HomeMy WebLinkAbout124 Woodridge Trl 03-2795 HVACPermit # v
112
Job Address: A
Description of Work:
Historic District: Coning:
CITY OF SANFORD PERMIT APPLICATION
Date:
Permit Type: Building Electrical Mechanical, Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration V/ 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 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 a:
Phone & Fax
Bonding Company:
Address:
Mortgage Lender:
Address:
ArchirecdEngineer
Address
Attach Proof of Ownership & Legal Description)
Phone:
Fax:
hone:
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 fN 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 may be found in the public records of
this count,,, and there may be additional permits required from other governmental entities such as water managemen tstricts, state agencies, or federal agencies.
Acceptance of permit is verification that I will notify the owner of the property of the require is of to en Law, FS 713.
a
Signature of Owner/Agent Date Signature ofContr r/Agent Dale
Print Owner/Agent's Name Pr'n Co is lame
6,)03 dJ
Signature of Notary -State of Florida Date gna re o iary-State of Flon'
UY L HISE
q, = MY COMMISSION # DD 164329
XPIRES: JanUaryc 24, 2007
Owner/Agent is _Personally Known to Me or Contractor/Agent is ;;••.•• aJl yrytt ttVy Nlll underwriters
Produced ID Produced ID FAf
APPLIC'A PION APPROVED BYi Bldg: Zoning: Utilities: ' FD:
llnitial & Date) (Initial & Date). (Initial & Date) (Initial & Date)
spcc,al Conditions.