HomeMy WebLinkAbout106 Kelly Cirx4„ , CITY OF SANFORD
" ` F BUILDING & FIRE PREVENTION
i . (9 i
'+ FEB i 3 2018 PERMIT APPLICATION
Application No:
Documented Construction Value: $ /t o
Job Address: ho %4,14L "A �n Historic District: Yes ❑ No Q/
Parcel ID: — 6- 1- Cho — D�® Residential Commercial ❑
Type of Work: New ❑ Addition ❑ Alteration Re air /❑ Demo ❑ Change of Use ❑ Move ❑
Description of Work:
Plan Review Contact Person: Title:
Phone: Fax: Email:
Property Owner Information
Name a�& Phone:
Street: Resident of property?
City, State Zip: �S
Contractor Information
Names Phone:
Street: j6 rz Fax:
City, State Zip: State License No.: 10// �
Architect/Engineer Information
Name:
Street:
City, St, Zip:
Bonding Company:
Address:
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
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 zoniipg.
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 ID
S
Print
Date
Signature of Notary -State of Florida Date
Contractor/Agent is Personally Known to Me or
Produced ID Type of ID
BELOW 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:
ENGINEERING:
COMMENTS:
UTILITIES:
FIRE:
Gas ❑ Roof ❑
Flood Zone:
# of Stories:
Plumbing - # of Fixtures
Fire Alarm Permit: Yes ❑ No ❑
WASTE WATER:
BUILDING:
Revised: June 30, 2015 Permit Application
Pro M. Record Card
Parcel: 12-20-30-511-0000-0570
Property Address: 106 KELLY CIR SANFORD, FL 32773
T
Paroal 12-2"()-5114X�570
} Owner DEBOSE, MORRELDA
Property Address 106 KELLY CIR SANFORD, FL 3277.3
Mailing 106 KELLY CIR SANFORD, FL 32773-
SUbdivision Name MONROE MEADOWS
Tax Disbict SI-SANFORD
DOR Use Code 01-SINGLE FAMILY
Exemptions
167.71
3.5
A 00
CID
8
!roiRP1q'Qounty
LOT 57
MONROE MEADOWS
PB 46 PGS 16 & 17
Tax Amount wMx)tA SOH: $1,531.69
2017 Tax Bill Amount $892.89
Tax Estimator
Save Our Homes Savings: $638.80
• Does NOT INCLUDE Non Ad Valorem Assessments
LOT 0.00 0.00 1 i
$20,000.00 $20.0001
http//parcel de tail. scpaft. org/Pa rcei Detail info.asox?P I 13=1 22030 61100000570 1/23118, 8:39 PM
Page 1 of 2
INSTALLER COPY
INSTALLATION SERVICES CUSTOM;;R CONTRA"' - WATER HEATER ONLY
cud �P LOW 'S OF SANFORD, FL, STORE # 1657 STD =. (407) 430-4060
3780 S ORLANDO DR C
y _ : MICHAEL MCKINLEY
SANFORD, FL 32773-5614 J ID:2362627
Date : 01 /20/2018
This is only a Quote for the merchandise and services printed below. This becorryment and issuance of a Lowe's receipt, upon which the entire agree-
ment, including the specifically completed pages of this document, the Termr -.th this document, the applicable portion(s) of Lowe's receipt, and any
other addenda or attachments hereto, shall be referred to herein as this "Cor' t
PLEASE READ THIS ENTIRE DOCUMENT, INCLUDING THE "TERMSSIGNING.
Lowe's Registration or Contractor License Number / Lowe's Contr
Florida Contractor License Number CGC1508417
Customer Name
Home Phone
S
MORRELDA DEBOSE
';"{"
321-578-1792
O
Customer Address
i
Other Phone
106 KELLY CIR
L
City
State / ^°rovince
Zip /Postal Code
D
SANFORD
FL
32773
Installation Address
T
106 KELLY CIR
O
Installation City
Installation State/Province
Installation Zip/Postal Code
SANFORD
FL
32773
MERCHANDISE AND INSTALLATION SUMMARY
MERCHANDISE SUMMARY
697986 : STK : 5YR EPP WATER HEATER: 5YR EPP WATER HEATER - CITY 1
816159 : E6-50H45DV : STK : AO SMITH 50-GAL 6YR ELECTRIC TALL: AO SMITH 50-GAL 6YR ELECTRIC TALL: AMERICAN WATER HEATER - QTY 1
Materials Price $ 4
INSTALLATION DESCRIPTION
Installation Type: Residential Number of Water Heaters to replace : 1
Store 1657 Project No. 530335231 for MORRELDA DEBOSE
Page 1 of 4
INSTALLER COPY
Water Heater Type : Electric
Emergency Installation : Yes
New Water Heater Stand Installation : No
Earthquake Strap Installation : No / No detail completed
Drain Pan / Line Installation Estimate : No / No detail completed
Permit Required : Yes
Who Will Obtain Permit : Independent Contractor
Additional Miles Traveled Over 20 : 0
Other Work Charge: Yes
Water Heater Size : Less than 75 Gallons
Hard Access Installation : No
Expansion Tank Installation : No
Piping Modification Estimate : No / No detail completed
Customer Understands Scope of the Heater Project: Yes
State Specific Permit : No
Permit Fee Yes
Describe other work needed : install expansion valve
Comments : customer needs install of intermittent water heater tear out of old 50
gallon and replacement of new.
Additional Specifications:
Notation: Lowe's will not make structural modifications or change power sources. Lowes's will not install a water Heater in any location where it would be un-
safe or a violation of building code, this also includes any location subject to flooding or installing a gas water heater in living spaces (bedroom, bathroom, etc.).
Federal and State regulations require water heaters to be set at 120 degrees Fahrenheit.
Additional Specifications: Federal law requires Lowe's to provide you with the pamphlet Renovate Right: Important Lead Hazard Information for Familes,
Child Care Providers and Schools. By signing this Contract, Customer acknowledges having received a copy of this pamphlet before work began informing
Customer of the potential risk of the lead hazard exposure from renovation activity to be performed in Customer's dwelling unit.
PHOTO RELEASE: Customer grants to Lowe's and Lowe's employees and independent contractors the right to take photograghs of the Premises where In-
stallation Services will be performed and all work performed at the Premises related to this Contract, and irrevocably grants to Lowe's all right, title, interest in
and to the photographs for use in all markets and media, worldwide, in perpetuity. Customer authorizes Lowe's to copyright, use and publish the photographs in
print and/or electronically, and agrees that Lowe's may use such photographs for any lawful purpose, including, but not limited to, marketing, advertising, publi-
city, illustration, training and Web content. By initialing here, Customer agrees to the foregoing. [Customer to initial to the left].
NOTICE TO CUSTOMER - PRICE CALCULATIONS: In order to properly perform the installation of certain Goods, the Contract Price may include more
Goods than actually will be installed based on the measured square footage of the Project Area. As a result, the parties agree that the lump -sum Price stated in
this Contract is calculated upon both the value of the estimated Goods required to fulfill the Contract (including waste), which may exceed the actual square
footage of the Project Area, and the labor which may be estimated based on the amount of Goods required to fulfill the contract (including waste). By signing
this Contract below, Customer acknowledges receipt of this notice and agrees and understands that the Price includes these costs which may not be refunded
once the Installation Services are performed..
NOTICE OF ARBITRATION AGREEMENT
This Contract provides that all claims by Customer or Lowe's will be resolved by BINDING ARBITRATION. Customer and Lowe's GIVE UP THE RIGHT TO GO
TO COURT to enforce this Contract (EXCEPT for matters that may be taken to SMALL CLAIMS COURT). Lowe's and Customer's rights will be determined by
a NEUTRAL ARBITRATOR and NOT a judge or jury. Lowe's and Customer are entitled to a FAIR HEARING. But the arbitration procedures are SIMPLER AND
MORE LIMITED THAN RULES APPLICABLE IN COURT. Arbitrator decisions are as enforceable as any court order and are subject to VERY LIMITED RE-
M. BY A COURT. FOR MORE DETAILS: Review the section titled ARBITRATION AGREEMENT, WAIVER OF JURY TRIAL AND WAIVER OF CLASS AC -
Store 1657 Project No. 530335231 for MORRELDA DEBOSE Page 2 of 4
INSTALLER COPY
TOTAL CHARGES OF ALL MERCHANDISE AND SERVICES
e applicable
SUB -TOTAL
*TAX
DELIVERY
ORDER TOTAL
BALANCE DUE
-Store 1657 Project No. 530335231 for MORRELDA DEBOSE Page 3 of 4
STORE COPY
s Home Centers, LLC
(Seal)
Print Name: :7zfeJA4,
Address
City State / Province Zip / Postal Code
(Seal)
Owner
Print Name
Co -Owner or Witness
Print Name
Customer acknowledges receipt of a true copy which was completely filled in prior to Customer's execution hereof. You the customer may cancel this transaction
at any time prior to midnight on the third business day after the date of this transaction. See the attached Notice of Right to Cancel for an explanation of
this right.
Store 1657 Project No. 530335231 for MORRELDA DEBOSE
Page 4 of 7