06/2009