HomeMy WebLinkAbout1002 Celery Ave - M05-003514 (HEAT PUMP REPLACEMENT) DOCUMENTSPermit #
Job Address:
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
n Date:
P co(�—
Zoning: Value of Work: $_ _ 3 Cg6 C'"6
Permit Type: Building Electrical Mechanical _4K Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service – # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential X_ Non -Residential Replacement X 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: �z®
Construction Type: # of Stories: # of Dwelling Units: _L__ Flood Zone: (FEMA form required for other than X)
Parcel #: / L(Attach Proof of Ownership & Legal Description)
Owners Name &Address: GP-,+ -/' C�62 CG:LeOZY A- �20-APCO_ 12'0
Phone:
Contractor Name &Address: p1((-
1C11CI_ d
Phone & Fax:,
Bonding Company:
Address:
Mortgage Lender: .
Address:
Architect/Engineer:
Address:
t ``St`ate License Number: (, CA-(— 65(54--,77—
2-73 Contact Person: 0kV (L_Le 1�1 I Phone:*)0G 6 U6 5676
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. 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 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 s 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 re ire e f Fl ida ;9/ v.
72-565
Signature of Owner/Agent Date Signature of Contra t Agent Date
s ck(4EZ J HilLe-
Print Owner/Agent's Name. Print Contractor/Agent's Name
�`•zS OS
Signature of Notary -State of Florida Date Signa Sat$. VVIllae 1
Commission # DD446957
E pires June 30, 2009
Owner/Agent is _ Personally Known to Me or Contractor tlrilt'is B eAP+eyfMaI�I�4F8A e or019
Produced ID Produced ID
APPLICATION APPROVED BY: Bld J V l h Zoning:
(Initial & ate)
Special Conditions:
Utilities:
FD:
(Initial & Date) (Initial & Date) (Initial & Date)
�s3
r'
OING, INC,
TO WHOM IT MAY CONCERN:
tq O FbP-0 Building Department
Please be advised that 6 "�j W ( LL D representing Mid Florida Air
Conditioning, Inc. is authorized to pull permits under my license for Mid Florida Air Conditioning Air,
Inc.
M.ichaell. Hall, Presidelit
License # CAC050422
State of Florida
County of Volusial
The foregoing instrument was acknowledged before me this � day of J C1 i ii ; �a�5 by
Michael J. Hall who is personally known to myself..
o '
Signat6e of Notary
��� AAatcia Rodrissiguesion
?j My CommDD327559
Expires June 09, 2008
Orlando
Winter Park
Altamonte
Longwood
(407) 528-5748
Service & Installation
Air Conditioning
Heating
Deland
Deltona
Sanford
Debary
(386) 668-8?52