HomeMy WebLinkAbout2251 WP Ball Blvd 04-2574 (mech)C tJs
Permit
Job Address: Qa S J LA) P QAA r_
Description of Work: M exX , A)
Historic District: Zoning:
CITY OF SANFORD PERMIT APPLICATION
Value of Work:
Date: ) a- 3 I) - o /
Permit Type: Building Electrical Mechanical 'X_ Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS Addition/Alteration Change of Service Temporary Pole
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:
Replacement New (Duct Layout & Energy Calc. 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:
Contractor Name & Address: Acyr r V H C,-T r •t.S O V1 IE G1r1 . S on jl to t Y
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 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 uireme is of Florida Lien FS 713.
Signature of Owner/Agent Date Signature of Contractor(AgFnt_ Date
Print Owner/Agent's Name
Signature of Notary -State of Florida
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY: Bldg:
Initial & Date)
Special Conditions:
Date Si ,if Notary -State of Florida
FLORENCEA. DE GRAVE
F t MY COMMISSION # DD 164280
E
Zoning: Utilities:
Initial & Date) (Initial & Date)
FD:
Date
Initial & Date)
I
12/30/04 02r42pm P. 004
011 O N
CITY OY SANFORD PERMIT APPLICATION
omit p : Datr. _ 3 d p
Job Address: 1A-) P
Description of work: j'Yl eel. _ G '
historic District, Zoning: Value of Work: S-56- o
Permit Type: Building Mft-trica) Mechanical Plumbing Tire Sprinkler/Alarm Pool
Electrical: New Service - # ofAMPS Addition/Alteration _ .- Cbmp of Service Temporary Pole
Methanleal: Residential Non-ResidentialReplacemcnt—_N ())act Layout & lsntxgy Cale. RoQvited)
Plurobing/ New Commercial: # of Fixtue # of Water & Sewer Lines__ # of Gas Lines
PlumbhWNow Residential: # of Wow Closets Plumbing Repair - Residential or Commercial
Occupancy Type: Residential Commercial lt dustlial Total .Square Footage
Construction Type: # of Stories: # ofDwelling Units: - blood Zone. (FeMA form regnired for other than X)
ParcelN: (Attaeb Proofof Orroersbip A Legal Description)
Owners Name &Addrers: fl 1 y"1 .1 es
Pboac
Sending Company:
Address:
Mortgage !.ender.
AJdras: •
J
Phone:
ArcbRect/F.ngineer: Phone:
Address Fax:
Application is hereby mado to obbic a permit to do the work and tnstallatiow as indioatud. I certify that no work or instdladon has oommcnu.•d prior to the
issuance of a permit and that all work will be performed to meet standards orall two regulating construction in tbis jurisdiction. I understand that a separetc
permit must he secured for FF FrMtCAL WORK, PLUMBING, SIGNS, WELLS, POOt•S, FURNACES, BOILERS, HEATERS. TANKS. and
AIR CONUITTOMAS, etc.
U
OWNSR S AF QAVJT: 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 OWNSR: YOUR FAILURE TO RECORD A NOTICE. OF COMMENCEMRNT MAY RESULT IN YOUR PAYING
TWiCE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WM YOUR LENDER OR AN
ATTORNEY BEFORE XPrORDING YOUR NOTICE OF COM M Nr rtMRNT.
d ICE: to addition to Ute tegoitcmcnts of tits permit, theta may be additional restrictions applicable to this property dwt may be found In the public recorda of
this county, and there: may be additional permits required from other governmental ontitics such as water maaigemcnt districts, stato agencies, or federal agencies.
Acceptance of permit is verification brat t will notify the owner of the property or the rhRme ta of Florida Licn FS 713.
Signature ofOwner/Agatt Dato Sigttalure of ContractojAMrr` Date
Print OwncdARcnfa Name
Signature of Notuy-State of Florida Dan
OwacdAgcnl 4 _ — Personally Known to Mc or
Produced ID
elf Notary tite Of Florida
e FLOE EWER DEGRAVE
2A . MYCOMMISSION # DO 184Y80
Ln
APPLICATION APPROVED BY: Bldg: Zoning: Utilities. I-M:
Initial A Due) (Initial a Date) (laitial & Data) (Initial A Date)
Special Conditions:
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