HomeMy WebLinkAbout1119 W 9 St 12-375 Drywall, insulation and cabinetsD NOV 2 8 2011 CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: / 3 7 Documented Construction Value: $15,073.01
Job Address: 1119 W 9TH STREET Historic District: Yes No
Parcel ID: 25-19-30-508-1114-0070 Zoning:
Description of Work: DRYWALL, INSULATION & CABINETS 1 fie E
Plan Review Contact Person: Title:
Phone: Fax: E-mail:
Property Owner Information
Name HEZEKIAH & LELIA ROSS Phone: 407-322-4397
Street: 1003 S MULBERRY AVENUE Resident of property?
City, State Zip: SANFORD FL 32771
Contractor Information
Name HOWARD CONSTRUCTION, LLC Phone: 904-541-1112
Street: 580-3 WELLS ROAD Fax: 904-541-1103
City, State Zip: ORANGE PARK FL 32073 State License No.: CBC058529
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Building Permit
Square Footage:
No. of Dwelling Units:
Electrical
New Service — No. of AMPS:
Architect/Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
PERMIT INFORMATION
Construction Type:
Flood Zone:
Mechanical
p (
Duct layout required for new systems)
o /
a
3
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.
r
Signa r of Owner/Agent Dat
fl
r, k OSS
Print Owner/Agent'samle(-
j A A
UlilJ
Sign'-ffrreyNotarylState of Florida Date
yrr ap6 iyotary Public State of Flonoa
J
Jennifer Koski
iy commission DD928560
qr G
r/
27/201310Excires
Ownei ' sona ly own to Me or
Produced ID Type of ID
APPROVALS: ZONING: UTILITIES:
ENGINEERING: FIRE:
COMMENTS:
Rev 11.08
Sig/nature of Comract o%r/A/gent Date
Print Contractor/Agent's Name
A d
Signature of N • ry-Sta4 of Florida Date
Moe ublic State of Florida
Koskimission DD928560
01271 013
Con ersonally 3own to Me or
Produced ID Type of ID
WASTE WATER:
BUILDING:
Client: Hezekiah & Lelia Ross
Property: 1119 W. 9th Street
Sanford, FL 32771
Mailing: 1003 S Mullberry Avenue
Sanford, FL 32771-2363
Operator Info:
Operator: RICKS
Estimator: Rick Patton
Company: Howard Construction, LLC
Business: 580 Wells Road
Orange Park, FL 32073
Reference:
Howard Construction, LLC
Position:
580-3 Wells Road
dUWA6® Orange Park, FL 32073CUMUtue
Us CBC058529 / CGC1512840
CCC1.326844 / CCC1327900
Tax ID# 59-3689148
Client: Hezekiah & Lelia Ross
Property: 1119 W. 9th Street
Sanford, FL 32771
Mailing: 1003 S Mullberry Avenue
Sanford, FL 32771-2363
Operator Info:
Operator: RICKS
Estimator: Rick Patton
Company: Howard Construction, LLC
Business: 580 Wells Road
Orange Park, FL 32073
Reference: Bret Nill
Position: Claims Adjuster
Company: American Integrity Insurance Company
Business: PO Box 26349
Tampa, FL 33623
Type of Estimate: Fire
Date Entered: 11/6/2011 Date Assigned:
Price List: FLOR7X OCT11
Labor Efficiency: Restoration/Service/Remodel
Estimate: W9THST-1119
File Number: AMERICAN INTEGRITY CL# ACH105509
Home: (407) 322-4397
Business: (407) 810-6658
Cellular: (407) 474-4740
Business: (866) 277-9871
National Law requires lead paint testing to be performed on homes built 1978 or prior. Lead practices will have to be
initiated if lead paint is found.
Living Room
W9THST-1119
Main Level
329.33 SF Walls
434.75 SF Walls & Ceiling
11.71 SY Flooring
41.17 LF Ceil. Perimeter
Height: 8'
105.42 SF Ceiling
105.42 SF Floor
41.17 LF Floor Perimeter
DESCRIPTION
Howard Construction, LLC
1. Clean the ceiling - Heavy
580-3 Wells Road
2. Seal then paint the ceiling (2 coats)
Orange Park, FL 32073
U9 CBC058529 / CGC1512840
4. Seal then paint the walls (2 coats)
CCC1326844 / CCC1327900
5. Clean baseboard
Tax ID# 59-3689148
Living Room
W9THST-1119
Main Level
329.33 SF Walls
434.75 SF Walls & Ceiling
11.71 SY Flooring
41.17 LF Ceil. Perimeter
Height: 8'
105.42 SF Ceiling
105.42 SF Floor
41.17 LF Floor Perimeter
DESCRIPTION QNTY
1. Clean the ceiling - Heavy 105.42 SF
2. Seal then paint the ceiling (2 coats) 105.42 SF
3. Clean the walls - Heavy 329.33 SF
4. Seal then paint the walls (2 coats) 329.33 SF
5. Clean baseboard 41.17 LF
6. Paint baseboard - two coats 41.17 LF
7. Clean door (per side) 2.00 EA
8. Paint door slab only - 2 coats (per side) 1.00 EA
9. R&R Ceiling fan & light - Standard grade 1.00 EA
10. R&R Vinyl tile -Standard grade 105.42 SF
11. Clean window unit (per side) 10 - 20 SF 1.00 EA
12. R&R Window blind - PVC - 1" - 7.1 to 14 SF 2.00 EA
13. Seal & paint wood window (per side) 1.00 EA
14. R&R Window AC unit - 1.00 EA
NOTES
W9THST-1119 11/22/2011 Page:2
0
IOWAR®
tees®
ui
Howard Construction, LLC
580-3 Wells Road
Orange Park, FL 32073
CBC058529 / CGC1512840
CCC1.326844 / CCC1.327900
Tax ID# 59-3689148
9'S' Bedroom Height: 8'
9.3-
T
324.00 SF Walls 101.75 SF Ceiling
425.75 SF Walls & Ceiling 101.75 SF Floor
1 + 11.31 SY Flooring 40.50 LF Floor Perimeter
I a• z- az• r 40.50 LF Ceil. Perimeter
1
ra r i z•i
DESCRIPTION QNTY
15. Clean the ceiling - Heavy 101.75 SF
16. Seal then paint the ceiling (2 coats) 101.75 SF
1.7. Clean the walls - Heavy 324.00 SF
18. Seal then paint the walls (2 coats) 324.00 SF
19. Clean baseboard 40.50 LF
20. Paint baseboard - two coats 40.50 LF
21. Clean door (per side) 2.00 EA
22. Paint door slab only - 2 coats (per side) 1.00 EA
23. R&R Vinyl tile - Standard grade 101.75 SF
24. Clean window unit (per side) 10 - 20 SF 2.00 EA
25. R&R Window blind - PVC - 1 " - 7.1 to 14 SF 2.00 EA
26. Seal & paint wood window (per side) 2.00 EA
27. R&R Light .fixture 1.00 EA
NOTES
Hallway
192.67 SF Walls
224.78 SF Walls & Ceiling
3.57 SY Flooring
24.08 LF Ceil. Perimeter
Height: 8'
32.12 SF Ceiling
32.12 SF Floor
24.08 LF Floor Perimeter
Missing Wall 3' 1" X 8' Opens into KITCHEN
W9THST-1119 11/22/2011 Page:3
V,
IOWAII
CMIMMth1
uc
Howard Construction, LLC
580-3 Wells Road
Orange Park, FL 32073
CBC058529 / CGC1512840
CCC1326844 / CCC1327900
Tax ID# 59-3689148
DESCRIPTION QNTY
28. Clean the ceiling - Heavy 32.12 SF
29. Seal then paint the ceiling (2 coats) 32.12 SF
30. Clean the walls - Heavy 192.67 SF
31. Seal then paint the walls (2 coats) 192.67 SF
32. Clean baseboard 24.08 LF
33. Paint baseboard - two coats 24.08 LF
34. Clean door (per side) 1.00 EA
35. Paint door slab only - 2 coats (per side) 1.00 EA
36. R&R Vinyl tile - Standard grade 32.12 SF
37. R&R Light fixture 1.00 EA
NOTES
F-4' 5- -}2' +-4' 4" -1 Bathroom
T 4 t -
236.00 SF Walls
Bad- I o
1 10'T ` i 282.13 SF Walls & Ceiling
tQ T' 5.13 SY Flooring
Hallway
29.50 LF Ceil. Perimeter
DESCRIPTION
38. Clean the ceiling - Heavy
39. Seal then paint the ceiling (2 coats)
40. Clean the walls - Heavy
41. Seal then paint the walls (2 coats)
42. Clean baseboard
43. Paint baseboard - two coats
44. Clean door (per side)
45. Paint door slab only - 2 coats (per side)
46. R&R Vinyl tile - Standard grade
47. R&R Light .fixture
Height: 8'
46.13 SF Ceiling
46.13 SF Floor
29.50 LF Floor Perimeter
QNTY
46.13 SF
46.13 SF
236.00 SF
236.00 SF
29.50 LF
29.50 LF
1.00 EA
1.00 EA
46.13 SF
2.00 EA
W9THST-1119 11/22/2011 Page:4
Howard Construction, LLC
580-3 Wells Road
RNOWAARRO Orange Park, FL 32073
uc CBC058529 / CGC1512840
CCC 1326844 / CCC 1327900
Tax ID# 59-3689148
CONTINUED - Bathroom
DESCRIPTION QNTY
48. Clean tub 1.00 EA
49. Seal & paint wood window (per side) 1.00 EA
50. Clean vanity - inside and out 1.50 LF
51. Clean countertop - Heavy 3.00 SF
52. Clean sink faucet 1.00 EA
53. R&R Wallpaper 118.00 SF
54. Paint chair rail - one coat 29.50 LF
55. Detach & Reset Water heater - 30 gallon - Electric - 6 yr 1.00 EA
56. Clean water heater - Light 1.00 EA
57. R&R Fiberglass tub surround only - Standard grade 1.00 EA
58. R&R Acoustic ceiling 46.13 SF
59. R&R Medicine cabinet - Standard grade 1.00 EA
60. R&R Shower curtain rod 1.00 EA
NOTES
1' 61- 3' -4-4' T' -I
F-4' 3"
in o
ilutd..
T T
1
Missing Wall
DESCRIPTION
61. R&R Ceiling fan & light
W9THST-1119
Kitchen
240.67 SF Walls
309.13 SF Walls & Ceiling
7.61 SY Flooring
30.08 LF Ceil. Perimeter
3' 1" X 8'
Height: 8'
68.47 SF Ceiling
68.47 SF Floor
30.08 LF Floor Perimeter
Opens into HALLWAY
11/22/2011
QNTY
1.00 EA
Page: 5
Howard Construction, LLC
580-3 Wells Road
Wr F.H. Orange Park, FL 32073
tLt CBC058529 / CGC1512840
CCC1326844 / CCC1327900
Tax 1D# 59-3689148
CONTINUED - Kitchen
DESCRIPTION QNTY
62. R&R 1/2" drywall - hung, taped, ready for texture 68.47 SF
63. R&R Acoustic ceiling 68.47 SF
64. R&R Blown -in insulation - 10" depth - R26 68.47 SF
65. R&R 1/2" drywall - hung, taped, floated, ready for paint 240.67 SF
66. Paint the walls - two coats 240.67 SF
67. R&R Batt insulation - 4" - R11 120.33 SF
68. R&R Baseboard - 2 1/4" 30.08 LF
69. Paint baseboard - two coats 30.08 LF
70. R&R Vinyl tile - Standard grade 68.47 SF
71. R&R Wood window - double hung, 10-15 sf, Standard grade 2.00 EA
72. R&R Attic entrance cover and trim 1.00 EA
73. R&R Range hood 1.00 EA
74. Range - freestanding - electric 1.00 EA
75. Refrigerator - top freezer - 14 to 18 cf - High grade 1.00 EA
76. R&R Cabinetry - upper (wall) units - Standard grade 6.00 LF
77. R&R Cabinetry - lower (base) units 6.90 LF
78. R&R Countertop - Flat laid plastic laminate 6.90 LF
79. R&R Sink - double 1.00 EA
80. Sink faucet - Kitchen 1.00 EA
81. R&R Casing - 2 1/4" 21.00 LF
82. Paint casing - two coats 21.00 LF
NOTES
W9THST-1119 11/22/2011 Page:6
0
BWAR®
i9rltr cgn
tic
Howard Construction, LLC
580-3 Wells Road
Orange Park, FL 32073
CBC058529 / CGC1512840
CCC 1326844 / CCC 1327900
Tax ID# 59-3689148
t±
31Porch
1
F- 4 2-1 9' 2"-
DESCRIPTION
333.33 SF Walls
41.9.28 SF Walls & Ceiling
9.55 SY Flooring
41.67 LF Ceil. Perimeter
Height: 8'
85.94 SF Ceiling
85.94 SF Floor
41.67 LF Floor Perimeter
QNTY
83. Clean the ceiling 85.94 SF
84. Paint the ceiling - two coats 85.94 SF
85. Clean part of the walls 83.33 SF
86. Seal then paint part of the walls (2 coats) 83.33 SF
87. Clean screen wall 250.00 SF
NOTES:
0
Exterior
4375.78 SF Walls
8939.06 SF Walls & Ceiling
507.03 SY Flooring
2003.39 SF Long Wall
486.20 LF Ceil. Perimeter
Subroom 1: Offset 1
336.00 SF Walls
426.00 SF Walls & Ceiling
10.00 SY Flooring
120.00 SF Long Wall
42.00 LF Ceil. Perimeter
LxWxH 222'7 3/16" x 20'6" x 9'
4563.28 SF Ceiling
4563.28 SF Floor
486.20 LF Floor Perimeter
184.50 SF Short Wall
LxWxH 15'x 6'x 8'
90.00 SF Ceiling
90.00 SF Floor
42.00 LF Floor Perimeter
48.00 SF Short Wall
W9THST-1119 11/22/2011 Page:7
0
NOWARD
ocnt tat
ue
Howard Construction, LLC
580-3 Wells Road
Orange Park, FL 32073
CBC058529 / CGC1512840
CCC1326844 / CCC1327900
Tax ID# 59-3689148
DESCRIPTION QNTY
88. Clean stucco 4711.78 SF
89. Paint the walls - one coat 4711.78 SF
90. Clean storm door (per side) - Light 2.00 EA
91. Paint door slab only - 2 coats (per side) 1.00 EA
NOTES
Miscellaneous
DESCRIPTION QNTY
92. Dumpster load - Approx. 30 yards, 5-7 tons of debris 1.00 EA
93. Taxes, insurance, permits & fees (Bid item) 1.00 EA
94. Electrical repair - for range hood wiring & recpts Kit. 1.00 EA
NOTES:
Lead Paint
DESCRIPTION QNTY
National Law requires lead paint testing to be performed on homes built 1978 or prior. Lead practices will have to be
initiated if lead paint is found.
95. Lead test fee - self test (per sample) 1.00 EA
96. Containment Barrier/Airiock/Decon. Chamber 0.00 SF
97. Containment Barrier - tension post - per day 0.00 DA
98. Eye protection - plastic goggles - Disposable 0.00 EA
99. HEPA Vacuuming - Detailed - (PER SF) 0.00 SF
W9THST-1119 11/22/2011 Page:8
G\
0
oow eo
gmtrwMi
uc
Howard Construction, LLC
580-3 Wells Road
Orange Park, FL 32073
CBC058529 / CGC1512840
CCC 1326844 / CCC 1327900
Tax ID# 59-3689.1.48
CONTINUED - Lead Paint
DESCRIPTION
100. Personal protective gloves - Disposable (per pair)
101. Add for personal protective equipment (hazardous cleanup)
NOTES
Grand Total Areas:
6,367.78 SF Walls
5,093.10 SF Floor
2,123.39 SF Long Wall
439.82 Floor Area
823.50 Exterior Wall Area
0.00 Surface Area
0.00 Total Ridge Length
5,093.10 SF Ceiling
565.90 SY Flooring
232.50 SF Short Wall
490.01 Total Area
91.50 Exterior Perimeter of
Walls
0.00 Number of Squares
0.00 Total Hip Length
11,460.88 SF Walls and Ceiling
735.20 LF Floor Perimeter
735.20 LF Ceil. Perimeter
1,656.00 Interior Walt Area
0.00 Total Perimeter Length
QNTY
0.00 EA
0.00 EA
W9THST-1119 11/22/2011 Page:9
Main Level
19' IF
mzl)i
Main Level
W9THST-1119 11/22/2011 Page: 10
Permit No.
Tax Folio No. 25-19-30-508-1114-0070
NOTICE OF COMMENCEMENT
State of Florida
County of Seminole
The undersigned hereby gives notice that improvement
will be made to certain real property, and in accordance
with Chapter 713, Florida Statutes, the following
information is provided in this Notice of Commencement.
ism No monsoon anininsoa Ila
MRYANNE MORSE, CLERK OF CIRCUIT COURT
SENINOLE COUNTY
AK 07670 Pg 13401 Qpg2
CLIEi KII S 0 2011127469
REMRDEO IMMM11 10tl6t51 AN
REMINS FEES 10. Cllr
RECORDED BY T Smith
1. Description of property: (legal description of the property, and street address if available)
LOT 7 BLK 11 TR 14 W MCLARKS SUBD PB 1 PG 108
2. General description of improvement: REPAIR FIRE DAMAGES PER INSURANCE CL# ACH105509
3. Owner information: Name: HEZEKIAH & LELIA ROSS
Address: 1119 W 9TH STREET SANFORD FL 32771
b. Interest in property: OWNER
c. Name and address of fee simple titleholder (if other than Owner): Name:
Address:
4. Contractor Name: HOWARD CONSTRUCTION, LLC Phone number: 904-541-1112
c. Address: 580-3 WELLS ROAD ORANGE PARK FL 32073
CERTMED Y
5. Surety Name (SE
Address: MARYANNt MOR
b. Amount of bond: $ CLERK
OURT
6. Lender: Name:
SEMIN4EquNTY,
FLORIDA
Address:
Lender's phone number:
7.a. Persons within the State of Florida designated by Owner upon whom notices or other documents may
provided by Section 713.13(1)(a)7., Florida Statutes: Name:
Address:
8.a. In addition to himself or herself, Owner designates of to receive a copy of the
Lienor's Notice as provided in Section 713.13(1)(b), Florida Statutes.
b. Phone number of person or entity designated by owner:
9. Expiration date of notice of commencement (the expiration date is 1 year from the date of recording unless a different
date is specified)
WARNING TO OWNER: ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE
NOTICE OF COMMENCEMENT ARE CONSIDERED IMPROPER PAYMENTS UNDER CHAPTER 71.3, PART I,
SECTION 713.13, FLORIDA STATUTES, AND CAN 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 COMMENCING WORK OR RECORDING YOUR NOTICE OF
1CP ENCE, , NT. 1; )
VIgnature of Owner or Owners Attt rized Officer/Director artner/Manager Signatory's Title/Office
The foregoing instrument was acknowledged before me this t day of n( , , ar j , by (name of person) as (type of
authority.... e.g. officer, trustee, attorney in fact) for (name of party on behalf of whom instrument was executed) .
lNA- -- (SEAL)
S1gnatur of Notary Public
Personally Known OR Produced Identification Type of Identification Produced
Verification pursuant to Section 92.525, Florida Statutes: Under penalties of perjury, I declare that I have read the foregoing and that
the facts stated 'p it are true to the best of my knowledge and belief.
c1 -'-} i?1% µ r: Huulic Mate.
Florida Sign"re of Natural Person StgnitieMbi e i Ke: {
v,+ U d
ys r'' tFfti+lt8 +
445hi n C OiT,r'11SSior
DDg28560 Rev. date 3/2008 i t iI [ it, -W1 ff "r % L t
r "?
j
y ' 9AME"- /. } „n EXDIrBS 111!
211. AWR.
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: Documented Construction Value: $
Job Address:
Parcel ID:
Description of Work:
Plan Review Contact Person:
Phone:
Name
Street: / 144 f S
City, State Zip:
Pp_ pp
Historic District: Yes No
Zoning:
Title:
Fax: E-mail:
Property Owner Information
Phone:
Resident of property? : M
Contractor Information 7 p
Name / l"JJ1% L S'e j: r,w p `a- f9/ ' I
Phone: 7
Street: - S V
Fax:
City, State Zip:
Al i) 32 d State License No.:
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Architect/Engineer Information
Phone:
Fax:
E-mail:
Mortgage Lender:
Address:
rkla- ::N:--3•,s.oas.we£v. .. -.
r n... .` .w.=4rd.
PE,RMIT INFORMATION
Building Permit
Square Footage: Construction Type:
No. of Dwelling Units: Flood Zone:
Electrical
New Service — No. of AMPS:
Plumbing
No. of Stories:
New Construction - No. of Fixtures:
Mechanical (Duct layout required fo new systems) Fire Sprinkler/Alarm No. of heads:
yedillI
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 M
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
Rev 11.08
X A 4, 4,- /- - )/
Signature of Contractor/Agent Date
Print ConAactor/Agent's Name
ak.//
Date
o,Pav PoetDEBBIE
BLANTOJ01NotaryPublic -State o
My Comm. Expires Feb 2
foFi dr°:' Commission # EE 6
Bonded Through NaCronal
NotContractor/Agent is Personwn to M or 1
Produced ID Type of i C' =' I / v/
UTILITIES: WASTE WATER:
BUILDING: