HomeMy WebLinkAbout1621 W 1 St 17-422; PLUMBING17
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CITY OF SANFORD
BUILDING & FIRE PREVENTION
tl SEP Q 5 2017 PERMIT APPLICATION
ICY:` — Lj Application No: /
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Documented Construction Value: S 1 (, &00
n c7`
Job Address: Historic District: Yes No
Parcel ID: Residential Residential Commercial
Type of Work: Ne t%LJ Addition Alteration Repair Demo Change of Use Move
Description of Work: w t~-\$ j e-3 ty New \tiuS) t CA_ &FT -t CZ
Plan Review Contact Person: u Kim! Title: Oumlle'
Phone:(g'b/- Fax: Emai1:
Property Owner Information
Name Phone:
Street: Resident of property?
City, State Zip
Contractor Information
Name k/'-;rr'f r tL. 4iA Phone:
qTt' r; Mf3f Q
Street: -4 ax:
City, State Zip: Da -At' -5t?, FL ? u 2-P State License No.:
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Phone:
Fax:
E-mail:
Bonding Company: Mortgage Lender:
Address: 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. 1 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: 5th Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application
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 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 ICC 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 bate Signatu6 of C gent 15ate
Print Owner/Agent's Name Print Contractor/Agent's Name
Signature of Notary -State of Florida Date
Owner/Agent is Personally Known to Me or
Produced ID Type of ID
Contractor/Agent is rsonally
Produced ID, Type of ID _
BELOW IS FOR OFFICE USE ONLY
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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
APPROVALS: ZONING:
ENGINEERING:
COMMENTS:
of Heads Fire Alarm Permit: Yes No
UTILITIES:
FIRE:
WASTE WATER:
BUILDING:
Revised: June 30, 201 S Permit Application
p fi
SEP -52017 i
13k
CITY OF SANFORD
BUILDING & FIRE PREVENTION
PERMIT APPLICATION
Application No: _?
Z
Documented Construction Value: $ U 4was
Job Address: Historic District: Yes NO. El
Parcel ID: Residential Commercial
Type of Work: :New LJ`' : Addition Alteration Repair Demo Change of Use MoveET
Description of Work: W l (` c9 t u aCQ_tf Y /c,
I ( C CC(-- ('b G19 L rS \ cry ;EtJ f2 U i LQ 'l-r_ Co
Plan Review Contact Person: Title:
Phone: Fax: Email:
Propert Owner Information
t:
Name Phone:
Street: .,.:. . ,<.:,. Resident of property?
City, State'Zip
Ia p4 f' I'tC-ibontractor Information
Name P"1 C Phone:
0'VStree`t: ,' .i 7 8 ,(} S c7 'Zi] Fax:
City, State Zip: EL lbIJ-PJ State License No.:-
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
Ph(
Fa3i
E -n
Mortgage
Address:
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT_MAYAESULT 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: 51' Edition (2014) Florida Building Code
Revised: June 30, 2015 Permit Application"
Ak
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 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 wilhibe figured based on the current ICC 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.
le -7.
Signature of Owner/Agent Date Signature of Contractor/Agent Date
Print Owner/Agent's Name Pri ntractor/Agent's Name
Signature of Notary -State of Florida Date Signature of Notary -State of Florida Date
DEB IE6,hl?dJ
MY comoSSImfi # r 17°t F,.
EXPIRES: February c
Bonded Thru Notary Public Undem: ;e < jF
Owner/Agent is; Personally' Known to Me or Contractor/Agent is Personally Known:to Me or
Produced ID Type of ID _ Produced ID—Type of ID
a
B=ELOW IS FOR OFFICE USE ONLY
Permits Required: Building. Electrical Mechanical Plumbing
Construction Type: Occupancy Use:
Total Sq Ft of Bldg: Min. Occupancy Load:
New Construction: Electric .- # of Amps
Fire Sprinkler Permit: Yes No # of Heads
APPROVALS: ZONING: UTILITIES:
ENGINEERING: FIRE:
COMMENTS:
Gas[] Roof
Flood Zone:
of Stories:
Plumbing -,# of Fixtures
Fire Alarm Permit: Yes No
WASTE WATER:
BUILDING:
Revised: June 30, 2015 1.
Permit Application