HomeMy WebLinkAbout110 Towne Center Blvd 12-1403APR 17 2012
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: A Ll 0 Documented Construction Value:
Job Address: J /13 T(-1 W J4 Historic District: Yes ❑ No
Parcel ID: Zoning:
Description of Work:
Plan Review Contact Person- Title:
Phone: Fax: E-mail:
Property Owner Information V07
Name Z� ts -<� 3Q1
�- I Phone. .
Street: Il U '7owitL Resident of property?:
City, State Zip: Z�C' � �o r
Contractor Information
Name rory- V Yv\"Uvv�ev- C- Phone,
L
Street: 76-0e-k-1 5 �- -o -e__ Fax: G7
City, State Zip:_ 0 V-j ( d2-1 :?4 ec- (-0 State License No.:
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Building Permit ❑
Square Footage: _
Architect/Engineer Information
Phone:
Fax:
E-mail•
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type: No. of Stories:
No. of Dwelling Units: Flood Zone:
Electrical ❑
New Service - No. of AMPS:
Plumbing ❑
New Construction - No. of Fixtures:
Mechanical ❑ (Duct layout required for new systems) Fire Sprinkler/Alarm ❑ No. of heads:
From: unknown Page: 212 Date: 3/27/2012 01:40:41
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Date., of Initial Call:
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Desuiripbon Of Andinp dIld work
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Total Lghor Costg�
Subtotal Cost,
Sales Tax: rl I
.................
Not to exceed-.
Estimate Form
National Maintmianoo & Build Out Compaloy
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_ • -•••• •••••��• +. wrvvwr -ry rayc. cra ualC. V/-f/LU I Vi.44.J0
National l�'�aintenanc'e Build Out 4R Vincent Circle, �
h• land. PA 18974
Company L LC Tel: (RRR) 3=10 -6900
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Fax: (RRR ) 242 -6100
Service Work Order Agreement
Work Order No. 117641
Customer No:
Customer Nate:
Address:
Phom No:
Fax No:
Mattress Giant-0(3
110 Town Center Boulevard
Sanford, FL 32 7 7 1 -0000
(-407)321 -6016
(407)321 -5018
Service Required.- = Perfonn replacement of unit ;;:2 as per quote
't'ork Performed:
;job complete: [] YES [l NO Date Completed:
' N TO, what needs to be done:
Date Issued: 0127'2012
Date !required:
Priority: 0.00
Work Type: I AC Service
Not to Exceed Limit: 0.00
.Job costs includes labor, material, travel and all applicable
taxes. If work is to exceed this limit, please call this office prior
to proceeding. failure to call for approval will result in no
payment.
PAYN•LENT: N \,fBOC will pay for the work performed on a net 45 basis from the day I -MBOC is in receipt of the proper paperwork.
Contractor must show breakdown of labor, tax and materials on all invoicing Contractor must also supply NX1130C with
a W -9 form and a current Certificate of Insurance showing General Liability and Workman's Compensation
(N12 B0C must be listed as certificate holder). Payment will be issued to the contractor for satisfactory completion of the
wort: authorized by NFI iBOC 'as long as a copy of NMBOC's work order is sighed by a store emplovee or manager and
accompanies the invoice.
Failure to submit a sinned wort: order will result in non - payment for the work performed
echnician Signature:
ore `vMarcager Signature: _. I hearby accept the work as described above
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