HomeMy WebLinkAbout2201 WP Ball Blvd 04-2581 (mech)w
CITY OF SANFORD PERMIT APPLICATION
Permit # : IL
Job Address: —0
Description of Work:
Historic District:
5D ) _ n , Date: I Ot- 3 0 _ O `/
Hezj ,191AC_
Zoning: Value of Work:
Permit Type: Building Electrical
Electrical: New Service — # of AMPS
Mechanical: Residential Non -Residential _
Plumbing/ New Commercial: # of Fixtures
Plumbing/New Residential: # of Water Closets _
Occupancy Type: Residential Commercial
Construction Type: # of Stories:
Parcel #:
Owners Name & Address:
Mechanical Plumbing Fire Sprinkler/Alarm Pool
Addition/Alteration Change of Service Temporary Pole
Replacement New (Duct Layout & Energy Cale. Required)
of Water & Sewer Lines # of Gas Lines
Plumbing Repair — Residential or Commercial
Industrial Total Square Footage:
of Dwelling Units: Flood Zone: (FEMA form required for other then X)
Attach Proof of Ownership & Legal Description)
Phone:
A
Contractor Name &Address: /St R'ry 0.ri 1 S I arr 1 Sow fg / L
State License Number:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
Contact Person: Phone:
Phone:
Fax:
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 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: 1 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 ofthis 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 1 will notify the owner of the property of the
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
APPLICATION APPROVED BY: Bldg:
Initial & Date)
Special Conditions:
Zoning:
of Florida Lien Law.FS 713.
tore ofContractodAeent Date
P gntractor/Agent's 1(Iameli
w"D
tt> FNIO bj0R6NOBN10ARAVE Date
MY COMMISSION A DD 164280INEXPIRES: November 12, 2006N'
1-m nVo Bonded Thru Budget NoteCo_tractor/Agent is Pgffl 6 tWApS
Produced ID 1 C_ `t jjo%`i
Initial & Date)
Utilities: FD:
Initial & Date) (Initial & Date)
10
I
iZ/90/04 OZt4Zprt P. 00S
CITY OF SANFORID PERMIT APPLICATION
Peratit M: 14 — S D' Date:
t Q+ 6 y
Job Address: QAJ 1' 1
Description ofWorlu r
Historic District: Zoning: Value ofWurk: S 15 boo
Permit Type: Building Electrical Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — 9 of AMPS Addidon/Altem6on Change of Service Temporary Pole
Mechanical: Residential Non-Rosidential Replacement New (Duct Layout & Eacrgy Cale. Required)
Plumbing/ New Commercial: I# ofFixtures N ofWater & Sewer Lincn _ B of Gas Ling
Plumbing/New Residential. n ofWater Closets Plumbing Repair — Residential or Commercial
Occupancy Type: Residential Commercial industrial Total Square )Footage:, _,,,
Construction Type: M of Stories: 0 of Dwelling Units: — Flood Zone: (FBMA fosse required for other than X)
Parcel 9: _ (Attach Proof of Ownership & Legal Deseription)
Owners Name & Addrtsr o G
Phooc• h
AdOresaa
Phone &
Bonding
Contact Person:
State License Ntrmber.
Address:
Mortgage Leader.
Address:
Architett/Raaiatsr: Phone:
Address: Vex:
Application is bercby made to obtain apermit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the
issiwce ofa permit and that all work will be perfarmcd to meet standards ofall laws regulating construction in this jurisdiction. I understand that a separate
pemit must be secured far Fl ArTRiCAL WORK, PLUMBING, SIGNS. WELLS, POOLS. FURNACES, BOILERS, HEATERS. TANKS, and
AiR CONDITIONER& etc.
QWNTiR'SAFFJIji I : I cMify that all ofthe faregoing information is accunac and that all work will be done in compliance with all applicable laws tagulating
coustruetion and zoning. WARNING TO OWNER: YOUR FAMURE TO MCORD A NU NCF. OF COMMENCEMENT MAY RESULT iN YOUR PAYING
TWICR FOR ENPROVEMENIS TO YOUR PROPERTY. If YOU INTEND TO OBTAIN FINANCING. CONSULT WM YOUR LENDER OR AN
A rTORNEY BEFORE RECORDING YOUR NOTICE OF COMMLNCUMENT.
NOTICg: In addition to rho toptaromertat of this permit, there may be additional restrictions applicable to Ibis property thol may be found in the public records of
this county, and them may be additional permits required from other governmental entities such as water management districts, start agenties, or foderal agencies.
Acceptance of permit is verification dtat I will notch/ the owner of the property of the
Sigmrute ofOwoa7Altent Dale
Print Owner/Agent's Name
Signature ofNotaryState of Florida Date
Owner/Agmt is _ Personally Known to Me or
Produced ID
of Florida Lien La . 'S 713.
ofContructodAttcnt Date
k,
ratUvmI6ISIONIDDIwo
EXPIRES: November 1Z = r."' er(ft Tani Neh
7 e 7tPro`
ndacod tU .. tV
Na 1,:,z;1C,
APPLICATION APFROVL'DBY: Bldg. Zoning: Utilities: FD:
toitial R Date) (initial & Aatc) (initial & Data) (initial & Date)
Spotbi Conditions:
k T.u;1{i'Pr13+ifi l l.,Wt,.iSr.;i:?i?ie":ariY:r i ii:sTs atltW.=1''Terr'b95ci'.%i%'`,err:i'7.t%:T;::.r".:i:i!•°:d'.•7.':r,^?.s'7 C... c• t Z:^:.;r,:,:....',,: .,.t r ,rkY.l ei: .'mr-'..lri:• ..du9'.9;:T•,. qis;+':Elf,,'."r:<3csF:'.L:^r,•.mnrtta+:s:•,vreian•,
POWER OF ATTORNEY
Date: January 5, 2005
I, Barry Harrison , do hereby authorize
Richard Daws to pull the Mechanical
Type of permit
A—). 9. ?,,V. I I vA_
Job address
UA-LVIft"-U
Notary
permits for
i1 S) WP 60A, 61vj
1 1J 51 V3 P Mo Ig
@L615 I w P 9 )vd
QL;..c> I W 1P 61 V d
BlvdI`tO) V.){, 6.,,1
PPe_rsonally known o me or driver's license # ,
State of Alabama, County of GPnPva on the 5th day of
January , 2005
WCommission LV ires Sept. 8, 2008