3705 S Orlando Dr - P05-002529 (REMODEL) DOCUMENTSCITY OF SANFORD PERMIT APPLICATION
Permit # : OS / Date: el0
Job Address: 3
Description of Work: F-C t I e'`r
i l y nivt t 00 1
Historic District: Zoning: Value of Work: $
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
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 Plumbing Repair - Residential or Commercial
Occupancy Type: Residential Commercial V/ Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
Owners Name & Address:
Contractor Name & Address:
Phone & Fax:4±!6
Bonding Company:
Address:
Mortgage Lender: .
Address:
Architect/Engineer:
Address:
6rrl — I'tw Ye
b Contact Person:
Attach Proof of Ownership & Legal Description)
Phone:
State License Number:
Phone:
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 n
this county, and there may be additional permits required from other governmental entities such as water management districts, state agencies, or. federal
Acceptance of permit is verification that I will notify the owner of the property of the requirements of da ie La S 713. '
Signature of Owner/Agent Date
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
re
of Notary -State of Florida
Date
Contractor/Agent is % rersonally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg: Zoning:
Initial & Date) (Initial & Date)
Special Conditions:
Utilities: FD:
Initial & Date) (Initial & Date)
I
POWER OF ATTORNEY
Date: 'f i/ ID!g-
5613 East Colonial Drive
Orlando, Florida 32807
407) 273-6260
Fax (407) 281-7835
I hereby name and appoint 61u C II) of IIERRELL
PLUMBING, INC., to be my lawful attorney in fact to act for me and apply to
the a(-jBuilding Department for a PLUMBING permit for work
to e performedat a location described as: 37oS_
S. Or1aftdo lOV- , and
to sign my name and do all things necessary to this appointment. Name
of certified contractor: STATE
OF FLORIDA COUNTY
OF ORANGE C
IMSTIAN J. PETERSON CFC1426657
i
SIGNATURE
OF CERTIFIEb CO CTOR The
foregoing instrument was acknowledged before me thi;WAdayof 2005,
by CF]RISTIAN J. PETERSON, who is,pmr,I lly known to me. li
NO
UBLIC MAE
C. PETERSON c
MY COMMISSION# DD058229 EXPIRES:
October 11, 2005 1-
MO-3-NOTARY FL Notay Service & Bonding, Inc.