HomeMy WebLinkAbout115 French Ave 12-1058 HVAC7 �CEIVED
MAR 7 2012
CITY OF SANFORD
B, Y: BUILDING & FIRE PREVENTION
PERMIT APPLICATION
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Application No: — �(�� Documented Construction Value: $ Ij Oct
Job Address: Historic District: Yes ❑ No ❑
Parcel ID: Zoning:
Description of Work: e-C -N-UO 3 5c -r--i \ /,r 1 ict-TI- +ce- w 7N / a yk e .?c71 j
Plan Review Contact Person: ku;i4 ei Title:
Phone: Fax: E -mail:
Property Owner Information
Name Phone:
Street: Resident of property?
City, State Zip:
Contractor Information
Name Phone: 381 - 3�i� -Ca zap
Street: WO 1406- s% 71/ > y Fax:
City, State Zip• L_6 mil; UAzD i::;L• 9-2750 State License No.: L L \_3COq rl S5
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E -mail:
Bonding Company:
Address:
Mortgage Lender:
Address:
PERMIT INFORMATION
Building Permit ❑
Square Footage: Construction Type:
No. of Dwelling Units: Flood Zone:
Electrical ❑
New Service — No. of AMPS:
Mechanical ❑ (Duct layout required for new systems)
No. of Stories:
Plumbing ❑
New Construction - No. of Fixtures:
Fire Sprinkler /Alarm ❑ No. of heads:
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: �, �, ZD)� UTILITIES:
VVI
ENGINEERING:
COMMENTS:
Rev 11.08
Signature of Contractor /Agent Date
Print Contractor /Agent's Name
E I A kLa -
, 0Z 0I. I Z
Signa re f ota -St to of Florida Date
Y�n'�e. DEBBIE BLANTON
Notary Public - State of ]2015
•_ My Comm. Expires Feb 25�: °;Commission # EE 60J 0Bonded Through National NotaContractor /Agent is Personall n to Me Qr
Produced ID Type of ID t Ir2 t •
WASTE WATER:
FIRE:
BUILDING:
ELECTRICAL CONTRACTORS
EC 13004755
r:7 ure,
Invoice
Date Invoice #
2/22/2012 23
All invoices shall be paid in full within 30 days after date of completion. All past due
amounts will accrue 18% or the statutory rate which ever is less. Any deviation from the
quote resultin in additional work will require written authorization. By signing this Payments /Credits $0.00
proposal you are accepting the terms as outlined above and authorizing D @ B Electrical
Contractors LLC. to begin work. In addition you are guaranteeing that D & B Electrical Balance Due
Contractors LLC. will be paid for work preformed. $1,200.00