HomeMy WebLinkAbout1526 French Ave 03-2680 HVAC77'—- `-F`777
CITY OF SANFORD PERMIT APPLICATION
Permit # : 0 _ - 2_6 e6
Job Address: 16-26 Fi--
Description of Worta P,
Historic District:
C
e A /,, 5 V 'r -fee &,t
Zoning: Value of Work:
Date:
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 - 1-'Replacemcnt k", 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 4-__"1ndustrial Total Square Footage:
Construction Type: # of Stories: # of Dwelling Units: Flood Zone: (FEMA form required for Ohetr than X)
Parcel #: (Attach Proof of Ownership& Legal Description)
Owners Name & Address: 46--t 4e
Phone:
Contractor Narne& Address: .4 Itr 14111-. 4evl-2 C_141 114
Phone & Fax: -70
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
ly S tbe License Number- 10 4112 -7 3 1!sr
7 4 7 4&Zphone: S ontact Person7
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 ofa permit and that all work will be performed to meet standards ofall 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 ofthe foregoing information is accurate and that all work will be done in compliance with all applicable. lmvs rogulating
construction and zoning. WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR I - 1ANING
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 requirements of Flonida iLien Ljw, FS 1 3.
Signature of Owner/Agent Date Signatture . Cont ctor/Ag t Dateof
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Print Owner/Agent's Name P o a r/Agen am
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Signature of Notary -State of Florida Date 111 - tnte of Floradn V Date X
Owner/Agent is Personally Known to Me ConVactor/Agent is Persvtyj r
or
Produced ID Kzoduced ID
APPLICATION APPROVED BY: Bldg: Zoning: Utilities: FD:
Initial & Date) (initial & Date) (Initial & Date) (Initial & Date)
Special Conditions: