HomeMy WebLinkAbout1119 Locust AvePermit # : D ��pp
// CITY OF SANFORD PERMIT APPLICATION // 7
/ %� (D Date:
Job Address:
Description of Work: fD�o
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Historic District:
Zoning:
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Value of Work: $ CAO,0_b44 LO 0
Permit Type: Building
Electrical _X,_ Mechanical Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service — # of AMPS 260
Addition/Alteration Change of Service _K_ Temporary Pole
Mechanical: Residential
Non -Residential
Replacement 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:
Construction Type:
# of Stories:
# of Dwelling Units: Flood Zone: (FEMA form required for other than X)
Parcel #:
(Atta%ch_ Prroof of Ownership & Legal Description)
Owners Name & Address:
ZZZ9 LuC
Phone:
Contractor Name & Address:
State License Number:
Phone & Fax:
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Contact Person: Phone:
Phone:
Address: 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: hi addition to the requirements of this permit, there may be additional restrictions rlicable to this property that may be Jf nd in the public records of
this county, and there may be additional permits required from other governmental entities ch as w r management districts, s agencies, or federal agencies.
i
Acceptance of permit is verification that I will notify the owner of the property of the req re s of Law, F '7 3.
A& V
Signature of Owner/Agent Date Signature of on or/At to
Print Owner/Agent's Name n C ct9e(Ag is Name
1. l�
% .)
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date
r`""""� DEBBIE BLANTON
MV COMMSSION # DD 188491
Owner/Agent is _ Personally Known to Me or Contract r/A F.P,St sosmllCrl4naty >Ia�N� or
Produced ID _ Pro u�Y�eWYP nTn ry r- w rA rnccount Assoc. co.
APPLICATION APPROVED BY: Bldg: Zoning: Utilities: FD:
(Initial & Date) (Initial & Date) (Initial & Date) (Initial & Date)
Special Conditions:
PACKARD ROOFING, INC.
JUNE 9, 2005
CITY OF SANFORD
BUILDING DEPARTMENT
300 N. PARK AVE.
SANFORD,FL 32771
FAX: 407-328-3859
RE: PERMIT #05-00001266 FOR 1 1 14 W. BTH ST.
DEAR SIR OR MADAM:
PLEASE CANCEL THE ABOVE REFERENCED PERMIT. 1 WILL NOT BE
COMPLETING THE WORK UNDER THIS PERMIT DUE TO THE HOMEOWNER
TERMINATING THE CONTRACT.
NEITHER THE FLAT NOR SLOPE PORTION OF THE ROOF WERE COMPLETED
UNDER THIS PERMIT.
SINCERELY,
L
CHARLES E. PACKARD, JR.
PACKARD ROOFING, INC.
FL LIC# CCC057656
2616 EL PORTAL AVE. • SANFORD, FL • 32773
PHONE: 407-330-3697 • E-MAIL:PACKARDROOFING®NETZERO.COM
j•d fr00S-98L (LOfr) eLir=OT 90 60 USC
CITY OF SANFORD PERMIT APPLICATION
Permit # : 05-00001166 Date: 06/24/2005
Job Address: 1119 Locust Avenue
Description of work: Install 1-5 ton, 1-3 ton split heat pump with ductwork and air distribution
Historic District: Zoning: Value of Work: $ 5,279.14
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 X Non -Residential Replacement New (Duct Layout & Energy Calc. Required)
Plumbing/ New Commercial: # of Fixtures # of Water & Sewer Lines # of Gas Lines
Plumbing/New Residential: # of Water Closets
Occupancy Type: Residential X Commercial Industrial
Construction Type: # of Stories: # of Dwelling Units:
Plumbing Repair — Residential or Commercial
Total Square Footage:
Flood Zone: (FEMA form required for other than X)
Parcel #: (Attach Proof of Ownership & Legal Description)
Owners Name & Address: Harlan Walker. 210.-S'_' Sanford Avenue, Sanford, 32771
Phone:
Contractor Name & Address: Certified Mechanical Co., Inc.
2502 Vulcan Road, Apopka, FL 32703 State License Number: CMC012816
Phone & Fax.407-294-6324 / 407-294-0952 Contact Person: Joe Smith Phone: 407-467-6784
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer:
Address:
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 such as water management districts, state agencies, or federal agencies.
le
Acceptance of permit is verification that I will notify the owner of the property of the requirements of FI � a Lie
Signature of Owner/Agent
Print Owner/Agent's Name
Date Signature of Contracto=ld
Ronald H.
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:
/24/2005
Date
Ar1ntL�tractor/ ncs e
Si- I (,12_4)0!5
gnature of Notary -State of Florida
, Re" Baldwin
Off
• My Commission DD106396
, Expires April 07 2008
Contractor/Agent is _ Personally Down to Me or
Produced ID
Utilities:
FD:
(Initial & Date) (Initial & Date) (Initial & Date)