2826 Gale Pl - E08-001562 (REPLACE OUTISDE RISER) DOCUMENTSCITY OF SANFORD PERMIT APPLICATION
Application # : w
r;, Submittal Date:
Job Address: c/ O tr4 t'P !' Value of Work: $ SZw•
Parcel ID: L 7 ' i L) •' 31. b s' U EZ)0 - U/ 5 Zoning: Historic District:
Description, of Work: &/e OLIT 5 /D e _ fe- sex_ Ft){C- F6LcJ e1(_ Square Footage:
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool Sign Ci
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 Commercial
Occupancy Type: Residential Commercial Industrial Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required)
v........................................................................ ................
Property. Owner: C F5 Sac4T V 4, S /
n
Contractor: A- fi el L 7 It
Ad ress: 3 R FF I L-7" 'e e14 (L 0 E 54A4-z°5 ` /12 Address: l %t a 00 L-) D Au e
PbpkA PL. 3-P7v.3 LArlIDQ I- 3 5
Phone:'t C) 7 y' -mail: Phone: g15Z'y0I State: License Number: CL A O Vol
Bonding Company: 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 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.
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 maybe 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 requirements of Florida Lien Law, FS.713.' "
Signature of Owner/Agent Date Signature of Contracttoor/A 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: UTIL: FD: _
Special Conditions:
Rev 07.07
Kgnature of Notary--Mte of Florida Date
s.an.............x .....
09ZV-ZCV(008) MUPBP°0e
80001E
Contractor/Agent is ZPenally Known fx'ia NV31dVW
ProducedIDNd08S0ENG:
BLDG:
SPECIAL POWERDF ATTORNEY,.
Date: April30, 2008 I
hereby name and appoint Cindy Boyd Of:
A+ Electric Group Inc To
be my lawful attorney in fact to act for. me and apply for permits to do electrical work at 2826
GALE PLACE in the CITY OF SANFORD, FLORIDA performed by A+ Electric Group Inc., and
to sign my name and do all things necessary to this appointment. Corlis
S Crowley — Qualifier- License number ECA002569 State
of Florida County
of Orange The
foregoing instrument was acknowledged by me this 30th day of APRIL, 2008 by CORLIS
S CROWLEY who is personally known by me who did/did not take an oath:. Notary
Public, MARTEAN
OSBORN My
commission expires: 8/9/2008 Seal: Fol.
t. ARMAw.
ccmo
4969 Bonded (
gpO)432.4254' Flotldbodr
As s, "' Electric
PHONE (
407) 895-6401 Group,
Inc. 922 Dowd Ave FAx (407) 898-5485 ioOrlando, Fl 32804 E-MAIL ` apluselectric1928@yahoo.com