3609 Orlando Dr - E02-000126 (DOLLAR TREE) DOCUMENTS - 2CITY OF SANFORD ELECTRICAL PERMIT APPLICATION
Permit Number: t Date: a ` 0/
The undersigned hereby applies for a permit to install the following electrical:
Owner's Name: 57� v1 �qr- T/'�� �-�j�
Address of Job:
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Electrical Contractor:
Residential:
Non -Residential:
By Signing this application I am stating that I am in compliance with City of Sanford Electrical Code.
Applicant's Signature
State License Number
Number Amount
Addition, Alteration, Repair (Residential & Non -Residential)
New Residential:
AMP Service
New Commercial:
AMP Service
Change of Service:
From AMP Service to AMP Service
Manufactured Building
Other:
Description of Work:
Application Fee:
$10.00
TOTAL DUE:
By Signing this application I am stating that I am in compliance with City of Sanford Electrical Code.
Applicant's Signature
State License Number
REVIEWID
By:r
Sanford Fire Pre enti n Div.
Date: 12
RECEIVE
OCT 1 7 2001
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PERMIT # o� •ix
OFFIC¢,F Copy