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Home My WebLink About303 W 3 St AlarmeA AUG 2 8 2(UfTY o[`�- ZSANFUKIJ �JIL I I PS ,BUILDING & FIRE PREVENTION _Pj= m IT A 0 Ylz=�RERIA[14�P, PLICATION $ 1 C4 q - CJ's Application No: cl Documented Construction Value: f L Job Address: _0, 11n, Historic District: Yes D No Parcel ]ED: 3 AG - w5oS - o c)C)is Zoning: _7 Description of Work: Plan Review Contact Person. Phone: Fax: M-Mle 0_T Title: E-mail: Property Owner Information Name 0C Mcg Phone: kcl - 40 a -1 C19 0 Street: Z>C> CcA Resident of property? City, State Zip: �� n�3 s:A L @01 l Contractor Information Name A 1)'k Phone: Street: 0 A 1.0 <Ae- (9 ki CCC A 0,L 6+ C_ -o 0n City, State Zip: . 01C 3 ")L State License No.: Ef Doo 11 al Name: Street: City, St, Zip: Bonding Company: Address: Architect/Engineer Information Phone: Fax: E-mail: Mortgage, Lender: Address: PERMIT INFORMATION Building Permit 13 Square Footage: 10 Construction Type No. of Dwelling Units: Flood Zone: Electrical New Service —No. of AMPS: Mechaniddl El (Duct layout required for new systeihs) No. of Stories: Plumbing 1:1 New Construction - No. of Fixtures: Fire Sprinkler/Alarm El 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 IiVIPROVEMENTS 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 fhe executed contract is submitted, credit will be applied to your permit fees when the permit is released. Signature of Owner/Agent Date Print Owner/Agent's Name Signature of Notary -State of Florida Date Owner/Agent is Personally Known to Me or Produced ID Type of ID APPROVALS: COMMENTS: Rev 11.08 ZON7Jtp UTILITIES: ENGINEERING: FIRE: Contractor/Agent is Produced ID D. tI _vPersonally Known to Me or Type of ID WASTE WATER: BUILDING: ----------------- ... ..... . ..... -- --------- -s ---------- ----------- ...... K. �M� EIU'S' SMALL BUSINESS CONTRACTI l ��a SII I��IIlI M 540OUEGO ii i. X — I A 0% y i 5ectiorl 1 - us Omer Into ADT LLC dba ADT Security'Servires (4ADT") Business Name ("Customer" or -I- or "me" or. my') 111Z Irl Office Address . r ZI Premises' 6,r 1P L 3Z9 I � Address Jeeb 0 inch - MAMP&I I I I I I I I I I p CAY Stater ZIP3VM ,407-6804OW ' Responsible "MeAl M4�IiO 1 L I 1.800.ADT.ASAP,3 27 (YP 248, 23) Protected Premiseefled) 0 Other (Non-Quallfied) _SSRequired) 0 Traditional Phone 0 other (Qualified) F 1Y, n, rT m`e ID Fill in-if.billing address is the Billing 11VI'l I IT TFR Address Billing Phone 14 n City LL I rz'] 'H -Z State 1p (Required) IF FAMILIARIZATION PERjOb.1!5 !YCTED INITIAL HERE — (see Paragraph B3 of the Terms and Conditions for explanation) J"IeW41 lb�19121011 I- IC� 10 1-- 1 1 1 JJ, I I I FM I I I I I I- I I I 1 1 lul EMAIL Communications Authorization: - I authorize ADTto provide me with information and updates about the security system and new ADT and third -party products and services to the contact information provided by me, I -may unsubscribe or opt out by emailing donotcontact@adLcom or by calling 888.DNC4ADT (888.362.4238). Initial here Confirmatlon.of Appointments: I authorize ADT to -call me usindan automated calling device to deliver a pre-recorded message"to set/confirm appolntT?nts f nd provide other Information or notices abo.Lifthe alarm system at the telephone number(s) provided by me. Initial here Ownership of System addEquipment 0CusWrner-Owried.tWADTOvUned Verticals; ORetail 0 Business Services *Personal Services . 0 Automativefrransportation (D Grocery/Food 0 Health Services 0 Restaurants 0 Wholesale 0 Other I acknowledge and agree to each of the following: (A) this Contract consists of six (6) pages. Before signing this Contract, I have read, understand and agree to each and every term of this Contract. Including but not limited to paragraphs C and E of the Important terms and conditions. (B) The initial term of this Contract Is three (3) years. (C) No alarm system can provide complete protection or guarantee prevention of loss or injury. Fires, floods, burglailes'robberies, medical problems and other WMents are unpredictable and cannot always be detected or prevented by an alarm system. Human error is always possible, and the response time of police, fire and medical emergency personnel Is outside the control of ADT. ADT may not receive alarm signals if communications or power is interrupted for any reason. (D) ADT recommends that I manually test the alarm system monthly and any time I chalnge -telephone service, by calling 1.800.ADTASAP. (E) This Con -tract requires final approval by an ADT authorized manager before ADT may provide any equipment or services, and If approval is denied, then this contract will be terminated, and ADrs only obligation will be to notify me of such termination and refund any amounts I paid in advance. ADT Re 5ent9f J-V�e 'Rep LIcense-Act Rep - ?if Reclutr6d) ID No. Y Customer's Approval: Original Signature Required C INSTALLER NOTES (Special rnsjjuajori§/Dire6efons LCs Street) :TT _. -----------------_ i . fi SMALL BUSINESS CONTRACT II��UIUtlI�IRi��I�iVII�II��II1 ! 540OUE00 CONTRbATEAY ®Aom COUN NO ' , , ` YOB LEAD -NO m SOURCE h arm Monitoting and Notificatign Sen•. Ma_m d Burglary (BAj - 0 Hold-up (HUA) I 0 Duress. Two�ry d ' M *If applicable sales tax not shown, It will be added to the first invoice Section. 3. Equipment to be Installed W! Co. III, .fir i --- - Monthly Service Charge On Site Services ply prce t ------------ — " tO.OtheY; ; • c .. 1 O Critical Condition Monitoring (CCM) -• To><ai.Monthly Service Charge O Flood OTemperature iI O Annual UL Certi icate Fee 0Parallel Protection - $ —^ W Munlcipal Electrical Permit $IR O ADT DataSource result in no municipal Wpolice response to an alar from the premises and/9•r a fine. i O Open/Close Login -- Installation Price O Supervised Scheduled open/Close I -- I Taxabl7AaLfnt'(1.eave blank ifAD`L-i 06d) Non-Tamount (Leave blank If ADT -Owned) O ADT Entry Solutions Connection Fee Other Services Sales Tax on Installation* Tax Exem gt No. 42b Quality Service Plan (QSP) / . )�L ! N Tax Fxpiratio4ate 01f Quality Servlce Plan (QSP) is Declined Customer I Total Instatfation Charge* must Initial here O Preventative Maintenance/lrrspections Per Year O1 02 03 04 06 012 i I 0 Training � i i O Direct Connection Services O Monthly Recurring Municipal Fee (Subject to change based on local law) O Customer to obtain and pay for municipal 1 alarm use permit *If applicable sales tax not shown, It will be added to the first invoice Section. 3. Equipment to be Installed W! Co. III, .fir i --- - Monthly Service Charge On Site Services �s �_ ? r.,•,i. t •s O Guard Response O Interi(o' O Extet ir➢r' ' `;� — " tO.OtheY; ; • c .. -• To><ai.Monthly Service Charge Initial Fee O Annual UL Certi icate Fee 6ADTtoT8btaln Electrical Permit W Munlcipal Electrical Permit $IR O Customer to obtain and -pay for initiallannual municipal alar use permit Failure to obtain and provide ADT'wlth the municipal alar use permit registration number could result in no municipal Wpolice response to an alar from the premises and/9•r a fine. w • O othe`— --- $r Installation Price Taxabl7AaLfnt'(1.eave blank ifAD`L-i 06d) Non-Tamount (Leave blank If ADT -Owned) Connection Fee Sales Tax on Installation* Tax Exem gt No. Tax Fxpiratio4ate I Total Instatfation Charge* r Deposit Received: 100% deposit required < $500 Minimum 50% deposit required $500•r O Money Order ® Check O Credit/Deblt Card 1111 I Balance Due* $ Olt" De*.e L"beation •