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121 Yale Dr - M08-000576 (HEAT PUMP CHANGEOUT) DOCUMENTSCITY OF SANFORD PERMIT APPLICATION Permit # : Q — Date: /A/a 7 Job Address: v1- f rd .32- Description of Work: .2, s h /3 Sc..Z - S-xJ a Historic District: Zoning: Value of Work: $ 4/400 " 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 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 #: / (Attach Proof of Ownership & Legal Description) Owners Name & Address: %t'd mES Z/ r/ 0/. Phone: a 13L 3• ©SS Contractor Name & Address: O '•, 1.4 rs /Ry41 4snu 4) .Ltd. `f ,Cen1 a)&4o .3 Z ZJb State License Number: e ocas-eo,W Phone & Fax: • 30-)117 *7•ri3D's-f-ZI Contact Person: %%?i ! - Phone: E50 7117 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. 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 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 o orida Lien Law, FS 713. 8. Signature of Owner/Agent Date a ontractor/Agent Date Print Owner/Agent's Name Print Contractor/Agent's Name y-vsl Signature of Notary -State of Florida Date Signat&of No to Florida Date Owner/Agent is _ Personally Known to Me or Produced ID APPLICATION APPROVED BY: Bldg: Initial & Date) Special Conditions: Zoning: Contractor/Agent is f Personally Known to Me or Produced ID Initial & Date) Utilities: FD: Initial & Date) (Initial & Date) AMITCHELL.A LOPEZ 3a) MY COMMISSION1DD733462 EXPIRES November 08, 2011 407) 398-0153 FlorldpNotarySeryice.com ti JANUARY 4 ,2008 ATTN: SEMINOLE COUNTY Re: Mechanical Permit Please consider this letter Official Authorization for WALT MOSEMAN to sign for and obtain, change, or amend permits for H.V.A.C. , for ALTAM ESE, MARTIN 121 YALE DR, SANFORD FL 32771 Parcel ID: 35=19-30-523-0000-0580 for COOL -WAY, INC. or William Kirtley the license holder. William Kirtley CAC 058064 STATE OF FLORIDA COUNTY OF SEMINOLE Sworn to and subscribed before me this WH day, of JANUARY , by William Kirtley who is personally known to me and who did not take an oath. a ry, ublic Name: typed, printed or stamped Notary seal MITCHELL A LOPEZ MY COMMISSION # DD733462 mod! EXPIRES November 08, 2011 401) 39"153 Flr,.idallotaryService.00m 1844 LONGWOOD - LAKE MARY ROAD • SUITE 1050 • LONGWOOD, FL 32750 407) 830-7117 • FAX (407) 830-8829 • WWW.COOL-WAY.COM