213 W 11 St - E08-001692 (ELECTRIC SERVICE TO CABINET) DOCUMENTSCITY OF SANFORD-PERMIT APPLICATION
Application # :
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Pp
q
Submittal Date:
Job Address: 7<h - r Value of Work: 5 oloo U
Parcel ID: Zoning: Hii]st ric District:
Description of Work: C 11 QBake oltgt
Permit Type: Building Electricals Mechanical Plumbing Fire Sprinkler/Alarm Pool Sign
Electrical: New Service — # of AMPS Addition/Alteration 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
Occupancy Type: Residential Commercial
Construction Type: of Stories:
Plumbing Repair — Residential Commercial
Industrial Occupancy Use Group(s):
of Dwelling Units: Flood Zone: (FEMA form required )
Property Owner: /9-7 T Contractor: Le f I C (I 11 L- I C 4Y I QQ I vzy)v-/-i 41r, rl
Address: f5m IV ra e- Address: 14a-50 f //
rL
Phone:g67-Z27--'0-,* E-mail: PhonA, L7-3ZL—&W, tate Lice se Number:
Bonding Company: Mortgage Lender:
Address: Address:
Architect/Engineer: 79 Phone:
Address:
Plan Review Contact Person: Phone: Fax:
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 JOB `SITE BEFORE THE
FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR
NOTICE OF COMMENCEMENT.
N TI E: 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 pr f-dse`irem-rida Lien Law, FS 713.
Signature of Owner/Agent Date Si ature of Contractor/Agent Date
I' lSmfflcrlin
Print Owner/Agent's Name rmiSt dontractorAgent's N e 03
Signature
of Notary -State of Florida Date Signature of Notary -State o lorida Date Owner/
Agent is. Produced
ID APPROVALS:
ZONING: Personally
Known to Me or UTIL:
u BARBARA
JEAN BEAM MY
COMMISSION # DD519634 EXPIRES:
Feb.16,2010 Contractor/
Agent is v nal prsto MeF 'da Note y semce.com Produced
ID ENG:
B LDG: Special
Conditions: Rev
07.07
I
LIMMITE]D POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: 3
I hereby name and appoint: l I /_S i' 5urnr, l
an agent of:r,, , co; r1 Fil,Pe-'ice'l-I 66y e-) Name
of Company) to
be 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: Street
Address) Expiration
Date for This Limited Power of Attorney: ti/ /A License
Holder Name: State
License Number: Signature
of License H STATE
OF FLORIDA COUNTY
O ,n The
foregoing instrument was acknowledged before me this J day of Qb-f- , 2000
by N Tk0r\ r, who is rsonallyknown to
me or who has produced as identification
and who did (did not) take an oath. Signature
Notary
Seal) Print
or type name Notary
Public - State of5ex r:,ra Commission
No. My
Commission Expires: 401 °
p4 BARBARA J EAN BEATry aMyCOMMISSION # DD519634 OFt
EXPIRES:
Feb.16,2010 407)
3g&0153 Florida Notary Service.com Rev.
3/27/07)
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CITY OF SANFORD, PERMIT APPLICATION
Application #: 08I & _ Submittal Date: S I. / O C%
Job
AddressA/; _ _ Value of Work: S Parcel
ID: i
Zoning:
Historic District: Description
of Work: Prvb 1 P C (Ce r 1 C SP rV l Ct`' 11 1 _f q are l
b in 'c p
quare ootage: Permit
Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Sign Electrical:
New Service — # of AMPS 160 Addition/Alteration Change of Service Temporary Pole Mechanical:
Residential Non -Residential. . Replacement New (Duct Layout & Energy Calc. Required) Plumbing/
New Commercial: # of Fixtures # of Witter & 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: -T1 AY Contractor n.n Oectr flu l Ooryowxboo Address: V11
We Ave Address:-4Ls6 Ala l ck QI k STP• Z/Z -3 55 Odabdu ` Phone.
401-?_
Z2- 02—q IE-mail: Phone:W1-3Z3-'7 te License Number: Bonding Company:
a Mortgage Lender: N la T Address: Address:
11 Architect/
Engineer:
N CI Phone: _ Address: Fax: _
Plan Review
Contact Person Phone:90 1-M-3 9= 775451- ZIQ % 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 pemvt 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 JOB SITE BEFORE THE FIRST INSPECTION.
IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT. N TI
E: 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 req . me of F1 -ien Law, FS 713. Signature of
Owner/Agent Date Signatuj of Contractor/Agent Date Print Owner/
Agent's Name Signature of
Notary -State of Florida Date Owner/Agent
is _ Personally Known to Me or Produced ID
APPROVALS: ZONING:
d S' u ' D% UTIL: FD: 1'*A"
0 CRYSTAL C SUMMERLIN MY COMMISSION *
DD510690 Q EXPIRES:
Jan.25,2010 407) 390.
0153 Florida Notary Service.com or gent
is Personally Known to Me or Produced ID
ENO: B
LDG: Z S //
31"p, rSpecial Conditions:
Rev 07.
07
LIMITED POWER OF ATTORNEY
Altamonte Springs, Casselberry, Lake Mary, Longwood, Sanford,
Seminole County, Winter Springs
Date: rJ 1 3 Io
I hereby name and appoint:. ( 'Q1" aD scq .4 &q:5 a / &gnc
an agent of.
of
to be 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:
le.
Street Address)
Expiration Date for This Limited Power of Attorney: /. DPC
License Holder Name:US+ln IOI I n i
State Licens
Signature of
STATE OF
COUNTYC
The foregoing instrument was acknowledged before me this ,Aay of ,
200 ,g , by jv,5+ln f 101-1 n I who is personally known
to me or o who has produced as
identification and who did (did not) take an oath.
Signature
Notary Seal) PrP 0'5V ynrre 4 10 Print
or type name c2Y;;
I f C SJM14c-cLNotary Public - State of Cd/i-l0/ 0 Illy CJLXPIMMISSIQan.
25N # D0690 90CommissionNo. D
D S/ 40& OF11106 {tES: J,2012010 407) 39"1.
53 Florida Notary Sarvice.com My Commission Expires: j - 2 - 21)/(9 Rev. 3/27/
07)