HomeMy WebLinkAbout225 Meadow Hills DrPermit # : 0 S
Job Address:
Description of Work:
Historic District:
CITY OF SANFORD PERMIT APPLICATION
Date: I — aS 0 115—
Zoning: Value of Work: S / uS 7 ,S °-
Permit Type: Building Electrical Mechanical --jZ— Plumbing Fire Sprinkler/Alarm Pool
Electrical: New Service - # of AMPS Addition/Alteration Change of Service Temporary Pole
Mechanical: Residential Non -Residential Replacement -j/— New (Duct Layout & Energy Cald. 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 #: I t!) - an - in - S C-S —000 - U 1 (aD (Attach Proof of Ownership & Legal Description)
Owners Name & Address: Don. t S l i-aA a r` Po QA X 4S & 3 S
Phone:' q4D —61 %B
Contractor Name & Address: _P)i d F LOn QCw t`f es. &k, %1/ a.
bQL&. 31)1 3 State License Number. fir_ /4C mnfi
Phone & Fax: 134 4 R-8 Tfa2 - 386-" g G3a 3 Contact Person: UM4 ii r D rr.-14ei Phone: Lie-aZ
Bonding Company:
Address:
Mortgage Lender:
Address:
Architect/Engineer: Phone:
Address: 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: I certify that all of the foregoing information is accurate and that all work will be done in compliance with all applicable laa r. regulating
construction and zoning, WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT fN Y01))t PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER Ult AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
NOTICE: In addition to the requirements of this permit, them 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 1 will notify the owner of the property of the requiremen f Florida ien , FS 7
Signature of Owner/Agent Date Sign,W o onda
n
gent Dale
eft,, L iSraen4C r
Print Owner/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is _ Personally Known to Me or
Produced ID
APPLICATION APPROVED BY
Special Conditions:
Bldg: t
1
Initial kwa
of aaarCaa}100"A Wa ...
My Commission DD327559
war Exploits June 09. 2000
Contractor/Agent is Personally Known to Me or
Produced ID
7-J 'O
Zoning:
Initial & Date)
Utilities: FD:
Initial & Date) (Initial & Date)
g r ot) 2Z
4
MID FLORIDA AIR
I "
JV0NINC, INC.,
TO WHOM IT MAY CONCERN:
Building Department % aa5 V-1 e<vow
Please be advised that . Tam, _ apery a r- , representing Mid Florida Air
Conditioning, Inc. is authorized to pull permits under my license for Mid Florida Air Conditioning Air,
Inc.
Michael J. Hall, President
License # CAC050422
State of Florida
County of Volusia
The foregoing instrument was acknowledged before me this _,Zday of ^ a 2005 by Michael
J. Hall who is personally known to myself. tea.
Ro"un JA
i 50t'i . MY com""Sion W3V& O S
nature o Not E*
m Jum 09, 2M Orlando
Winter
Park Altamonte
Longwood
407)
628-5748 Service &
Installation Air
Conditioning Heating
Deland
Deltona
Sanford
Debary
386)
668-8752