2836 Central Dr - M08-001502 - HVACCITY OF SANFORD PERMIT APPLICATION
Application # : A _/.%j J U
p
Submittal Date: w
Job Address: GAD C-- U, Value of -Work: S u
Parcel ID: ' E/lV C7`l/_ —5k J-OW(9-o/oaoning: Historic District:' _ Description
of Work: +4 l 5.r %AP .5+inn Square Footage: Permit
Type: Building Electrical Mechanical 10( Plumbing Fire Sprinkler/Alarm Pool Sign Electrical:
New Service - # of AMPS _ Addition/Alteration Change of Service Temporary Pole Mechanical:
Residential Non -Residential Replacement ` New (Duct LaVOLIt'& Energ, Calc. Required) Plumbing/
New Commercial: # of Fixtures _ _ # of Water & Sewer Lines____ # of Gas Lines Plumbing/
New Residential: # of Water Closets Plumbing Repair - Residential Commercial Occupancy
Type: Residential Commercial Industrial Occupancy Use Group(s): Construction
Type: __ -_ `# of Stories: - _ # of Dwelling Units: _ Flood Zone - __ (FENIA form required) y.....
7.........................................•.'......r....°....--............................... Property
Ow((neer::91A'Ck- /n
Fq l J 6oL Contractor:/`,IV,I,(' 9&1 0-17- n'tJ"/k, Addressac
b /.0'L . _- Address: I o6ci L . TWhU/ fc.-I A >oe_, Phone: / "
rE-mail: P Unt / State License Number: 6---66 / Bonding
Company: Address:
Architect/
Engineer: Address:
Plan
Review Contact Person: Mortgage
Lender: Address:
Phone:
Fax:
Phone:
Fax: E-mail: 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 infonnation 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. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
INSPECTION. 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 Florida Lien Law, FS 713 Signature
of Owner/Agent Date Sig&Wre of Contractor/Agent Date PAD
111 Print
Owner/Agent's Name Print ontr tor/CLq Signature
of Notary -State of Florida Date Signature ry e o•P r2y 2p o o. eDaiv' o : #
D ®• t . D 445 01!
Oz
29°nd tit D6Owner/
Agent is __ Personally Known to Me or Contractor/Agent isP 65r/(gtltlhtQ® Produced
ID -- — Produced ID l
JJlllll (l 1111 \\\\ APPROVALS'
ZONING: UfIL: FD: ENG. BLDG:_ _ Special
Conditions: Rev
07.07