HomeMy WebLinkAbout2915 Carrier Ave 09-421 HVACO,9 • q 2001 CITY OF SANFORD PERMIT APPLICATION
Application # : nn Submittal Date:
Job Address: 9 C rr i Pr f 1 t/ a Value of Work: $ 5co •oo
Parcel ID' cco -do - 31-3oo - Zoning: / Historic District: l
Description of Work: , sL I I new a am 1) 1 c,6, l �4" Square Footage: d
Permit Type: Building ❑ Electrical P 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 Cale. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential ❑ Commercial ❑ Industrial ❑
Plumbing Repair— Residential ❑ Commercial ❑
Occupancy Use Group(s):
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required )
.............................................................................//.++. ��..�............. .I...-..............1..........
Property Owner: San -Q)rcJ Nitr(mJr f4U^���Yi Contractor: Char �e Lundgit_t sl
Address: Ia0 Re
1,yof Address: ID bb e-(-1 Blvd.
San arc! , FL DD 7 3 SCiel -Qxcl , EL 32 77 3
Phone:` S-�iO1i E- mail: ��v &Oos:G •nG Phone:QS- -x/183 State License Number:�IZi30�3I0�
Bonding Company: /tl : Mortgage Lender: N I I—�
Address: Address:
Architect/Engineer: N 4 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.
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.
if� is ven iicatio hat I will notify the owner of the propel
igent Date Sign t
T_b l or A6
Name I Z
hlL� P /1-7/Q5
PHYLLIS I, GIBSQN
MY COMMISSION #DD477598
l EXPIRES: OCT 02, 2009
,q Bonded t u h 1 st State Insurance
Owner /Agent is _
Produced ID
APPROVALS: ZONING:
Special Conditions:
Rev 07.07
UTIL.
Date
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tty oft requireme is of Flor "da Lien La ,"FS 713.
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202— /ractor /Age Da e
.on for /Agent's Name
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MY COMMISSION #DD477598
EXPIRES: OCT 02, 2009
Bonded through 1st State Insurance
Contractor /Agent is ' Personally Known to Me or
Produced ID
ENG: BLDG: