HomeMy WebLinkAbout1751 WP Ball Blvd 04-2580 (mech)CITY OF SANFORD PERMIT APPLICATION
Permit #: 0 `4 c O D
Job Address: S I L
Description of Work: Ina CAP
Historic District:
Date: I a- 3 t) ' o q
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 Industrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #: (Attach Proof of Ownership & Legal Description)
Owners Name & Address:
Contractor Name & Address:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Phone: _
SD e"
State License Number:
Contact Person: Phone:
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. 1 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.
Acceptance of permit is verification that I will notify the owner of the property of the r quire cots of Florida Lien L w, FS 713.
Signature of Owner/Agent Date Signature of Contractor/Agent Date Ul
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg:
Initial & Date)
Special Conditions:
Zoning:
rn pntrautvrtt%g r rvaI t
of * lhieldftlill DD 164280 Date
EXPIRES: November 12, 2006
r0d Bonded Thru BudgetNotery Service$
Contractor/Agent is Personal) K ow to Mq or
Produced ID3 1,d
Initial & Date)
Utilities: FD:
Initial & Date) (Initial & Date)
12/30/04 02 s 42pm P . 007
o S
C p
CITY OF SANhORD PERMIT APPLICATION
Permit # :s. L.],_ t 7 d j 1 Date: i 3 o q
Job Address:
Description of work:L
Historic District: 74ning: Value of Work: S
Permit Type-. Building Electrical Mahanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addidon/Altcrativn Change of Scrvicc Temporary Polc
Mechanical: Residential Non -Residential . Replacement New _e (Duct TAyout tit Energy Cale. Required)
Plumbing/ New Commercial: # of Fixtum # of Water & Sewer Lines # of Gras Lines
Plumbing/New Residential: # of Water Closets Plumbing Repair — Residential or Comincreial
occupancyType- Rasidcatial Cortmtcreial Industrial Total Square l•ootagg•
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (TEMA form rtgolmd for other ttdao X)
Parcel Y:
Owocts Name & Address:
Phone
ProofofOw•nerabip & LcgN Descriytloo)
Phan
Reading ComDaeF -
Address:
MoMaRe Lender.
Address:
ArchitectTit sneer. Phone:
Addrew Pax:
Application is hereby wade to obtain a permit to do thew** and installations as indicated. I eeniN that no work or installation has commented prior to the
isauaooa of a permit and the all work will be performed to meet slmdards ofall laws regulating construction in this jurisdiction. I understand that a separate
permit must be secured for ELECnUCAL WORK, PLUMBING. SIGNS, WELLS, POOLS, FURNACES, BOILERS. HEATERS, TANKS and
AIK GURUIT(ONERS, eta.
OWNEKS AFFIDAVIT: I cm* that all of the foregoing information h accurate and dwl all work win be done in compliance witb all applicable laws regulating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NO'110E OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVI MMM TO YOUR PROPERTY. IF YOU INTRND TO OBTAIN FINANCING.1701vc1 11.T WITH YOUR LENDER OR AN
A'I'IVKN1iY BEFORE RECORDING YOUR NOTICE OF COMMBNC6Ml1NT.
NOTICE: Io addition to the requirements of this permit, there maybe additional restrictium applicable to this property that may be found in the public records of
this county, and then: may be additional permits required from odor governmental entities such as wane management disoiet% state ageacies, or federal agencies.
Acceptant* of permit in vcr nation that lwill notify the owaer of the proputy of the
Signature ofOwner/ARent Date
Print OwnrWAgcot's Name
Signature of Notary-S= ofFlorida Date
Owncr/Agent it -_ Pdasonally Known to Me or
Produced ID
ents ofFlorida Lien w, FS 713.
3 - V 1
to 10k4
Si -A 111 101 4D0184280 Date
EXPIRES: November 12.2006
jsn aeeelr tMr Btgtrl l'IatN Srovkrs
C trotror/Arent is onany Koow$ to MQ or
Produced ID I, 3 S C,
APPLICATION APPROVED BY: Bldg: Zoning: Utilities: FD:
loitial & Date) (Initial & uate) (Initial & Due) (In1tlal & Date)
Special Conditions:
V
7e`GG1rda?RlC4Xkl:i 1}:=%:... ,t'.'•`t"„!1t .`r........"',"r;:r.`•fi:`,'{:b' :i.. , •'.9!::1'C' '\•,:'. a•ov