3609 S Orlando Dr - BC01-002478 (ROSS) (FIRE) DOCUMENTSCITY OF SANFORID PERMIT APPLICATION C>
Permit No.: 0' c% _ Date:
Job Address: RoDQ 5, 0P gr•e1a Aire Y'AO P rJ LdA 100 4- Parcel
No.: Description
of Work: Attach
Proof of Ownership(& Legal Description) Type
of Construction: Flood Zone: Valuation
of Work: $ 91 a `cupancy Type: Residential /Commercial Industrial Number
of Stories: I Number of Dwelling Units: Zoning: Total Square Footage: 11
Owner: r Clo Address:
City
State: Phone
No.: Fax No.: Zip:
Contractor:
So v+he& %+ <54-s- 'n left 5 r , Address:
17W W, iQturjAA gavel City:
5AOJg' of J State: r,1, Zip: $'Ll-)l ' State License No.: Q92 i 0`tQc_)o f$'7 Phone No.:
L401) wr i qyl X 3oog Fax No.: (4o—A 6 r?- 45 9.3 Contact Person:
r,44 MtAqu i: Phone No.: (t40-)) fir 154 q k 1,00y Title Holder (
If other than Owner): Address: Bonding
Company:
Address: Mortgage
Lender:
Address: Architect:
Phone
No.: Address: Fax
No.: 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. of permit
is verification that I will notify the owner of the property of the re uire is f Florida Lien Law, FS 713. q o
Dl o if Oi+
e(A_ge_n% Date S a re Co rac /Agent Date Print Owner/
Agent's Name no PkkX
f=n Aa o Print Contractor/
AQent's Name A_' Date
HAVTi~
i_
f2 SAMTGS 7y cF.,,
n n Exp. 4IW2002 lam, CC
73OW7 rjmm i
l caw I.D. Own /Age
is Personally Known to Me or Pr uced
ID otary-State
of Florida Date y Mary
Leathers My Commission
CC950743 a" Expires
June 28, 2004 Contractor/Agent
is Personally Known to Me or Produced ID
APPLICATION APPROVED
BY: i "/ Date: 9'—f0 - 0 7 Special Conditions:
A—
CITY OF SANFORD FIRE DEPARTMENT
FEESX-OA SERVICES
PHONE # 407-302-1091 * FAX #: 407-330-5677
p
DATE: 10 01 PERMIT #: 0 ( 4 O
BUSINESS NAME / PROJECT: kip 'k I. 1z
00
ADDRESS: 0 1 d _ DK-
PHONE N%o FAX NO.(gO7)
CONST. INSP. [ ] C / O INSP.:[ ] REINSPECTION [ ] PLANS REVIE
F. A. [ ] F.S. [ ] HOOD [ ] PAINT BOOTH [ ] BURN PWZIT [ ]
TENT PERMIT [
C]
TANK PERMIT [ ] OTHER [ ]
TOTAL FEES. $ (PER UNIT SEE BELOW)
COMMENTS: ® •
Address / Bldg. # / Unit # Square Footage Fees per Bldg / Unit
1.
2. _ AA
3.
4.
5.
6.
7.
8.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Fees must be paid to Sanford Building Department, 300 N. Park Ave., Sanford, FI. 32771 Phone # -407-
330-5656. Proof of Payment must be made to Fire Prevention division before any further services can take
place. I certify that the above is true and correct and that
will comply with all applicable codes and ordinances
of the City of Sanford, Florida.
Sanford Fire Preventi Division Y?pplicant's Signature