HomeMy WebLinkAbout116 E 1 St 12-1684 Plumbing for new barI I
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F CITY OF SANFORD
REC�14
�VRr,T. ING &FIRE PREVENTION
JUL 2012
PERMIT APPLICATION
Application No: l Doc m entad Constrae#ion.Y lue: $ �� C
Job Address: i✓ k 4 Historic District: Yes ,IJ' No ❑
Parcel TD:
Description of Work: _2L() iM11 i 1`ptl� /.��
Zoning:
Plan Review_ Contact Person: Title:
Phone: CG T ` 11 Fax: E-mail: e1�Z�4�
) ` � Property Owner Information
l G i j41� iC; CG `'-`
Name �i/ i45�� ��!�/" !�ZU fCl2 -rt E5 Phone:
Street
City, State Zip:
Resident of property? :
f� Contractor Information
Name \Jl� -'T j�/q ;✓ Phone: 'lo',_ ZV 7
Street: 0!5�W 71 L l r-' &1L f%Z Fax:
City, State Zip: ( _ �� ✓L%4 "3 7I 3 State license No.: r�-�
Architect/Engineer Information
Name: Phone:
Street: Fax:
City, St, Zip: E-mail: —
Bonding Company: Mortgage Lender:
Address: Address:
Building Permit ❑
Square Footage:
PERMIT INFORMATION
.Construction Type: No. of Stories:
No. of Dwelling Units: Flood Zone:
Electrical ❑
New Service – No. of AMPS: -
Mechanical ❑ (Duct layout required for new systems)
Plumbing ❑
New Construction - No. of Fixtures:
Fire Sprinld.er/Alarm Q No. of heads:
IE
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 UVVIPROVEMENTS 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.
102-/15- /z,
sture of Owner/Agent Date Sig Lure of Contractor/Agent Date
Owner/Agent's Name Pr�6tontractor/Agent's Name k "WHO
Signature of Notary -State of Florida Date
Owner/Agent. is Personally Known to Me or
Produced ID Type of ID
APPROVALS: ZONING:
ENGINEERING:
COMMENT'S:
Rev 11.08
UTILITIES:
FIRE:
Signature ofNotar3 a! fad ofoWi /SS'•e -5, Date
z : January % • C� •
19
A 11>10
1-10 4z
a•°bo
Contractor/Aged/Q)A ' � -;town to Me or
Produced ID i�'d`f
WASTE WATER:
BUILDING:
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Project name: Washburn Imports - Imperial North
Building Permit #: 12-1684
Customer. Washburn Imports
Address: 116 E. 1 st Street
Sanford, Fl. 32771
Contact number. Michael Blaise 407-927-5694
Email:
Today's date: 7.15.12
Estimate Price: E -$5,6119——
Terms:
5,619Terms: N/A
Deposit Amount: N/A
Project Description: Plumbing work to be performed under Building Permit# 12-1684
• Estimate 584 (See Attached) from Central Florida Plumbing is approved.
• Payments to be as agreed between CF Plumbing and Blaise Built, Inc.
• Additional desired work scope from client to be addressed and approved by a Blaise Built representative and
Central Florida Plumbing prior to commencement.
Approved by (Blaise Built, Inc):
Date:
Approved by (Central Fl Plumbing):
Date: 7 / t, //Z-
Blaise
/Z
Blaise Built Inc. '
blaisebuiltC�D,,,gmail.com
407.927.5694 - Michael Blaise
407.375.9547 - Clint Larson
CBC# 1256125