HomeMy WebLinkAbout108 Park Ave 12-7877JAN 31 2012
D _+} CITY OF SANFORD
F3`�: - BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: 1 Documented Construction Value: $ t
Job Address: / a PG ✓ / t yf Historic District: Yes ❑ No ❑
Parcel ID: /,n Zoning:
Description of Work: l/'�S7�rX�" low yo lli 9e y o i cz , d n L , i,✓ /y. I
Plan Review Contact Person: Title:
Phone:
Name A 0 b Po Wk lkis
Street:
City, State Zip:
Fax:
E -mail:
Property Owner Information
Phone:
Resident of property? :
Contractor Information
Name _Sf✓� U/4 L! he Phone: 3F6 5_7E_ O `{ 00
Street: 6S-0 B (yo( Fax: 3 86 S 7� o `( q p
City, State Zip: 3 -7 a- State License No.: E6— 13 0001/06
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Building Permit ❑
Square Footage:
No. of Dwelling Units:
Electrical ❑
New Service — No. of AMPS:
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type:
Flood Zone:
Plumbing ❑
No. of Stories:
New Construction - No. of Fixtures:
Mechanical ❑ (Duct layout required for new systems) Fire Sprinkler /Alarm ❑ No. of heads:
t Line
Communications, inc.
Low Voltage Wiring Quote
Insurance Risk Services
12/20/11
Straight Line Communications will provide all labor, parts, and materials to install the
following:
Voice, Data and TV Wiring $ 2,200
• Ten (10) dual (voice /data) outlet locations, each with two CAT 5E PVC cables. At
the station end, voice cable will be terminated on a four wire RJ11 telephone jack.
Data cable will be terminated with an RJ45 CAT 5E data jack. These jacks will be
mounted in a flush mount two port faceplate.
• Fifteen (15) dual (voice /data) cubicle outlet locations, each with two CAT 5E PVC
cables. Cables will be routed through adjacent wall or powerpole (provided by
others) and into raceway at bottom of customer provided modular furniture. At the
station end, voice cable will be terminated on a four wire RJ11 telephone jack. Data
cable will be terminated with an RJ45 CAT 5E data jack. These jacks will be
mounted in a surface mount two port faceplate.
• One (1) dual (voice /data) floorbox outlet location, with two CAT 5E PVC cables. At
the station end, voice cable will be terminated on a four wire RJ11 telephone jack.
Data cable will be terminated with an RJ45 CAT 5E data jack. These jacks will be
mounted in a flush mount two port faceplate.
• Two (2) TV outlet locations, each with one RG6 PVC cable. Cable will be terminated
with a "F" connector and mounted in a flush mount TV faceplate.
• One (1) data/TV outlet location in conference room, including one CAT 5E PVC and
one RG6 PVC cable. Data cable will be terminated with an RJ45 CAT 5E data jack.
TV cable will be terminated with an "F" connector. These jacks will be mounted in a
flush mount two port faceplate.
• Two (2) CATS data outlet locations for I video cameras to hallway locations near
entry doors
• At the wiring closet, voice cables will be terminated on three 66 blocks. Data cables
will be terminated on a forty eight port CAT 5E patch panel, mounted on a hinge
bracket.
• All cables to be tested and labeled.
Security System Prewire
• Prewire for:
• Two (2) LCD Keypads
• Two (2) Motion Detectors
• Two (2) Exterior Door Contacts
• Interior Siren
650 Deltona Blvd. Deltona, FL 32725 Ph :386.575.0400 Fax: 386.575.0448 EG 13000279
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. 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.
The City of Sanford requires payment of a plan review fee. A copy of the executed contract is required in order
to calculate a plan review charge. If the executed contract is not submitted, we reserve the right to calculate the
plan review fee based on past permit activity levels. Should calculated charges exceed the documented
construction value when the executed contract is submitted, credit will be applied to your permit fees when the
permit is released.
Signature of Owner /Agent
Print Owner /Agent's Name
Date
Signature of Notary-State of Florida Date
Owner /Agent is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING: UTILITIES:
ENGINEERING:
COMMENTS:
Rev 11.08
101-111
Signa re o Contractor /Agent Date
Print Contractor /Agent's Name
Signature NotpX-8tajeofFlorida0EBBIE E ANEU(e
Y
2�, „ �•: Notary Public -State of Florida
�; • My Comm. Expires Feb 25, 2015
Commission # EE 60162
Bonded Through National Notary Assn.
Contractor /Agent is Personally Known to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING: