HomeMy WebLinkAbout201 W 17 St 17-381; ELECTRICALECEIVE CITY OF SANFORD
BUILDING & FIRE PREVENTION
@ FED Q 8 2017 PERMIT APPLICATION
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BY' — Application No:
Documented Construction Value: $
Job Address: Zo/ W /7 T'F S7;pf--.r Historic District: Yes u No
Parcel ID: Residential [Commercial
Type of Work: New Addition Alteration Repair Demo Change of Use Move
Description of Work: E/t,,044eL-z0/G
Plan Review Contact Person: 'e3 tg Title:
Phone: Fax: Email: SrRV c4C RiQf '`l?+2'G,T a • `"``
Property Owner Information /'
Name -yL'4" YM/^u170 e*e Phone: 7 3 S'O y2_7'/ Street:
w / 7 ri/ ST Resident of property? : Yf S City,
State Zi !'?,.., f .'32_ 77JE st0S
31 ns: aa kn 9 nra r :c `''C' :ntr ctor In Iformation Name "
l o i J 0d-- /<Phol Street:
trav Fax: City,
State Zip: Name:
Street:
City,
St, Zip: _ Bonding
Company: Address:
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32 77/ 4f
97 <f/G fOl-'/ State
License No.: Architect/
Engineer Information Phone:
Fax:
E-
mail: Mortgage
Lender: Address:
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.
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. FBC
105.3 Shall be inscribed with the date of application and the code in effect as of that date: 5"' Edition (2014) Florida Building Code Revised
June 30, 2015 Permit Application
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NOTICE: In addition to the requirements of this permit, there Imay be additional restrictions applicable to this property that may be
found in the public records of this county, and there may be additional permits requited from other governmental entities such as water
management districts, state agencies, or federal agencies. f
Acceptance of permit is verification that 1 will notify the owner of the property of the regti irements of Florida Lien Law, FS 713.
The City of Sanford requires payment of a plan review fee at the time of permit submittal. A copy of the executed contract is required
in order to calculate a plan review charge and will be considered the estimated construction value of the job at the time of submittal.
The actual construction value will be figured based on the current 1CC Valuation Table in effect at the time the permit is issued, in
accordance with local ordinance. Should calculated charges figured off the executed contract exceed the actual construction value,
credit will be applied to your permit fees when the permit is issued.
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.
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
Signature of Contractor/Agent Date
A49.3 1 *-,- 6 ...
Print ractor/Agent's Name
Signature of NQta!y.Stat of,FlQrida. to
c ;;"' °
O'••, ANNETTE BLAND
Notary PuMit - Stato of ibrl"
CommiSSIN 0 69 06*3
My Comm. Et" Jaa 16, *11
Produced ID Type of ID
BELOW IS FOR OFFICE USE ONLY
Permits Required: Building Electrical Mechanical Plumbing Gas Roof
Construction Type:
Total Sq Ft of Bldg:
Occupancy Use:
Min. Occupancy Load:
Flood Zone:
of Stories:
New Construction: Electric - # of Amps Plumbing - # of Fixtures,
Fire Sprinkler Permit: Yes[] No # of Heads
APPROVALS: ZONING: UTILITIES:
ENGINEERING:
COMMENTS:
FIRE:
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
or
Revised: June 30, 2015 Permit Application
Florida Star Electric, LLC
404 S. Palmetto Avenue
Sanford, FL 32771
Phone: (407) 416-8001
License # ER 13013250
E-mail: serviceO-floridastarelectric.com
Job Estimate
FOR: Lyla Maurer
201 W 17t' Street
Sanford, FL 32771
Date: January 23, 2017
SCOPE OF WORK
Replace FPE service panel
REPLACE FPE PANEL
Cost: $900.00 ur °
GENERAL PROVISIONS
All work shall be completed in a professional manner and in compliance with all
applicable building codes.
Panel replacement will require a service disconnect and a permit
Thank you for the opportunity to bid on the wiring upgrade for your home. If you have
any questions, please feel free to contact me.
Bob Hearn, Florida Star Electric, LLC
Contract Agreement
IN WITNESS WHEREOF, the parties agree to the scope of the service provided and the
terms of payment and duly affix their signatures under hand and seal.
nC(,u Aj .,— 4y k___
customer)
date
contractor)
FI rida Star Electric, LLC
2 '6_"-'O'%date